Soins de santé résilients et réchauffement climatique en Suisse : une mesure à considérer avec sérieux

Introduction : Il est crucial que les institutions sanitaires développent des plans de contingence pour affronter les conséquences du réchauffement climatique (RC) menaçant sévèrement la santé publique ; or, peu d’actions sont engagées par les directions des systèmes de soins suisses. Nous nous intéressons aux soins de santé résilients, car ils permettent d’aborder la façon dont les institutions anticipent les crises, s’y adaptent et s’y transforment, en conséquence.  Méthode : Cette recherche qualitative comporte deux volets où seul le premier est présenté : 1) les impacts du RC sur la santé de la population/le fonctionnement des institutions sanitaires suisses selon des spécialistes internationaux du climat, 2) les perceptions des directions des systèmes de soins suisses face au RC, ainsi que les mesures d’adaptation/d’atténuation engagées pour y répondre. Les données ont été collectées via une méthode Delphi comportant trois étapes : entretiens individuels, hiérarchisation des impacts/des mesures, consensus final. Les entrevues ont été enregistrées/retranscrites pour réaliser une analyse thématique. Résultats : Sept thèmes ont émergé : 1) effets du RC sur la santé humaine, 2) évolution des besoins/attentes en matière de soins, 3) impacts de ces besoins sur les institutions de soins, 4) effets physiques du RC sur les institutions, 5) facteurs contextuels, 6) mesures d’adaptation, 7) mesures d’atténuation. Discussion et conclusion : La prochaine étape vise un consensus entre les experts pour valider cette typologie qui servira à réaliser des entretiens avec les responsables d’institutions sanitaires suisses pour évaluer leurs perceptions des risques et leur état de préparation face aux conséquences du RC.Introduction : Il est crucial que les institutions sanitaires développent des plans de contingence pour affronter les conséquences du réchauffement climatique (RC) menaçant sévèrement la santé publique ; or, peu d’actions sont engagées par les directions des systèmes de soins suisses. Nous nous intéressons aux soins de santé résilients, car ils permettent d’aborder la façon dont les institutions anticipent les crises, s’y adaptent et s’y transforment, en conséquence.  Méthode : Cette recherche qualitative comporte deux volets où seul le premier est présenté : 1) les impacts du RC sur la santé de la population/le fonctionnement des institutions sanitaires suisses selon des spécialistes internationaux du climat, 2) les perceptions des directions des systèmes de soins suisses face au RC, ainsi que les mesures d’adaptation/d’atténuation engagées pour y répondre. Les données ont été collectées via une méthode Delphi comportant trois étapes : entretiens individuels, hiérarchisation des impacts/des mesures, consensus final. Les entrevues ont été enregistrées/retranscrites pour réaliser une analyse thématique. Résultats : Sept thèmes ont émergé : 1) effets du RC sur la santé humaine, 2) évolution des besoins/attentes en matière de soins, 3) impacts de ces besoins sur les institutions de soins, 4) effets physiques du RC sur les institutions, 5) facteurs contextuels, 6) mesures d’adaptation, 7) mesures d’atténuation. Discussion et conclusion : La prochaine étape vise un consensus entre les experts pour valider cette typologie qui servira à réaliser des entretiens avec les responsables d’institutions sanitaires suisses pour évaluer leurs perceptions des risques et leur état de préparation face aux conséquences du RC

Mapping hippocampal function with immediate-early genes

The hippocampal formation plays a central role in the brain network essential for memory function, but the contribution of distinct hippocampal regions in specific memory processes is the subject of current debates. The expression of immediate-early genes (IEGs) can be used to map regional brain activity. However, only one IEG is generally used to map regional brain activation, considering that even though different IEGs contribute to different cellular processes they can be used interchangeably to study regional brain activity. First, we evaluated the expression of the three IEGs Arc, zif268 and c-fos in the rat hippocampal formation following the exploration of a novel environment, as compared to control rats that were simply taken out and placed back into their cages. Second, we evaluated the postnatal functional maturation of distinct hippocampal regions using c-fos expression..

