Au-delà des soins : un travail de conciliation

Cet article remet en question une vision de la prise en charge familiale des proches adultes dépendants qui réduit ce travail aux soins directs à la personne. Il montre qu'au-delà des soins s'impose un important travail de conciliation qui vise à maintenir un équilibre entre les multiples besoins et les exigences de chacune des sphères de la vie : sphères de vie personnelle, sociale et familiale; sphères liées au travail salarié et à la prise en charge. Les données qui sous-tendent cette réflexion viennent de plusieurs recherches sur le sujet menées par les auteurs depuis 1987, dont l'une porte sur la conciliation du travail salarié et des soins aux proches. Des implications pour la pratique en maintien à domicile sont dégagées en conclusion.This article question a conception of family caregiving which limits the work involved to personal care and help with ADL's. Evidence is presented which shows that beyond this direct care, caregivers are forced to accomplish substantial juggling work to maintain a balance between the multiple needs and demands of all areas of their lives : personal life, social and family life, employment, as well as caregiving. The data that support this article have been gathered over several studies, which the authors have carried out since 1987, including one on balancing work and family caregiving. Implications of these findings for homecare practice are raised in the conclusion

Le maintien en milieu naturel : une question de santé mentale

Dans le cadre du débat sur la désinstitutionnalisation, aussi bien des psychiatrisé(e)s que des personnes âgées, nous assistons depuis le début des années 80 à une inflation du discours sur la valorisation des milieux de vie naturels. Ce type de discours a pour effet d'occulter la réalité des personnes âgées en perte d'autonomie maintenues en milieu naturel et des familles qui assument la prise en charge d'un parent âgé dépendant. Cet article examine les conditions et les facteurs susceptibles d'affecter la santé mentale des acteurs concernés.Ever since the beginning of the 80s, we are witness to a debate on deinstitutionalization, of the elderly as well as of psychiatric clients, that has overemphasized the benefits of placing people in their natural surroundings. This debate has in effect omitted to talk of the living conditions of functionally impaired elders maintained in their natural surroundings, of families who take care of a dependant parent. This article examines the conditions and factors liable to affect the mental health of all concerned

Methodological reporting in feasibility studies : a descriptive review of the nursing intervention research literature

Background In reaction to weaknesses in feasibility studies reporting, the Consolidated Standards of Reporting Trials (CONSORT) statement published an extension for feasibility studies in 2016. Aim The aim of this study was to systematically review and appraise the reporting of feasibility studies in the nursing intervention research literature based on the CONSORT statement extension for feasibility studies. Method Papers published prior to January 2018 that described feasibility studies of nursing interventions were retrieved. Components of feasibility studies were coded, and code frequencies were analysed. Results The review included 186 papers. Although most papers (n = 142, 76.3%) included the label ‘pilot’ or ‘feasibility’ in their title, reporting for other components generally did not adhere to one or several CONSORT recommendations. Most papers reported objectives (n = 116, 62.4%), designs (n = 95, 51%), or rationales for sample size (n = 165, 88.7%) that were incongruent with the purpose of feasibility studies. Discussion This review results in two main implications for nursing research. First, we noted that the reporting of feasibility studies is weak. While all papers described feasibility studies, almost half focused exclusively on testing the effectiveness of an intervention. Second, we identified rationales for sample size along with key references that could offer guidance in reporting feasibility studies while being coherent with the CONSORT recommendations

Efficacy of adaptive e-learning for health professionals and students : a systematic review and meta-analysis

Objective Although adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding the efficacy of AEEs in improving knowledge, skills and clinical behaviour in health professionals and students. Design Systematic review and meta-analysis. Data sources CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science from the first year of records to February 2019. Eligibility criteria Controlled studies that evaluated the effect of an AEE on knowledge, skills or clinical behaviour in health professionals or students. Screening, data extraction and synthesis Two authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. AEEs were reviewed with regard to their topic, theoretical framework and adaptivity process. Studies were included in the meta-analysis if they had a non-adaptive e-learning environment control group and had no missing data. Effect sizes (ES) were pooled using a random effects model. Results From a pool of 10 569 articles, we included 21 eligible studies enrolling 3684 health professionals and students. Clinical topics were mostly related to diagnostic testing, theoretical frameworks were varied and the adaptivity process was characterised by five subdomains: method, goals, timing, factors and types. The pooled ES was 0.70 for knowledge (95% CI −0.08 to 1.49; p.08) and 1.19 for skills (95% CI 0.59 to 1.79; p<0.00001). Risk of bias was generally high. Heterogeneity was large in all analyses. Conclusions AEEs appear particularly effective in improving skills in health professionals and students. The adaptivity process within AEEs may be more beneficial for learning skills rather than factual knowledge, which generates less cognitive load. Future research should report more clearly on the design and adaptivity process of AEEs, and target higher-level outcomes, such as clinical behaviour

