La méditation de pleine conscience dans l’intervention en soins spirituels avec les patients en psychiatrie

Au cours des dernières années, dans la foulée du programme de méditation pleine conscience élaboré par Jon Kabat Zinn, les services de soins spirituels intègrent de plus en plus la médiation au sein de leurs interventions. Cet article présente les résultats d’une recherche visant à évaluer les effets d’un programme de méditation « Soin spirituel pour un mieux-être » sur diverses dimensions psychiques et spirituelles. Les données ont été recueillies auprès de 21 patients suivis en externe en psychiatrie à l’Hôpital de l’Enfant-Jésus selon 3 temps de mesure : avant le programme, immédiatement à la fin du programme et 3 mois après. Les résultats suggèrent une amélioration chez les patients immédiatement à la fin du programme mais qui tend à s’atténuer 3 mois plus tard. Cette recherche pose, entre autres, des questions concernant les mesures d’évaluation de la dimension spirituelle.In recent years, in the wake of Jon Kabat Zinn's mindfulness meditation program, spiritual care services are increasingly incorporating meditation into their intervention. This article presents the results of a research to evaluate the effects of a "Spiritual Care for a Well-being" meditation program on various psychic and spiritual dimensions. Data were collected from 21 outpatients in psychiatric care at the Enfant-Jésus Hospital measured at 3 time-intervals : before the program, immediately at the end of the program and 3 months thereafter. The results suggest an improvement in patients immediately at the end of the program, which however tends to subside 3 months later. This research raises, among other things, questions concerning measurement of the spiritual dimension

Cerebrovascular complications in patients with community-acquired bacterial meningitis: occurrence and associated factors in the COMBAT multicenter prospective cohort

Abstract Background Community-acquired bacterial meningitis is a rare but severe central nervous system infection that may be associated with cerebrovascular complications (CVC). Our objective is to assess the prevalence of CVC in patients with community-acquired bacterial meningitis and to determine the first-48 h factors associated with CVC. Methods We analyzed data from the prospective multicenter cohort study (COMBAT) including, between February 2013 and July 2015, adults with community-acquired bacterial meningitis. CVC were defined by the presence of clinical or radiological signs (on cerebral CT or MRI) of focal clinical symptom. Factors associated with CVC were identified by multivariate logistic regression. Results CVC occurred in 128 (25.3%) of the 506 patients in the COMBAT cohort (78 (29.4%) of the 265 pneumococcal meningitis, 17 (15.3%) of the 111 meningococcal meningitis, and 29 (24.8%) of the 117 meningitis caused by other bacteria). The proportion of patients receiving adjunctive dexamethasone was not statistically different between patients with and without CVC (p = 0.84). In the multivariate analysis, advanced age (OR = 1.01 [1.00-1.03], p = 0.03), altered mental status at admission (OR = 2.23 [1.21–4.10], p = 0.01) and seizure during the first 48 h from admission (OR = 1.90 [1.01–3.52], p = 0.04) were independently associated with CVC. Conclusions CVC were frequent during community-acquired bacterial meningitis and associated with advanced age, altered mental status and seizures occurring within 48 h from admission but not with adjunctive corticosteroids