Faculté des sciences infirmières – Travaux et publications

URI permanent de cette collectionhttps://hdl.handle.net/1866/577

Cette collection accueille les publications savantes et d’autres types de travaux d’auteur.e.s associé.e.s à cette unité. Voir aussi les collections Thèses et mémoires et Production étudiante de l'unité.

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Caring for a violent relative with severe mental illness : a qualitative study
Etienne, Paradis-Gagné; Holmes, Dave; Jacob, Jean Daniel; Université de Montréal. Faculté des sciences infirmières (Sage, 2020)
Background: According to the literature reviewed, although families living with a mentally ill relative often face violence, this issue has been little studied in nursing. Methods: We conducted a qualitative research study to explore the experience of families dealing with this complex reality. We adopted Jacques Donzelot's theory of the government of family as our theoretical framework and used grounded theory as our research methodology. In total, 14 participants who had been victims of violence perpetrated by relatives with severe mental illness were interviewed. Findings: Qualitative analysis led to the identification of five themes: (a) medico-legal apparatus; (b) experience of violence; (c) the family's responsibility toward the violent relative; (d) exclusion and stigmatisation; and (e) suffering and resilience. The present paper focuses on the study's central theme: the family's responsibility toward the violent relative.
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Critical research and qualitative methodologies : theoretical foundations and contribution to nursing research
Paradis-Gagné, Etienne; Pariseau-Legault, Pierre; Université de Montréal. Faculté des sciences infirmières (Springer, 2022)
Background: Methodological approaches that draw on critical perspectives (critical ethnography, critical phenomenology, and critical grounded theory) share common concepts, including social justice, reflexivity, positionality, pragmatism and social transformation. These approaches differ from conventional phenomenology, ethnography and grounded theory despite sharing common methodological grounds. Purpose: In this article, we will outline the major contributions of critical theory, as a research paradigm, to the development and evolution of qualitative methodologies. In particular, we will discuss their application to nursing research. The historical and conceptual underpinnings of these critical methodologies will first be described to highlight their paradigmatic characteristics and implications for nursing. Implications for Practice: Although not yet widely employed in nursing research, critical qualitative methodologies are particularly well suited to the discipline as they shed light on issues of power, social control, and marginalization among the vulnerable populations with whom nurses practise on a daily basis. The use of critical approaches can expose the epistemic injustice and social and health inequality that continue to prevail in our society.
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Les apports méthodologiques et théoriques de l’analyse critique du discours pour la recherche en sciences infirmières
Paradis-Gagné, Etienne; Domingue, Jean-Laurent; Université de Montréal. Faculté des sciences infirmières (Association de Recherche en Soins Infirmiers, 2024)
L’analyse critique du discours est une approche méthodologique qui permet une remise en question des structures qui relèguent certaines idées et personnes à la marge. Dans le domaine de la santé, cette approche, issue de la linguistique critique, est utile pour mettre en relief les nombreux processus sociétaux qui privilégient une certaine conception de la santé et des soins au profit d’autres perspectives considérées comme « alternatives ». Pourtant, en sciences infirmières l’analyse critique du discours est encore trop peu utilisée malgré son potentiel émancipatoire. Nous attribuons cette réticence entre autres à ses ancrages théoriques, à son origine linguistique, et au flou et à la variabilité dans ses méthodes d’analyse. L’objectif de cet article est donc de mieux comprendre comment l’analyse critique du discours peut être utilisée dans la discipline des sciences infirmières afin de mettre en exergue les inégalités sociales et enjeux de pouvoir. Différents exemples d’études réalisées en utilisant l’analyse critique de discours sont aussi présentés afin d’illustrer concrètement comment cette approche peut être utilisée en sciences infirmières.
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Psychiatry, risk and vulnerability : the significance of Robert Castel's work for nursing
Paradis-Gagné, Etienne; Pariseau-Legault, Pierre; Université de Montréal. Faculté des sciences infirmières (Wiley, 2019-12)
Robert Castel is an eminent figure in the social sciences because of his innovative contributions to various social and health fields. The seminal work of this poststructuralist author and social activist has influenced several research disciplines, but has not yet had a significant impact on nursing. In this article, we will present the thinking of this man, who considered himself a sociologist, philosopher and “historian of the present.” We will examine the most important issues he explored during his career, including the psychiatric apparatus, the management of risk and the social vulnerability. We believe that this thinker's perspective on diverse social issues is very relevant to nursing practice and research and to the health sciences in general. The concepts he developed and utilized with finesse provide us with a critical reading of many contemporary health issues, particularly in mental health and psychiatric nursing. Castel's critical and engaged approach incites mobilization for social justice and greater protections for marginalized and vulnerable persons. These principles of advocacy and social justice are also at the heart of the nursing profession.
