Recherche en Soins Infirmiers最新文献

The contemporary challenge in the field of health is undeniably that of devising a way to integrate humans and the environment that is beneficial to health. This article presents the universal cosmic imperative (UCI) philosophical perspective and the notion of the cosmic imperative that leads human beings to be creative in their relationship to nature. It begins by consolidating the exegesis of the internal evolution of Roy’s theory and identifying its influences. The epistemological and philosophical postulates upon which Roy’s theory was built are specified, and then the evolution of Roy’s thought is described in three main phases. The article then moves on to describe and explain the epistemological openings that Roy’s theory allows from the point of view of current health issues, especially environmental medicine, in a macro-meso-micro perspective of global health. Roy’s thinking is part of the question of the current turning point in the discipline of nursing (cure-care-healing) and the definition of its focus. Roy’s theory resists current theoretical developments, which it allows us to describe and question in a pattern that is fruitful for researchers.

Introduction : Hospitalized patients are at risk of unrecognized clinical deterioration that may lead to adverse events.Context : Rapid Response Teams (RRTs) exist around the world as a strategy to improve patient safety.Objective : To explore how RRTs work, their characteristics, impacts, and methods of implementation.Design : Literature review.Method : Consultation of the databases CINAHL, MEDLINE, PUBMED, COCHRANE library, SCOPUS, and PROQUEST Dissertations and Theses. Keywords : “health care team” and “rapid response team”.Results : 121 articles were included. The collected data were divided into five categories : 1) composition and operation of RRTs, 2) benefits and limitations of RRTs, 3) perceptions of RRTs by health care teams, organizations, and patients, 4) implementation strategies, and 5) facilitators and barriers to implementation.Discussion : Although there are many articles related to RRTs, it appears that : 1) few studies analyze the difference in outcomes in hospitalized patients related to the composition of RRTs, 2) few studies describe how RRTs should work, 3) more studies are needed on the impacts of RRTs on hospitalized patients, 4) organizations’ and patients’ perceptions of RRTs are not well studied, and 5) more studies are needed on the best way to implement an RRT.Conclusion : The results show that there is a lack of studies on the difference in outcomes in hospitalized patients related to the composition of RRTs, on how RRTs should work, on the impacts of RRTs on hospitalized patients, on organizations’ and patients’ perceptions of RRTs, and on the factors that influence the success or failure of the implementation of an RRT.

Introduction : Despite the number and importance of French-language guidelines related to palliative sedation for adults, these texts have never been the subject of a linguistic analysis.Objectives : This study aimed to explore and analyze the terms used for sedation and their definitions in Belgian, French, Quebec, and Swiss guidelines.Methods : Current documents were subjected to textual, terminological, and conceptual analysis.Results : Belgian, Quebec, and Swiss guidelines use the same term to refer to sedation, without, however, conceptualizing it in a consistent way. By contrast, guidelines developed in France use various terms but define sedation in a similar (but not identical) way. Cultural specificities linked to end-of-life legislation in those countries and region were identified as a potential causal factor.Discussion and conclusion : The diversity of terms and definitions inevitably reinforces the imprecision of the medical language, and the terminology in particular. This is likely to have a negative impact on communication between healthcare professionals, patients, and their families. Efforts should be made to homogenize the terminology and definitions used in guidelines.

Introduction : People living with type 2 diabetes are brought to make demanding behavioral changes that can lead to self-management difficulties.Background : The guidelines recommend that healthcare professionals follow a person-centered approach (PCA) when caring. However, this approach seems difficult to adopt in practice.Objective : Coconstruct an intervention inspired by the concept map (CM) to promote the adoption of PCA by nurses during self-management support encounters.Method : This study is based on a model for developing evidence-based nursing interventions. Five experts (2 patients, 2 nurses, 1 educational specialist) collaborated in the coconstruction of the intervention.Results : The Person-Centered Approach Diabetes Self-Management Support (PCA-DSMS) intervention has been developed in accordance with the foundations of a PCA and the CM. It includes four steps : 1) Introduce the intervention ; 2) Develop the Needs Map ; 3) Intervene according to priority needs ; 4) Conclude and plan a follow-up.Discussion : More studies are needed to explore whether the intervention is acceptable and feasible as well as its ability to lead nurses to adopt PCA.Conclusion : The PCA-DSMS could bring nurses to adopt a PCA.

