Sante Mentale au Quebec最新文献

Background The experience of breast cancer diagnosis leads to being confronted with the unknown and uncertainty. In some cases, patients develop symptoms of psychological distress after the diagnosis, which can have a negative influence during and after treatment. In Quebec, there are several breast cancer clinics that appear to offer psychological assessment to patients and psychosocial services during the different phases of the disease. To our knowledge, few Quebec studies have looked at the effectiveness of and access to psychosocial services in times of non-crisis. The COVID-19 pandemic also led to changes in breast clinics (e.g., closure of screening clinics, reception of diagnosis remotely, changes in treatment plans). However, no Canadian study has qualitatively examined patients' experiences of the impact of the pandemic on access and effectiveness of these services. Objectives The first objective of this qualitative study is to describe the perspectives of Quebec women who received a breast cancer diagnosis and/or treatment during the pandemic on the access to and effectiveness of psychosocial services. In addition, the second objective is to identify patient recommendations for improving the well-being of patients receiving psychosocial oncology services. Method As part of this larger project, we conducted semi-structured interviews with 18 Quebec patients (M = 47.05 years, SD = 9.07) diagnosed and/or treated for breast cancer before and during the pandemic. Descriptive analyses performed in MaxQDA allowed us to establish a thematic guide and narrative summaries. Results A minority of participants (n = 6) were offered psychosocial services at the time of their diagnosis. Although not all of them used the resources offered, they appreciated having them available. In contrast, 12 participants did not receive psychosocial resources, and more than half of these women were unsatisfied as they experienced intense psychological distress following diagnosis, which continued during treatment. Many women (n = 12) had to seek help on their own. Conclusion In order to improve the long-term experience of patients in times of crisis and non-crisis in Quebec, the results show that it could be beneficial to offer psychosocial services based on the needs of users, rather than solely on the severity of psychological symptoms.

Objective Common mental disorders, such as anxiety and depression, have many individual and societal consequences. Various treatments are available for people with these diagnoses, including medication and cognitive behavioral therapy. When these disorders are mild or moderate, psychotherapy is the recommended first-line treatment, given its greater long-term efficacy than pharmacotherapy. However, this is not what is observed in practice: medication is much more widely used than psychotherapy, the latter's accessibility being greatly reduced by long waiting lists. An alternative to these accessibility difficulties is the stepped-care model, which includes guided self-help. These are low-intensity interventions that enable more people to be treated with fewer resources (e.g., fewer meetings with a professional). The Programme québécois pour les troubles mentaux (PQPTM; Quebec Program for Mental Disorders) is a stepped-care model recently implemented in some settings in Quebec. The aim of this study is to gather the perceptions of social workers (SWs) in a Centre intégré (universitaire) de santé et de services sociaux (CI[U]SSS; Community mental health center) on the implementation of the PQPTM guided self-help. Methods To this end, three focus groups of approximately 1h30 were conducted with 13 SWs. The data were coded and analyzed using a thematic qualitative inductive-deductive approach, based on the Consolidated Framework for Implementing Research (CFIR) and the participants' responses obtained during the focus groups. Results The barriers and facilitators to PQPTM guided self-help implementation identified relate to different CFIR constructs: intervention characteristics (e.g., monitoring, type of self-help), internal implementation parameters (e.g., training, organizational pressures), caregiver characteristics (e.g., experience, appropriation time), user characteristics (e.g., age, personality) and process (e.g., treatment integrity, supervision). The results of this qualitative study show that SWs have varied perceptions and opinions of the PQPTM guided self-help: 64% of the themes discussed were nuanced, while 25% were considered exclusively as barriers and 11% exclusively as facilitators. Conclusion These results shed light on the factors that can contribute to the successful implementation of the PQPTM guided self-help in Quebec, with a view to improving it at the heart of the specific CI(U)SSS of the current study and in other mental health centers in Quebec. Several recommendations are made in this respect: for example, to increase upstream planning for future implementations, to maintain access to training and supervision, and to guarantee the availability and printing of self-help guides.

Objectives Natural disasters have a significant impact on mental health. Data collected from the population offer a unique opportunity for post-disaster monitoring to help identify psychological support needs. The aim of this study is: 1) to identify psychopathological aspects for the county of Prêcheur at risk from lahars (volcanic lava), and 2) to phenotype psychopathological aspects from data collected from the population. Method We applied an artificial intelligence (AI) assisted psycho-phenotyping method to data from 40 people over a 20-month period, to extract psychopathological and psychiatric aspects linked to traumatic natural hazards. These were then compared with the results of psychometric tests measuring overall mental health and post-traumatic stress. Results Rumination and negativation were among the most important psychopathological aspects identified. In addition, we noted the presence of re-experiencing and avoidance as core psychiatric dimensions over time. Among these, cognitive avoidance and emotional avoidance were found and seem to have emerged after the disaster. Conclusion We have proposed a new syndromic surveillance approach for mental health based on digital data that can support conventional approaches by providing additional useful information in the context of a disaster. Further studies are needed to better control bias, identify associations with valid instruments, and explore computational methods for continuous adjustment of the AI-analysis model.