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Judiciarization of people suffering from mental illness : a critical analysis of the psychiatric-judicial interface
Paradis-Gagné, Etienne; Jacob, Jean Daniel; Université de Montréal. Faculté des sciences infirmières (Wiley, 2020-06)
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Implementation of the mental health nurse practitioner role in forensic settings : a case report
Paradis-Gagné, Etienne; Guimond, Valérie; Université de Montréal. Faculté des sciences infirmières (Lippincott, Williams and Wilkins, 2020)
This is a case report about the implementation of the mental health nurse practitioner role in forensic psychiatric settings. We will present its implementation and issues encountered during this process, such as a lack of understanding of the role in staff teams, scope of practice limitations, tension stemming from the conflict between treatment and punishment approaches, and the risk of medicalization of nursing. This case report, based on the authors' experiences, represents an early contribution to research on advanced nursing practice in forensic psychiatry, an area that has yet to receive much attention in the literature.
Accès libre
Gilles Deleuze's societies of control: Implications for mental health nursing and coercive community care
Paradis-Gagné, Etienne; Holmes, Dave; Université de Montréal. Faculté des sciences infirmières (Wiley, 2021-11)
Since the era of deinstitutionalisation, many clinical approaches have emerged to enable the care and treatment of people suffering from mental illness. In recent years, the use of coercive approaches in the community (e.g., outpatient commitment or community treatment orders) has also increased internationally. Although nurses' role regarding these coercive approaches is central and significant, few empirical and theoretical writings have tackled this controversial nursing practice. The purpose of this paper is to analyse coercive nursing care through the lens of French philosopher Gilles Deleuze's concept of ‘societies of control’. Taking up Michel Foucault's work on disciplinary power, Deleuze explores how the move from the striated spaces of closed institutions to the smooth spaces of societies of control took place since the middle of the 20th century. According to Deleuze, the overall objective of ‘societies of control’ is no longer simply to govern deviant behaviour in closed environments (e.g., psychiatric hospitals and prisons) but to ensure a regime of unrelentless surveillance in the open spaces of our communities.
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Apprentissage coopératif et jugement clinique : perspective d’infirmiers et d’infirmières expertes en soins critiques
Dastous, Audrey; Boyer, Louise; Lavoie, Patrick; Université de Montréal. Faculté des sciences infirmières (EDP Sciences, 2024)
Contexte : Les activités d’apprentissage coopératif sont bénéfiques pour l’apprentissage des infirmiers et des infirmières novices et débutantes. Toutefois, les connaissances sur le processus d’apprentissage lors de ces activités ainsi que leur apport pour les infirmiers et les infirmières expertes demeurent limités. But : Cette étude avait pour but d’explorer, selon la perspective d’experts et d’expertes en soins critiques, la contribution d’activités d’apprentissage coopératif à leur compétence à poser un jugement clinique. Méthodes : Pour cette étude qualitative descriptive, des entrevues semi-dirigées ont été réalisées auprès de sept experts et expertes en soins critiques et ayant fait l’expérience récente d’activités d’apprentissage coopératif avec des infirmiers et des infirmières à différents stades de développement, de novice à expert. Les données ont fait l’objet d’une analyse thématique. Résultats : La discussion lors d’activités d’apprentissage coopératif permet aux experts et aux expertes de développer leur jugement clinique par des processus de comparaison et d’explication. Ces processus leur permettent de remettre en question leur raisonnement, de comprendre leurs automatismes, de faire l’état de leurs connaissances et de les approfondir. Les caractéristiques de ces activités, soit l’établissement d’un environnement sécuritaire et l’hétérogénéité du groupe d’apprenants, semblent être des conditions préalables et essentielles à la discussion. Conclusion : Ces résultats suggèrent que les infirmiers experts et les infirmières expertes bénéficient de la discussion au sein des activités d’apprentissage coopératif au même titre que les infirmiers et les infirmières moins expérimentés. La constitution de groupes de formation diversifiés représente une avenue porteuse pour maximiser les bénéfices des activités d’apprentissage coopératif, particulièrement en présence d’apprenants de différentes professions, milieux cliniques et stades de développement.
