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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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.
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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)
Accès libre
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)
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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.
Accès libre
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.
Accès libre
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.
Accès libre
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)
Accès libre
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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Beliefs and experiences of educators when involved in the design of a Learning-by-concordance tool : a qualitative interpretative study
Deschênes, Marie-France; Akremi, Haifa; Lecours, Lise; Moussa, Ahmed; Jobin, Vincent; Fernandez, Nicolas; Université de Montréal. Faculté de médecine; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2024-07-25)
Background Based on the involvement of qualified educators in its design, the Learning-by-Concordance tool aims to promote the learning of reasoning in contexts of uncertainty. However, data are still scarce on the experience of educators in terms of sharing and exposing their reasoning processes using this tool. Purpose This study sought to explore the beliefs and experiences of educators when involved in the design of a Learning-by-Concordance tool. Method This research used a descriptive qualitative design. Four dialogue groups were conducted with educators with different roles and responsibilities while designing a Learning-by-Concordance tool. A descriptive interpretative analysis of educators' verbatim quotes was done. Findings A total of 14 participants took part in the study. The results show the discomfort of educators despite their recognized expertise. Three themes emerged: 1- the need to be reassured by the opinions of colleagues; 2-feeling like impostors; and 3- concerns for the quality of instructional supports. Conclusions The role taken by educators for teaching reasoning in contexts of uncertainty is to draw on practical experience where different types of knowledge intersect and are mobilized, to overcome feelings of insecurity, and to engage in close and authentic conversation with learners.
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Educational strategies used in master's and doctoral nursing education : a scoping review
Vinette, Billy; Lapierre, Alexandra; Lavoie, Audrey; Leclerc-Loiselle, Jérôme; Charette, Martin; Deschênes, Marie-France; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2023-06-25)
Background Advanced practice nurses and future nursing researchers must be adequately educated with the best available evidence. However, we know little about educational strategies and their characteristics used explicitly to educate advanced practice nurses and future researchers. Method A scoping review was used to map the latest educational strategies used in master's and doctoral nursing education between 2011 and 2021. Components of educational strategies were extracted based on the Guideline for Reporting Evidence-Based Practice Educational Interventions and Teaching and the Saskatchewan Education Department Framework of Professional Practice. The New World Kirkpatrick Model was used to categorize the associated learning outcomes. A narrative description approach was used to synthesize the findings. Results A total of 56 studies were included. Several information was missing regarding the theoretical foundations of the educational strategies. A total of 158 educational strategies were identified. Individual work (e.g., homework) was the most popular educational strategy. Most studies assessed learning outcomes related to reactions (e.g., satisfaction) or learning (e.g., knowledge). Conclusion More studies should be done using interactive instruction or multimodal approaches, while the authors should better describe intervention components. A systematic review of effectiveness needs to be conducted to evaluate the best educational strategies in the master's and doctoral nursing education.
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Nurses' practices regarding procedural pain management of preterm infants
De Clifford-Faugère, Gwenaëlle; Aita, Marilyn; Le May, Sylvie; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2019-02)
Background. It is well known that preterm neonates can feel pain which can be expressed through specific behaviors and signs. Repeated and untreated pain has consequences for the preterm neonates such as hypersensitivity to pain, as well as important repercussions on their motor and intellectual development. The use of non-pharmacological interventions for pain management by nurses is imperative to prevent these consequences in the NICU. The aim of this study is to survey neonatal nurses’ interventions for pain management of preterm neonates. Methods. Twenty (20) nurses were recruited for this pilot observational survey study. Standard pain management interventions used by nurses during heel prick were evaluated by means of a questionnaire. In addition, 11 out of the 20 nurses were observed during heel prick to evaluate what and how interventions were done. Results. All infants (n=11) received at least one pain management intervention during heel prick. Heterogeneity in pain management practices used by nurses is considerable. For 95% (19/20) of nurses, sucrose is a standard intervention reported in the survey but observations showed that it not always applied (64%). Positioning is more used (64%) by nurses than reported in the survey (45%). Swaddling also was also reported as a standard intervention by 45% of nurses, but it does not appear to be adequately performed (36%). Conclusion. According to the results, it would be essential to review nurses’ knowledge and skills regarding standard pain management interventions, during painful procedures, as the quality of these practices is questionable. Homogeneity of the standard of care is particularly important in research to allow an appropriate comparison between study groups and prevention study bias.
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Prise en charge non pharmacologique de la douleur procédurale des nouveau-nés prématurés : quelles interventions ?
