Recherche en Soins Infirmiers最新文献

Background : The integration of nurse practitioners into primary healthcare settings is highly complex, yet it has not been extensively studied with regard to broader socioprofessional changes occurring in health care.Objective : This study sought to examine the integration and negotiation of the role of nurse practitioners in interprofessional primary healthcare settings.Method : A critical ethnography framed by actor-network theory and Foucault's concepts of discourse and power was conducted in three different primary healthcare models in which semi-structured interviews (n=23 nurse practitioners), direct observation, and document analysis were performed.Results : Organizational aims, practice standards, nurse practitioners' right to self-determination, collaborative dynamics with physicians, and patient management were identified as integration factors that produced greater instability, needs for negotiation, and professional, identity, and moral difficulties for nurse practitioners.Discussion : The findings from this study challenge the widespread perception that the role of nurse practitioners lacks clarity and enable a renewed understanding of their integration process in primary healthcare settings.

Introduction : Sleeping with your infant (known as co-sleeping) is a proximal parenting practice. In some societies, 80 percent of children sleep with their parents. In France, a culture of sleeping separately has emerged, and the practice of co-sleeping has been associated with sudden infant death syndrome (SIDS). International recommendations tend to advise against co-sleeping and to devalue it as a practice.Material and methods : Two focus groups with co-sleepers (n=6) complemented by ten in-depth interviews were organized to identify the motivations and organization that mothers and their partners have when it comes to practicing co-sleeping with their children. A content analysis of what was said in the interviews by individuals and couples enabled us to find out more about the needs that co-sleeping responds to, as well as parents' co-sleeping practices.Results : Co-sleeping, made taboo by SIDS, responds to emotional and practical factors. The couple's life does not seem to be negatively impacted by it. The positive relationship it allows parents to have with their children is valued. Recommendations may often describe this way of sleeping as "unsafe," but co-sleepers support this parenting practice, along with breastfeeding.Conclusion : The results highlight the health education importance for co-sleepers. Being educated about co-sleeping will ensure that their practice is safe and will mean that they do not isolate themselves socially to hide it because they only have partial knowledge of the SIDS safety measures.

Context : The current COVID-19 context has placed nurses at the heart of the pandemic, due to the critical role they play within the population. However, media and professional discourses are influencing the identity and clinical practice of nurses.Objective : Review the literature on the construction of the popular identity of nurses and their roles during the COVID-19 pandemic.Method : Several data sources were consulted : Eureka, Google News, Education Resources Information Center (ERIC), Sociological Abstracts, Cumulative Index to Nursing Information and Allied Health Literature (CINAHL), MEDLINE, and Social Sciences Abstracts. Manual searches of government and professional sites were also conducted.Results : Of a total of 281 papers indexed, 73 were retained. The literature analysis identified the following themes : 1) identity images of nurses during this pandemic and their professional roles ; 2) the sometimes paradoxical nature of media and political discourse ; and 3) the fact that this discourse seems to influence clinical nursing practice, which is being assigned new roles.Conclusion : This article raises awareness among decision-makers about the multiple roles of nurses and the public image of nurses during a pandemic, and takes a critical look at popular discourses related to nurses' identity and how this identity changes during a pandemic.

Introduction: Elderly people who receive appropriate transitional care after hospitalization experience fewer complications.

Context: However, in Quebec, transitional care for the elderly is limited to case management and targets elderly people who are in need of resources. This often excludes those who remain in homes for the elderly.

Objectives: The objective of this study was to identify the unmet needs of elderly people during the posthospitalization transition to intermediate care facilities in Quebec, as well as the strategies they use on a daily basis to cope with these needs.

Methods: A descriptive qualitative study was conducted as part of an intervention research process. Eleven elderly participants and health professionals were recruited (n=11).

Results: The results presented suggest a need to support patients' capacity for self-care, unmet during the post-hospitalization transition to intermediate care facilities.

Discussion: Supporting the self-care abilities of elderly people can help ensure their safety when living in homes for the elderly.

Conclusion: Supporting the capacity for self-care is an important component of transitional care after hospitalization, including for elderly people with disabilities.