Accès libre
Covert administration of medication in nursing homes : a scoping review
Thériault, Vincent; Bourbonnais, Anne; Nguyen, Bich-Lien; Williams-Jones, Bryn; Université de Montréal. Faculté des sciences infirmières; Université de Montréal. École de santé publique. Département de médecine sociale et préventive (2024-10)
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Nurturing clinical decision-making through simulation : highlighting the value of the human experience amidst the rise of technology
Lavoie, Patrick; McDermott, Donna; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2023-11-14)
Accès libre
A comparison of nurses’ situation awareness and eye-tracking data in precardiac arrest simulations
Lavoie, Patrick; Lapierre, Alexandra; Khetir, Imène; Doherty, Amélie; Thibodeau-Jarry, Nicolas; Rousseau-Saine, Nicolas; Crétaz, Maude; Benhannache, Rania; Mailhot, Tanya; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2023-07-23)
Eye tracking has emerged as a new technology for assessing nurses' visual attention in simulation, but its relationship with situation awareness, a precursor to clinical decision-making, remains to be defined. This study compared role-based situation awareness and visual attention using eye-tracking in simulation. Methods Newly hired nurses participated in a cardiac arrest simulation as part of an orientation program. Eye-tracking data were collected to assess visual attention during the prearrest period. Participants completed a situation awareness questionnaire after the simulation. Data were compared according to participants' roles in the simulation. Results Results suggest a role-based difference in nurses' visual attention and situation awareness: designated nurses (n = 12) looked at the patient more often, for longer periods and were more aware of signs of patient deterioration than teammates (n = 14). Conclusions : This study was the first to combine eye-tracking and situation awareness data to compare two nursing roles during a precardiac arrest simulation. The findings also suggest gaps and learning needs in nurses' understanding of signs of patient deterioration and other nontechnical skills.
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The therapeutic relationship in the context of involuntary treatment orders : the perspective of nurses and patients
Lessard-Deschênes, Clara; Goulet, Marie-Hélène; Université de Montréal. Faculté des sciences infirmières (Wiley, 2021-09-22)
ntroduction: Involuntary treatment orders (ITO) can impact the nurse–patient ther-apeutic relationship (TR) negatively. Despite the increasing use of ITOs around theworld, few studies have explored their influence on the TR from the perspectives ofnurses and patients.Aim: To describe the TR in the context of ITOs as reported by nurses and individualsliving with a mental illness.Method: Secondary data analysis of qualitative interviews with nurses (n = 9) andpatients (n = 6) was performed using content analysis.Results: Participants described the TR as fundamentally embedded in a power im-balance amplified by the ITO, which was discussed through the conflicting roles of nurses, the legal constraints imposed on patients and nurses, the complex relationbetween the ITO and the TR, and the influence of mental healthcare settings' context.Discussion: Nurses and patients' views were opposed, questioning the authenticityof the relationship.Implications for Practice: Nurses should be aware of the patients' lack of faith in theTR to ensure that they are sensitive to patients' behaviours that may falsely suggestthat a relationship is established. Further studies should explore ways to alleviate theburden of the management of ITOs on nurses and allow for a trusting relationship tobe build.
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Coercion in psychiatric and mental health nursing : a conceptual analysis
Paradis-Gagné, Etienne; Pariseau-Legault, Pierre; Goulet, Marie-Hélène; Jacob, Jean Daniel; Lessard-Deschênes, Clara; Université de Montréal. Faculté des sciences infirmières (Wiley, 2021-03-10)
The use of coercion in psychiatric and mental health nursing is a major challenge, which can lead to negative consequences for nurses and patients, including rupture in the therapeutic relationship and risk of injury and trauma. The concept of coercion is complex to define and is used in different ways throughout the nursing literature. This concept is defined broadly, referring to both formal (seclusion, restraint, and forced hospitalization), informal (persuasion, threat, and inducement), and perceived coercion, without fully addressing its evolving conceptualizations and use in nursing practice. We conducted a concept analysis of coercion using Rodgers’ evolutionary method to identify its antecedents, attributes, and associated consequences. We identified five main attributes of the concept: different forms of coercion; the contexts in which coercion is exercised; nurses’ justification of its use; the ethical issues raised by the presence of coercion; and power dynamics. Our conceptual analysis shows the need for more nursing research in the field of coercion to achieve a better understanding of the power dynamics and ethical issues that arise in the presence of coercion.