De Clifford-Faugère, Gwenaëlle; Lavallée, Andréane; Aita, Marilyn; Université de Montréal. Faculté des sciences infirmières (Lavoisier, 2018-12)
Les nouveau-nés prématurés ressentent la douleur et sont soumis à de nombreuses procédures douloureuses au cours de leur hospitalisation en service de néonatalogie. La douleur non soulagée et répétée peut entrainer des répercussions importantes pour leurs développements intellectuel et moteur. Il est donc essentiel de soulager leur douleur. Cet article a pour but de faire l’état des connaissances actuelles sur les interventions non-pharmacologiques de prise en charge de la douleur.
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An unnecessary pain : a commentary on Gao et al. (2018)
De Clifford-Faugère, Gwenaëlle; Aita, Marilyn; Colson, Sébastien; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2018-06-30)
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Systematic review and meta-analysis of olfactive stimulation interventions to manage procedural pain in preterm and full-term neonates
De Clifford-Faugère, Gwenaëlle; Lavallée, Andréane; Khadra, Christelle; Ballard, Ariane; Colson, Sébastien; Aita, Marilyn; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2020-06-24)
Background Preterm and full-term neonates undergo many painful procedures during their hospitalization in the neonatal intensive care unit. Unrelieved and repeated pain can have important repercussions on their motor and intellectual development. Still, pain management interventions are limited for neonates. Objective This systematic review aimed to evaluate the effectiveness of olfactive stimulation interventions on the pain response of preterm and full-term infants during painful procedures. Design Systematic review and meta-analysis. Data sources An electronic search was conducted from inception to August 2019 in PubMed, MEDLINE, Embase, CINAHL, PsycINFO, Web of Sciences, CENTRAL, Scopus and ProQuest. Review methods Study selection, data extraction, assessment of risk of bias and quality of evidence were performed by two independent reviewers. Results 3311 studies were screened. Of the 14 studies included studies (n = 1028 infants), results from 10 were combined in meta-analysis. The latter demonstrated that olfactive stimulation interventions using a familiar odor were effective compared to standard care on pain reactivity (SMD -0.69; 95% CI -0.93 to -0.44; I2 = 20%, p < 0.00001), pain regulation (SMD -0.40; 95% CI -0.66 to -0.14; I2 = 13%, p = 0.002), crying duration during (SMD -0.42; 95% CI -0.73 to -0.10; I2 = 47%, p = 0.009) and after the procedure (SMD -0.37; 95% CI -0.68 to -0.07; I2 = 0%, p = 0.01), heart rate after the procedure (MD -3.87; 95% CI -7.36 to -0.38; I2 = 99%, p = 0.03), oxygen saturation during (MD -0.47; 95% CI -0.86 to -0.08; I2 = 91%, p = 0.02) and after the procedure (MD -0.56; 95% CI -0.99 to -0.13; I2 = 99%, p = 0.01). No adverse event was reported. Conclusion These findings are based on low to very low quality of evidence limiting our confidence in effect estimates. More rigorous trials with a larger sample size are needed to enhance the comprehension of the mechanisms underlying olfactive stimulation interventions and the interventions’ efficacy.
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Nurses' perception of preterm infants' pain and the factors of their pain assessment and management
De Clifford-Faugère, Gwenaëlle; Aita, Marilyn; Feeley, Nancy; Colson, Sébastien; Université de Montréal. Faculté des sciences infirmières (Lippincott, Williams & Wilkins, 2022)
In the neonatal intensive care unit, preterm infants undergo many painful procedures. Although these can impair their neurodevelopment if not properly managed, only half of the painful procedures are optimally handled. This cross-sectional study aimed to evaluate nurses' perceptions of preterm infants' pain, to evaluate nurses' pain assessment and management practices, as well as to identify the individual and contextual factors that influence nurses' assessments and interventions for pain management. Secondary analyses, including a mixed-model analysis, were performed with data from a larger study (n = 202 nurses). Nurses were found to have attitudes and perceptions in favor of preterm infants' pain management, although they reported using few standardized instruments to assess pain. Nurses stated that they widely used sucrose, non-nutritive sucking, and positioning as pain management interventions, while skin-to-skin contact was rarely practiced. Nurses' attitudes and perceptions influenced their pain assessment practices, which predicted their implementation of interventions. Several contextual (country, level of care, and work shift) and individual factors (age, level of education, had a preterm infant, perceptions of family-centered care, and skin-to-skin contact) also predicted nurses' pain assessment and management practices.

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