Effects of implementation strategies on nursing practice and patient outcomes : a comprehensive systematic review and meta-analysis

Acknowledgements The authors wish to acknowledge the contribution of Jérémie Blondin for the development of search strategies and the search in bibliographical databases. We thank Ariane Ballard for contributing to study selection. We thank the individuals who responded to requests for additional data, including Jens Abraham, Patrick Akande, Marvin J. Bittner, Ian Blanco Mavillard, Nicolle P. G. Boumans, Marian C. Brady, Diane L. Carroll, Andrea Chaplin, Lorena Charrier, Francine M. Cheater, Lynn Chenoweth, Yeu-Hui Chuang, Lorenzo Cohen, Kelly Jo Cone, Susan Cortez, J. Randall Curtis, Barbara Davies, Tina Day, Marlies de Rond, Dennis de Ruijter, Helen Edwards, Mohamed Elzeky, Ruth Engelberg, David Evans, Valeria Fabre, Tobias Filmer, Christopher R. Friese, Marjorie Funk, Matthew Bidwell Goetz, Salla Grommi, Mary Beth Happ, Michael Hendryx, Manuela Hödl, Anita Huis, Alison Hutchinson, Yueh-Juan Hwu, Ali Khani Jeihooni, Céleste Johnston, Eileen F. S. Kaner, Zahra Karimian, Kristina H. Karvinen, Sedigheh Khanjari, Mahnaz Khatiban, Serena Koh, Sascha Köpke, Ruth Kleinpell, Una Kyriacos, Jan van Lieshout, Li-Chan Lin, Elizabeth Manias, Edward R. Marcantonio, Gabriele Meyer, Sandy Middleton, Tatsuya Morita, Janneke Noordman, Mary Patricia Nowalk, Jane Ogden, Christine Paul, James A. Rankin, Marilyn Rantz, Susan M. Ray, Staci S. Reynolds, Young Sook Roh, Jeffrey M. Rothschild, Reza Sadeghi, Trygve Johannes Lereim Sævareid, Parvin Mangolian Shahrbabaki, Davide Sisti, Wilma ten Ham-Baoyi, Sousan Valizadeh, Maritta Välimäki, Ayse Kacaroglu Vicdan, Thomas von Lengerke, Laura Wagner, Timothy Walsh, Marcia Weaver, Chistopher Weir, and Carla Zotti.Peer reviewe

Évaluation par des méthodes mixtes de l'impact sociétal de Breathing Games, une communauté interdisciplinaire co-créant des technologies libres en santé

Poster presented to the colloquium "Les innovations en méthodes mixtes en sciences sociales et de la santé" of the ACFAS congress at McGill University in Montreal. Award of the best poster

Radiographic assessment of the femorotibial joint of the CCLT rabbit experimental model of osteoarthritis

<p>Abstract</p> <p>Background</p> <p>The purposes of the study were to determine the relevance and validity of in vivo non-invasive radiographic assessment of the CCLT (Cranial Cruciate Ligament Transection) rabbit model of osteoarthritis (OA) and to estimate the pertinence, reliability and reproducibility of a radiographic OA (ROA) grading scale and associated radiographic atlas.</p> <p>Methods</p> <p>In vivo non-invasive extended non weight-bearing radiography of the rabbit femorotibial joint was standardized. Two hundred and fifty radiographs from control and CCLT rabbits up to five months after surgery were reviewed by three readers. They subsequently constructed an original semi-quantitative grading scale as well as an illustrative atlas of individual ROA feature for the medial compartment. To measure agreements, five readers independently scored the same radiographic sample using this atlas and three of them performed a second reading. To evaluate the pertinence of the ROA grading scale, ROA results were compared with gross examination in forty operated and ten control rabbits.</p> <p>Results</p> <p>Radiographic osteophytes of medial femoral condyles and medial tibial condyles were scored on a four point scale and dichotomously for osteophytes of medial fabella. Medial joint space width was scored as normal, reduced or absent. Each ROA features was well correlated with gross examination (p < 0.001). ICCs of each ROA features demonstrated excellent agreement between readers and within reading. Global ROA score gave the highest ICCs value for between (ICC 0.93; CI 0.90-0.96) and within (ICC ranged from 0.94 to 0.96) observer agreements. Among all individual ROA features, medial joint space width scoring gave the highest overall reliability and reproducibility and was correlated with both meniscal and cartilage macroscopic lesions (r_s= 0.68 and r_s= 0.58, p < 0.001 respectively). Radiographic osteophytes of the medial femoral condyle gave the lowest agreements while being well correlated with the macroscopic osteophytes (r_s= 0.64, p < 0.001).</p> <p>Conclusion</p> <p>Non-invasive in vivo radiography of the rabbit femorotibial joint is feasible, relevant and allows a reproducible grading of experimentally induced OA lesion. The radiographic grading scale and atlas presented could be used as a template for in vivo non invasive grading of ROA in preclinical studies and could allow future comparisons between studies.</p