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Contribution d’un pair aidant au retour post-isolement en santé mentale : une étude qualitative exploratoire
Goulet, Marie-Hélène; Larue, Caroline; Côté, Cindy; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2018)
L’utilisation de l’isolement en psychiatrie est une mesure de dernier recours lorsque la personne est dangereuse pour elle-même ou pour les autres. Un retour post-isolement est alors préconisé. Cette étude qualitative exploratoire visait à explorer les retombées du retour post-isolement par un pair aidant ayant déjà été exposé à une mesure d’isolement. Des entrevues individuelles et de groupe avec les gestionnaires, les infirmières et le pair aidant avant et après l’implantation de l’intervention ont été réalisées. Les retombées ont été positives tant pour les patients, l’équipe soignante et le pair aidant. L’intégration d’un pair aidant a eu un effet levier sur la qualité des soins perçue en améliorant la compréhension par l’équipe soignante du vécu de l’expérience d’une mesure coercitive. Des défis perdurent quant à l’intégration du nouveau rôle de pair aidant. L’intégration d’un pair aidant à l’équipe de soins constitue une valeur ajoutée dans la prévention des comportements agressifs.
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Identification and analysis of factors contributing to the reduction of control measures for a population with intellectual disability
Larue, Caroline; Goulet, Marie-Hélène; Prévost, Marie-Josée; Dumais, Alexandre; Bellavance, Jacques; Université de Montréal. Faculté des sciences infirmières (Wiley, 2018)
Background A cohort of 11 patients with an intellectualdisability and a psychiatric diagnosis present severebehavioural disorders in psychiatric hospital of Quebecin 2009. Control-measure use for this clientele has nowbeen reduced. How do management personnel, familiesand care teams explain the changes? What clinicalinterventions did management and care providersimplement that contributed to the reduction?Method A retrospective case study was conducted. Fivefocus groups were held with people involved in theircare, and the patient ﬁles were examined.Results The factors contributing to this change were thecohesion of the care providers, the involvement of the familiesand the efforts to determine the function of the behaviour.Implications This study may inspire other care teams totry new approaches in dealing with patients with severebehavioural disorders. Also, the model of factors andinterventions supporting a reduction in seclusion andrestraint measures may inspire future studies.
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Médecine traditionnelle chinoise pour les comportements réactifs des personnes vivant avec un trouble neurocognitif
Ferreira, Adriana; Bourbonnais, Anne; Nguyen, Bich-Lien; Université de Montréal. Faculté des sciences infirmières; Université de Montréal. École de santé publique (2024-10)
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The exercise of nurses' clinical leadership in hospital care units : a qualitative multiple case study
Boutin, Geneviève; Pepin, Jacinthe; Brault, Isabelle; Université de Montréal. Faculté des sciences infirmières (Wiley, 2024)
Aims: This study aims to describe the exercise of clinical leadership by nurses within hospital care units, identify the factorsinfluencing it and explore how nurses perceive its impact.Design: Qualitative multiple case study.Method: The study involved 36 interviews, 120 h of observation and documentary analyses with nurses across various roleswithin three nursing teams to capture collective leadership. Thematic and cross-case analyses were also conducted.Results: Nurses' clinical leadership was manifested in five distinct forms, irrespective of their role: (1) initiating actions involv-ing reflective thinking and intervention, (2) influencing others through coaching, (3) actively participating in and mobilisingefforts to enhance the quality of care, (4) fostering optimal synergy and team cohesion, and (5) leveraging personal and collabo-rative capacities. Factors influencing this leadership included clinical, human and material resources, time, a work environmentthat promotes autonomy and a positive work climate. Nurses perceived their leadership as having a positive impact on patients,themselves, the interdisciplinary team and the organisation. These findings were integrated into a modellisation of the exerciseof nurses' clinical leadership based on Le Moigne's (La Théorie du Système Général. Théorie de la Modélisation. Paris: PressesUniversitaires de France, 2006) philosophical approach.Conclusion: This study provides a perspective on nurses' collective clinical leadership in hospital care units, emphasising its lev-erage effect and the achievement of positive impacts. The proposed model serves as a valuable tool for nurse managers to betterunderstand and support the exercise of clinical leadership.Implications for the Profession: The model can guide nurse managers in supporting clinical leadership within teams, assistindividual nurses in associating clinical leadership with their practice and assist with mobilising their leadership skills.Impact:• This study explores how nurses across various roles within a hospital care unit exercise clinical leadership.• The findings reveal five active forms of nurses' clinical leadership, perceived by nurses to positively impact patients, the inter-disciplinary team and the organisation.• Nurses and managers can use these five forms to foster a collective approach to clinical leadership.Patient or Public Contribution: None.What Does This Paper Contribute to the Wider Community?• This study introduces an innovative model for understanding and promoting nurses' clinical leadership.• It provides insights into the positive impact of this leadership approach and the significance of promoting it.
