Apports d'un programme psycho-éducatif pour les proches aidants de personnes vivant à domicile avec une démence

Les proches aidants ont un rôle clé dans la prise en charge et le maintien à domicile des personnes atteintes de démence. Cependant, ce rôle peut être une source de stress et d’épuisement pour eux. AEMMA est un programme psycho-éducatif conçu pour offrir les outils nécessaires aux proches aidants pour mieux gérer leur stress au quotidien

Situations difficiles quotidiennes des proches aidants de personnes atteintes de démence vivant à domicile: une étude qualitative

Les proches aidants jouent un rôle important dans la prise en charge à domicile des personnes atteintes de démence dont 50% vivent à domicile avec le soutien d’un proche aidant. Avec le temps, ce rôle peut devenir pénible pour le proche aidant qui risque de s’épuiser

Assessing Specific Discipline Techniques: A Mixed-Methods Approach

This study explored, in a community sample of mothers of toddlers, parenting beliefs and values, to gain insight into the parent–child relationship. Acceptance of specific discipline techniques (DTs), and their actual use in daily life were examined. A mixed-methods approach comprising three different methods was used: (1) parenting beliefs and values were explored with Q-methodology; (2) acceptance of the DTs was assessed with the questionnaire Dimensions of Discipline Inventory; and (3) actual use of those DTs in daily-life incidents of discipline was documented using ecological momentary assessment for ten consecutive days. The results showed the mothers’ parenting beliefs and values reflected a warm parent–child relationship. The mothers rated explaining rules, timeout, removal of privileges, and social reinforcement as moderately to highly acceptable. However, planned ignoring received a low acceptance rating. Mothers’ high acceptability ratings of the DTs contrasted with moderate use when they were faced with their misbehaving child, with the exception of explaining rules, which was always manifested. Yelling and spanking received the lowest acceptance ratings. Nonetheless, in daily life, yelling was employed as often as timeout. These findings suggest the need for more attention to be paid to both acceptance and daily use of specific DTs in order to highlight DTs which parents may have difficulty implementing

Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up

Urben S, Pihet S, Jaugey L, Halfon O, Holzer L. Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up. Objective: To investigate short-term outcomes of a computer-assisted cognitive remediation (CACR) for adolescents with psychotic disorders or at high risk for psychosis. Method: Cognitive abilities and clinical status were assessed at baseline (N = 32) and at 6-month follow-up (N = 22) after enrolment in either a CACR (treatment group) or a computer games (control group) program (8 weeks). Results: With regard to the cognitive abilities, no amelioration was found in the control group while, in the CACR group, significant improvements in inhibition (p = 0.040) and reasoning (p = 0.005) were observed. Furthermore, symptom severity decreased significantly in the control group (p = 0.046) and marginally in the CACR group (p = 0.088). Improvements in cognitive abilities were not associated with symptoms' amelioration. Finally, increase in reasoning abilities was related to the median effective work time in sessions of CACR (R = 0.64, p = 0.024). Conclusion: At follow-up, enhanced cognitive abilities (reasoning and inhibition), which are necessary for executing higher-order goals or adapting behaviour to the ever-changing environment, were reported in adolescents participants of the CACR. Thus, further studies are needed to confirm and extend these interesting result

Assessing Specific Discipline Techniques: A Mixed-Methods Approach

This study explored, in a community sample of mothers of toddlers, parenting beliefs and values, to gain insight into the parent-child relationship. Acceptance of specific discipline techniques (DTs), and their actual use in daily life were examined. A mixed-methods approach comprising three different methods was used: (1) parenting beliefs and values were explored with Q-methodology; (2) acceptance of the DTs was assessed with the questionnaire Dimensions of Discipline Inventory; and (3) actual use of those DTs in daily-life incidents of discipline was documented using ecological momentary assessment for ten consecutive days. The results showed the mothers' parenting beliefs and values reflected a warm parent-child relationship. The mothers rated explaining rules, timeout, removal of privileges, and social reinforcement as moderately to highly acceptable. However, planned ignoring received a low acceptance rating. Mothers' high acceptability ratings of the DTs contrasted with moderate use when they were faced with their misbehaving child, with the exception of explaining rules, which was always manifested. Yelling and spanking received the lowest acceptance ratings. Nonetheless, in daily life, yelling was employed as often as timeout. These findings suggest the need for more attention to be paid to both acceptance and daily use of specific DTs in order to highlight DTs which parents may have difficulty implementing

Implicit and explicit self-esteem as predictors of reactive and proactive aggression in adolescent boys and girls