Introduction : Wound care represents a public health issue and is an important concern for nursing care.Context : Despite the availability of best practice recommendations and clinical practice guidelines, there is a lack of use of this evidence in clinical practice.Objectives : The aim of this integrative review is to identify the barriers to nurses’ optimal knowledge transfer in wound care.Method : An integrative literature review based on Whittemore and Knalf’s (2005) methodology was conducted ; six databases were searched.Results : Of the 82 articles that were retrieved, 13 were retained for analysis. They were all published in English. The literature highlights a theory–practice gap in wound care. Barriers related to knowledge, attitudes, and environmental factors contribute to this gap.Discussion : Nursing could benefit from interventions to improve its role in wound care. The perspectives of new graduate nurses as well as nurses working in rural healthcare settings were limited.Conclusion : A strategic plan, adapted to the situation of each healthcare facility, could improve the quality of wound care practice.

Nurses have a leading role in weaning patients from mechanical ventilation (WMV) given their constant presence and their continuous monitoring. To promote proper WMV, nurses must exercise autonomy and be involved in decision-making. However, in certain care contexts, there is little involvement of nurses. The purpose of this text is to establish the characteristics of the concept of autonomous decision-making applied to nursing during WMV. An analysis of this concept was carried out according to the evolutionary method of Rodgers. The identification of the attributes, antecedents, and consequences made it possible to note ambiguity in the definition of this concept. Nurses use autonomous decision-making for the execution of assigned tasks and when they make decisions according to a pre-prescribed decision-making algorithm. Significant foundations for the decision-making autonomy of critical care nurses during WMV emerged from this analysis : scope of practice, in-depth knowledge of the patient, and commitment to the success of WMV. Participation in interdependent decision-making allows nurses to bring the patient’s perspective into decisions. Avenues of reflection have also emerged, including decisions based on evidence to provide new avenues for autonomous decision-making.

Introduction : The caritative impact of nursing care provided in forensic mental health settings is rarely questioned.Context : Caritative nursing care is indirectly regulated by the Review Board (RB), a para-judicial court which ensures public safety.Objective : This study presents a critical reflection on the political and social effects of the RB, forensic psychiatry hospitals and practices of forensic mental health nurses.Method : The reflection is centered on the concepts of biopower, degradation ceremonies, moral career and identity (re)construction.Results : ‘Therapeutic’ nursing practices are useful for disciplinary purposes in the forensic psychiatric hospital, insofar as they permit the identification and management of dangerous persons. However, the practices also fall within the biopolitical scope of the RB, since they assist the latter in ensuring public safety.Discussion : The forensic psychiatric environment can prove problematic for nurses, requiring a double allegiance, whereby their responsibilities to patients (consent and confidentiality) and to the institution (protection of the public) can lead to tension.Conclusion : The analytical framework of the study allows for a reassessment of other presumed processes in psychiatric environments, which nonetheless constitute just as many rituals of identity (re)construction.

Introduction : A discussion paper based on a teaching experience, and presenting a reflective viewpoint developed as part of the university nursing course Theory in Nursing.Context : A critical look at the historiography and reference works used in nursing courses.Objectives : To shed new light on the foundations of the nursing discipline by seeking to better integrate the participation of religious communities in the development of nursing knowledge.Method : Analysis of articles from Recherche en soins infirmiers and a reflective approach influenced by an interdisciplinary perspective linking nursing science, history, and the contribution of Pierre Bourdieu’s work.Results : Observation of the complete absence of contributions to nursing knowledge before Florence Nightingale (1820-1910) and of a century-long silence after her.Discussion : Analysis of the observed reflex to disavow the legacy of nursing sisters in Quebec through the analysis of three aspects : the Nightingalian episteme, the historiographical positioning of nurses and historians, and the construction of knowledge based on the experience of the Sisters of Providence at the Hôpital Saint-Jean-de-Dieu.Conclusion : By ignoring the Franco-Catholic origin of the scientific field of nursing, this disciplinary knowledge deprives itself of a powerful nursing model.