Introduction : One solution proposed by the authorities to address public health issues is to deploy a new category of professionals with a greater range of skills : advanced practice nurses (APNs). The literature identifies the complexity of the deployment projects of these professionals. The PEPPA model approved by the International Council of Nurses is the reference model for the introduction of APNs. The objectives of this study were to explore various stakeholders' perceptions on the introduction of APNs into health institutions, in order to propose recommendations to support the institutions.Method : A multicenter qualitative study was conducted in France's Provence-Alpes-Côte d'Azur region with physicians, managers, nurses, patients, and advanced practice students.Results : APNs are beneficial for patients and the health system, but their introduction into health institutions brings with it risks, primarily linked to their integration. APN introduction projects need to be well planned and should prioritize their integration.Discussion : Results consistent with the PEPPA model identified seven recommendations to facilitate the successful introduction of APNs into hospitals.Conclusion : This work needs to be continued with studies related to the out-of-hospital setting and the evaluation of the successfulness of APNs' introduction.

Introduction: It is well recognized that the nursing profession is stressful. This is due to the pressure of studies and internships during the three years of training, which could affect the health and academic results of nursing students. However, some students react positively to stress and are considered resilient, since they bounce back and rise to the challenges set in the face of this stress. Empirical studies have identified academic, clinical, personal, and social factors related to the resilience of nursing students.

Method: The objective of this descriptive correlational study was to explore some of the factors related to student resilience in the undergraduate nursing program at a university in Beirut. The data was collected using a standardized interview guide combining four North American instruments and the demographic academic profile of the students.

Results: More than half of the students are resilient, and, among all the factors, only the feeling of self-efficacy is a significant predictor of the nursing students' resilience.

Discussion: This study offers concrete guidelines for a nursing intervention promoting the retention of students in nursing training.

Introduction and background: In Quebec (Canada), the Multi-clientele Assessment Tool (Outil d'évaluation multi-clientèle, OEMC) profoundly transformed the practice of home care professionals (HCP), including nurses. Since 2015, all home care patients with a completed OEMC have been counted to assess the performance of services. If performance targets are not reached, funding renewal is threatened, exerting pressure on HCPs.

Objective: The objective of this article is to review the OEMC's implementation in order to understand its political nature and its impacts on the practice of HCPs and patients' lives.

Material and method: Drawing on the works of Michel Foucault and Gilles Deleuze, we propose a poststructuralist analysis of OEMC documents.

Results: Shifting from disciplinary societies to societies of control, the OEMC insidiously contributes to the regulation of home care services as well as patients' lives. The will of HCPs to apply their field of expertise is in opposition with the OEMC's purposes.

Discussion and conclusion: To not complete the OEMC when it is deemed unnecessary would require a negotiation by HCPs. However, HCPs' autonomy is compromised by discourses repressing all forms of resistance.

Introduction : Psychotic disorders usually begin during adolescence or early adulthood. The first psychotic symptoms are said to be attenuated in their prodromal phase. It is essential to identify them and initiate follow-up as early as possible to limit the severity of symptoms or even prevent a psychotic transition. However, there is still some uncertainty about the progression of symptoms. The aim of this exploratory study was to show the difficulties that surround the construction of a therapeutic alliance in this context.Methodology : The method adopted was a field survey.Results : Uncertainty about the development of disorders and their worsening and the fact that they are assessed by evaluating the patient's functional weaknesses led professionals to develop a relationship based on knowledge that is acquired empirically and that is in line with a phenomenological approach. Thus, professionals mobilized dynamic and interactive communication techniques to try to forge a therapeutic alliance.Conclusion : It has been shown that professionals seek to build a therapeutic alliance with young people presenting an uncertain evolution toward psychosis using a phenomenological, personalized, and pragmatic logic.

Context: In ICUs, many patients are intubated. UE is an indicator of the quality of care.Isolation associated with "air" precautions may increase the number of UEs in mechanically ventilated (MV) COVID patients.The main aim of the study was to compare the rate of UE between a COVID-19 period and a control period. The secondary aims were to identify UE risk factors and to study the experience of caregivers during the COVID-19 period.

Method: The method of choice was a retrospective single center case-control study. MV patients aged ≥ 18 years were eligible in two periods: the control period from 01/02/2020 to 29/02/2020, and the COVID-19 period from 01/03/2020 to 31/03/2020. An anonymous survey was given to ICU caregivers in Vannes Hospital.

Results: The UE rate was 17% (n=7) vs. 20% (n=9) control period vs. COVID-19 period (p=0.58), with nocturnal preponderance (75%). A quarter (n=4) of patients fulfill MV weaning criteria at the time of UE. A 71% (n=49) survey response rate was obtained. The COVID-19 period had a higher estimated UE risk for 76% (n=37) of caregivers, who felt that they had a greater workload, difficulties with monitoring, and decreased regular visits to patients' rooms.

Conclusion: Contrary to the caregiver experience, we reported a similar UE rate over both the COVID-19 period and the control period.