Interventions infirmières dans la gestion de la douleur chez les patients atteints de drépanocytose

La drépanocytose est une maladie génétique dont les douleurs aiguës sont la principale caractéristique. Cependant, la majorité des patients voient leur douleur sous-évaluée et sous-traitée par les soignants. L’objectif de ce travail est de recenser les pratiques basées sur les preuves afin d’améliorer le contrôle de la douleur pour ces patients. Notre démarche a été guidée par les concepts de sentiment d’impuissance, souffrance totale et qualité de vie, ainsi que par la théorie de gestion des symptômes. Dans cette revue de littérature, nous avons cherché des articles par motsclés dans les bases de données. Onze articles ont été sélectionnés selon des critères préétablis afin de répondre à la question de recherche suivante: “Quelles sont les actions infirmières dans la gestion de la douleur chez les patients atteints de drépanocytose?”. Les résultats montrent que, si la stratégie la plus utilisée est l’administration de traitements antalgiques, les massages, la relaxation et les exercices de respiration semblent efficaces en complément aux traitements médicamenteux. De nombreuses stratégies sont couramment utilisées par les patients bien qu’elles n’aient pas été validées scientifiquement. Des recherches sont donc nécessaires afin d’évaluer le bien-fondé de ces pratiques

“Do Not Protect Us, Train Us.”—Swiss Healthcare Students’ Attitudes Toward Caring for Terminally Ill Patients

Positive attitudes and a sense of competence toward end-of-life care are the key to adequately support terminally ill patients. This qualitative study aims to explore healthcare students’ attitudes toward caring for terminally ill patients. Eleven students from the University of Applied Health Sciences in Switzerland participated in focus groups. Attitudes were overall positive. Most participants felt that supporting dying patients was a way to achieve professional fulfillment. However, most students felt not competent in palliative care and lacking experience. They wanted to receive better training, more specifically in good practices and appropriate behaviors. Our study fills a knowledge gap regarding the opinions and pedagogical needs of healthcare students, and highlights the importance of experiencing end-of-life care during the educational process. We recommend early exposure to terminally ill patients and appropriate attitudes toward death and dying as part of the bachelor’s curriculum, accompanied by benevolent guidance from teachers and health professionals

Factors associated with health professionals’ stress reactions, job satisfaction, intention to leave and health-related outcomes in acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organisations

Abstract The aim of this study is to identify (1) the extent of work-related stress and (2) stressors associated with cognitive and behavioral stress reactions, burnout symptoms, health status, quality of sleep, job satisfaction, and intention to leave the organization and the profession among health professionals working in acute care /rehabilitation hospitals, psychiatric hospitals, nursing homes, and home care organizations. Background Health professionals are faced with various stressors at work and as a consequence are leaving their profession prematurely. This study aimed to identify the extent of work-related stress and stressors associated with stress reactions, job satisfaction, and intention to leave and health-related outcomes among health professionals working in different healthcare sectors (acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organizations). Methods This study is based on a repeated cross-sectional design, which includes three data measures between 2017 and 2020 and 19,340 participating health professionals from 26 acute care / rehabilitation hospitals, 12 psychiatric hospitals, 86 nursing homes and 41 home care organizations in Switzerland. For data analysis, hierarchical multilevel models (using AIC) were calculated separately for hospitals, nursing homes, and home care organizations, regarding health professionals’ stress symptoms, job satisfaction, intention to leave the organization / profession, general health status, burnout symptoms, and quality of sleep. Results The main findings reveal that the incompatibility of health professionals’ work and private life was significantly associated (p < 0.05) with their stress reactions, job satisfaction, intention to leave, and health-related outcomes in all the included work areas. The direct supervisor’s good leadership qualities were also associated with health professionals’ job satisfaction regarding all work areas (B ≥ 0.22, p = 0.000). In addition, a positive perceived bond with the organization (B ≥ 0.13, p < 0.01) and better development opportunities (B ≥ 0.05, p < 0.05) were associated with higher job satisfaction and a lower intention to leave the organization and profession among health professionals. Also, a younger age of health professionals was associated with a higher intention to leave the organization and the profession prematurely in all the included work areas. High physical (B ≥ 0.04, p < 0.05) and quantitative demands (B ≥ 0.05, p = 0.000) at work were also associated with negative health-related outcomes