This study aims at examining gender differences and their association with implicit and explicit self-esteem (SE), and reactive and proactive aggression in adolescents. Hundred and eighteen adolescents (60 boys and 58 girls) performed the Implicit Association Test assessing implicit SE. The Rosenberg Self-Esteem scale was used to measure explicit SE. Reactive and proactive aggression were assessed with the self-report Reactive and Proactive Aggression Scale. Results showed that girls characterized by both low explicit and implicit SE (insecure SE), or by high explicit but low implicit SE (defensive SE), showed more reactive aggression than girls reporting high explicit and implicit SE (secure SE) or low explicit but high implicit SE (anxious SE). In contrast, none of these SE types were associated to reactive aggression in boys. Finally, no significant association was found between the different types of SE and proactive aggression, for both genders

A Randomized Controlled Trial of the Effectiveness of Computer-Assisted Cognitive Remediation (CACR) in Adolescents with Psychosis or at High Risk of Psychosis

Background: Computer assisted cognitive remediation (CACR) was demonstrated to be efficient in improving cognitive deficits in adults with psychosis. However, scarce studies explored the outcome of CACR in adolescents with psychosis or at high risk. Aims: To investigate the effectiveness of a computer-assisted cognitive remediation (CACR) program in adolescents with psychosis or at high risk. Method: Intention to treat analyses included 32 adolescents who participated in a blinded 8-week randomized controlled trial of CACR treatment compared to computer games (CG). Cognitive abilities, symptoms and psychosocial functioning were assessed at baseline and posttreatment. Results: Improvement in visuospatial abilities was significantly greater in the CACR group than in CG. Other cognitive functions, psychotic symptoms and psychosocial functioning improved significantly, but at similar rates, in the two groups. Conclusion: CACR can be successfully administered in this population; it proved to be effective over and above CG for the most intensively trained cognitive abilit

Pflegende Angehörige für Unterstützungsprogramme finden

Pflegende Angehörige müssen über bestimmte kognitive, persönliche und zeitliche Ressourcen verfügen, um an Unterstützungsprogrammen teilnehmen zu können. Angepasste Rahmenbedingungen, vertrauensvolle Beziehungen, umfassende Informationen und eine adressatengerechte Sprache erleichtern die Teilnahme an solchen Programmen.Les proches aidants doivent disposer de certaines ressources cognitives, personnelles et temporelles pour pou-voir participer aux programmes de soutien. Des cadres adaptés, des relations empreintes de confiance, des informations exhaustives et un langage adapté aux destinataires facilitent la participation à de tels programmes

Reliability, validity and relevance of needs assessment instruments for informal dementia caregivers ::a psychometric systematic review

Objective: The objective of this review was to identify reliable and/or valid needs assessment instruments for informal dementia caregivers that are relevant for clinical practice, research and informal caregivers. Introduction: Informal dementia caregivers report important unmet needs at all stages of the disease. In addition, they often indicate that health care providers insufficiently attend and adapt to their multiple needs. A systematic and patient-centered assessment is needed to address this lack of knowledge and understanding. However, existing quantitative needs assessment questionnaires are limited in terms of psychometric testing. Qualitative measures are time-intensive and difficult to conduct on a large scale, with growing economic pressure. Information about the methodological quality and the characteristics of needs assessment instruments are crucial for clinicians and researchers to make informed decisions about the most reliable and valid tool for their specific purpose. Inclusion criteria: This review considered studies on multidimensional needs assessment instruments for informal dementia caregivers living at home. Psychometric studies or other types of studies with sufficient data to evaluate methodological quality were included if they considered at least one outcome for reliability or validity. Methods: Studies in English, French or German and published until February 2019 were searched in four databases: Embase, MEDLINE, CINAHL and PsycINFO. After screening the titles, abstracts or full texts for eligibility, the provisional included studies were assessed for methodological quality with a standardized tool for systematic reviews of measurement properties. After data extraction using a standardized tool, the quality of the measurement properties was rated and compared using predefined quality criteria. Results: Eighteen articles covering 14 different needs assessment instruments were included in the review. Eleven publications focused on the development or the evaluation of an instrument. In addition, a development report, a manual and five studies, not aimed primarily at validation but containing sufficient information about the development or the evaluation of the used instruments, were included. The systematic evaluation of the instruments revealed that half of them had excellent content validity. In contrast, structural validity was rarely examined, and mostly with an insufficient sample size or a questionable analysis. None of the instruments had optimally tested and good internal consistency. Regarding reliability, test-retest agreement was rarely tested and inter-rater agreement was evaluated using controversial procedures. Comparing the different instruments reviewed, the “Partnering for better health – living with chronic illness: dementia” had the best psychometric evidence, and the “Questionnaire of consultation expectations” was also partly supported, while most other instruments presently had limited psychometric soundness. Conclusions: Despite the good evidence for some psychometric properties, further developments in the field of needs assessment for informal dementia caregivers are needed, particularly regarding structural and construct validity, as well as test-retest reliability and sensitivity to change. To enhance conceptual clarity, the development of an underlying theoretical model of needs should be prioritized