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Cross-sector collaboration to improve access to community services for people living with diabetes : contributions from actor-network theory
Layani, Géraldine; Tremblay, Alexandre; Lussier, Marie-Thérèse; Godbout, Isabelle; Bihan, Hélène; Gosselin, Claire; Pierre, Mégane; Motulsky, Aude; Isabelle, Brault; Rodrigues, Isabel; Kaczorowski, Janusz; Vanie, Marie-Claude; Yapi, Sopie Marielle; Université de Montréal. Faculté des sciences infirmières (Sage, 2023)
Diabetes is a global public health issue. The Public Health Agency of Canada published a Diabetes Framework 2022 which recommends collaborative work across sectors to mitigate the impact of diabetes on health and quality of life. Since 2020, the INMED-COMMUNITY pathway has been implemented in Laval, Québec developing collaboration between healthcare and community sectors through a participatory action research approach. The aim of this article is to gain a better understanding of the INMED-COMMUNITY pathway implementation process, based on the mobilization of network actor theory. Qualitative analysis of semi-structured interviews conducted from January to March 2023 with 12 participants from 3 different sectors (community, health system, research), were carried out using actor-network theory. The results explored the conditions for effective intersectoral collaboration in a participatory action research approach to implement the INMED-COMMUNITY pathway. These were: (1) contextualization of the project, (2) a consultation approach involving various stakeholders, (3) creation of new partnerships, (4) presence of a project coordinator, and (5) mobilization of stakeholders around a common definition of diabetes. Mediation supported by a project coordinator contributed to the implementation of an intersectoral collaborative health intervention, largely due to early identification of controversies.
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Multiple stakeholders’ perspectives of involuntary treatment orders : a meta-synthesis of the qualitative evidence toward an exploratory model
Goulet, Marie-Hélène; Pariseau-Legault, Pierre; Côté, Cindy; Klein, Alana; Crocker, Anne; Université de Montréal. Faculté des sciences infirmières (Taylor and Francis Group, 2019-06-03)
Involuntary treatment orders (ITOs) represent coercive leverage for treatment adherence against the will of individuals incapable of providing consent. ITOs have failed to demonstrate benefits in quantitative studies, but little attention has been paid the growing body of qualitative evidence on ITOs. The current study is an interpretative meta-synthesis designed to integrate qualitative evidence and enhance our understanding of stakeholders’ perspectives (service users, relatives, professionals, psychiatrists) of ITOs in the context of mental health care. Forty-four studies met the following inclusion criteria, peer-reviewed empirical qualitative studies, and focus on perspectives and experiences of ITOs in a mental health context. Themes resulting from the analysis are: an ITO as leverage to manage compliance and risk; legal concerns; learning to play the game; building a therapeutic relationship in a coercive context; positive and negative impacts of ITOs; family involvement; and discharge. Based on these themes, an exploratory model of ITOs is proposed.
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Relocation of hospitalized older people to long-term care homes following a recent loss of functional independence : a scoping review protocol
Nguyen, Bich-Lien; Bourbonnais, Anne; Brummans, Boris H.J.M.; Thériault, Vincent; Auclair, Isabelle; Ferreira, Adriana; Université de Montréal. Faculté des sciences infirmières (2024)
Background. Many older people who experience a loss of functional independence, following a hospitalization must move to a long-term care home. These transitions are often unexpected and can have significant consequences. Several studies have explored different aspects of these transitions, but no knowledge synthesis addressing this phenomenon has been identified. Aim. Our aim is to map available knowledge about the relocation of older people from the hospital to a long-term care home, following a decline in health and loss of functional independence. Methods. Following the Joanna Briggs Institute (JBI) Manual, a scoping review will be conducted of the relocation of older people, aged 65 and over, from the hospital to a long-term care home. It will also include the perspectives of stakeholders involved in this process. We will search seven databases and gray literature, as well as conduct a retrospective search. Documents published since 2004 and from all countries will be included. The search will be limited to English and French texts. After a calibration exercise, records will be selected by two independent researchers in duplicate, first by title and abstract, and then by full text. Data extraction and quality assessment will be conducted according to the JBI Manual. Analysis of evidence will consist in content analysis and descriptive statistics. Results will be presented by means of charts, graphs, and narrative descriptions. Discussion. Our findings will help to identify areas of research that should be developed in order to gain insight into the process of integrating a long-term care home from a hospital.

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