Objectives To introduce the concept of digital well-being and explore the place of digital tools in the service of this well-being. Methods The article is based on a description of the concept of digital well-being, the intervention models currently available and the possibilities for improvement of these models. Findings Over the past decade, smartphone use has become almost ubiquitous in modern society. The average person spends several hours a day on their device, especially among teenagers and young adults. With smart, interactive, convenient and always-on connectivity, individuals face new challenges and pressures related to when, where, how and how intensively they choose to connect or disconnect from the services provided by the smartphone. Problematic smartphone use has been linked to mental health disorders and functional problems. The concept of digital well-being has recently been introduced to address this challenge of using digital technologies to promote well-being. This is the subjective and individual experience of an optimal balance between the advantages and disadvantages associated with digital technology. Today's interventions are mostly based on technological tools focusing on screen-time control. The results of such interventions are mixed. Conclusion Better integration of dynamic human-machine interfaces may be essential for optimal efficiency of tools aiming to support digital wellbeing.

The history of nuns at the Saint-Jean-de-Dieu Hospital, like that of lay nurses, has remained in the blind spot of women's history. And yet, over the past 30 years, the history of nursing has clearly highlighted the important achievements of French-Canadian religious and nurses in Quebec history, as well as the real opportunities for fulfillment and self-fulfillment that these careers offered women. This is what this article aims to remind us of, by revisiting the achievements of the militant Sister Augustine. Objective To bring Sister Augustine's activist journey out of the blind spot of IUSMM history. Method The preferred cultural microhistory is built around the "evidentiary paradigm," based on the identification and interpretation of discrete and scattered signs drawn from the Archives Providences de Montreal. Results If the Quiet Revolution has left its mark on people's minds, and above all has been interpreted as a turning point that constituted an exceptional springboard for the modernization of Quebec, we often forget the price paid by all the strong women of the first half-century who were the engineers and driving forces behind a complete and efficient healthcare system. The fact that they were nuns discredit them from any scientific knowledge and is enough to make us forget that nuns were at the top of the hierarchy of their institutions, and that they demonstrated their know-how as the country's first caregivers. Conclusion Despite Sister Augustine's half-century of fervour, her notable achievements, and her determination to develop and teach knowledge within the walls of Saint-Jean-de-Dieu, her career is inextricably linked to the evolution of the IUSMM.

Objectives To examine the transfer of knowledge in psychiatry, longitudinally, over more than 35 years, through the 4 editions of the manual "Psychiatrie clinique" published in Quebec, thanks to the initiative of the publication directors affiliated with the Institut universitaire en santé mentale de Montréal (formerly the Louis-H. Lafontaine Hospital). Our hypothesis is that the evolution of the content and form of such a manual reflects an evolution of knowledge in psychiatry with a naturally educational vocation which of what must be known and applicable in the discipline. We expect, in our longitudinal examination, to identify the evolution of this knowledge transfer and the contexts of this change. Method We compare the form and content of the editions of 1980, 1988, 1999-2001 and 2016. One of the directors (Lalonde P.) is associated with the 4 editions. We examine more specifically the number and disciplinary origin of the authors, the evolution of the themes and titles of the chapters. Results The weight of the manual increased from 1155 to 4181 g. There is an increase of 107% in the number of pages, 390% in the number of authors and 118% in the number of chapters. Some chapters have disappeared: Neuroses, Homosexuality. Several have appeared: Epistemology, Genetics, Neurobiology, Brain Imaging, Eating Disorders, Chronic Pain, etc. The bio-psycho-social approach has remained the reference framework since the beginning. DSM classifications of diseases have evolved. Trends in psychosocial treatments are discernible, having increased from 7 to 13 chapters. The multidisciplinary aspect has increased. The sections that have grown the most are child psychiatry and geriatric psychiatry as well as drug addictions. Conclusion From 1980 to 2016, the work reflected the evolution of scientific knowledge, thanks to the contributions of multiple authors, clinicians, and researchers, selected for their expertise. Initially aimed at family physicians, its readership has expanded to medical students, psychiatry residents and other health sciences students. Several generations of learners, now clinicians, doctors, general practitioners, or specialists, have referred to it. Over time, the success of "Psychiatrie clinique: approche bio-psycho-sociale" has spread throughout the international Francophonie, making it possible to disseminate encyclopedic clinical knowledge in an original Quebec work. The evolution of psychiatry is reflected very well through this analysis of the 4 editions of this manual.