Adapting to the unexpected ::problematic work situations and resilience strategies in healthcare institutions during the COVID-19 pandemic’s first wave

The COVID-19 pandemic’s first wave required considerable adaptation efforts on the part of healthcare workers. The literature on resilient healthcare describes how the collective regulation strategies implemented by frontline employees make essential contributions to institutions’ abilities to cope with major crises. The present mixed-methodology study was thus conducted among a large sample of employees in a variety of Swiss healthcare institutions and focused on problematic real-world situations experienced by them and their managers during the pandemic’s first wave. It highlighted the anticipatory and adaptive strategies implemented by institutions, teams and individuals. The most frequently cited problematic situations involved organisational changes, interpersonal conflicts and workloads. In addition to the numerous top-down measures implemented by institutions, respondents also identified personal or team regulation strategies such as increasing staff flexibility, prioritising tasks, interprofessional collaboration, peer support or creating new communication channels to families. The present findings underlined the importance of taking greater account of healthcare support staff and strengthening managerial capacity to support interprofessional teams including those support staff

How can we help healthcare workers during a catastrophic event such as the COVID-19 pandemic?

Healthcare workers (HCWs) have significantly suffered during the COVID-19 pandemic, reporting a high prevalence of anxiety, depression and post-traumatic stress disorder (PTSD). We investigated with this survey whether HCWs benefitted from supportive measures put in place by hospitals and how these measures were perceived. This cross-sectional survey, which was conducted during the first wave of COVID-19 at the Geneva University Hospitals, Switzerland, between May and July 2021, collected information on the use and perception of practical and mental health support measures provided by the hospital. In total, 3461 HCWs participated in the study. Regarding the practical support measures, 2896 (84%) participants found them useful, and 2650 (76%) used them. Regarding the mental health support measures, 3149 (90%) participants found useful to have the possibility of attending hypnosis sessions, 3163 (91%) to have a psychologist within hospital units, 3202 (93%) to have a medical nursing psychiatric permanence available seven days a week, and 3171 (92%) to have a hotline available seven days a week. In total, 436 (13%) HCWs used at least one of the available mental health support measures. During the COVID-19 pandemic, the support measures were valued by HCWs. Given the high prevalence of psychiatric issues among HCWs, these measures seem necessary and are likely to have alleviated the suffering of HCWs

How things changed during the COVID-19 pandemic’s first year ::a longitudinal, mixed-methods study of organisational resilience processes among healthcare workers

COVID-19 had a huge impact on healthcare systems globally. Institutions, care teams and individuals made considerable efforts to adapt their practices. The present longitudinal, mixed-methods study examined a large sample of healthcare institution employees in Switzerland. Organisational resilience processes were assessed by identifying problematic real-world situations and evaluating how they were managed during three phases of the pandemic’s first year. Results highlighted differences between resilience processes across the different types of problematic situations encountered by healthcare workers. Four configurations of organisational resilience were identified depending on teams’ performance and ability to adapt over time: “learning from mistakes”, “effective development”, “new standards” and “hindered resilience”. Resilience trajectories differed depending on professional categories, hierarchical status and the problematic situation’s perceived severity. Factors promoting or impairing organisational resilience are discussed. Findings highlighted the importance of individuals’, teams’ and institutions’ meso- and micro-level adaptations and macro-level actors’ structural actions