Faculté des sciences infirmières – Travaux et publications
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Item Accès libre Decibels Intervention : intervention approach based on the meanings of vocal behaviours of older people living with a neurocognitive disorder : manual for family and formal caregiversBourbonnais, Anne; Lalonde, Marie-Hélène; Université de Montréal. Faculté des sciences infirmières (Centre de recherche de l’Institut universitaire de gériatrie de Montréal, 2018)In long-term care facilities (LTCF), most residents have major neurocognitive disorders, for example, Alzheimer’s, vascular, mixed, frontotemporal or Lewy body disease. Among these older people, up to 60% of them manifest vocal behaviours. These vocal behaviours can indicate an ill-being in the older people who manifest them. They also have many consequences for the person with this type of behaviour, such as social isolation, overmedication and increased anxiety. These behaviours also affect other people in the environment (e.g. other residents, family or formal caregivers). Concerned by this situation and wishing to increase the well-being of older people living with Alzheimer’s disease, our research team has developed an intervention to help formal and family caregivers of older people manifesting vocal behaviours. This intervention took the form of an approach based on the meanings of vocal behaviours. A memory aid tool presenting the various elements of this approach is available in the toolbox at the end of this manual (Tool 1). This manual presents our intervention approach, which is divided as follows. First, it defines the key terms used in the approach to ensure readers’ understanding. Second, it presents the principles underlying the approach and how to implement this approach. Finally, each step of the approach is explained. Various tools that could be useful in carrying out this approach are presented in the appendix.Item Accès libre Intervention décibels : une démarche d’interventions basée sur les sens des comportements vocaux de personnes âgées vivant avec un trouble neurocognitif : manuel des proches et des soignantsBourbonnais, Anne; Lalonde, Marie-Hélène; Université de Montréal. Faculté des sciences infirmières (Centre de recherche de l’Institut universitaire de gériatrie de Montréal, 2018)Dans les centres d’hébergement et de soins de longue durée (CHSLD), la majorité des résidents sont atteints d’un trouble neurocognitif majeur comme la maladie d’Alzheimer, vasculaire, mixte, frontotemporale ou à corps de Lewy. Parmi ces personnes âgées, jusqu’à 60 % d’entre elles manifestent des comportements vocaux. Ces comportements peuvent indiquer un mal-être chez les personnes âgées qui les manifestent. Ils entrainent plusieurs conséquences sur la personne qui a ce type de comportement telles que l’isolement social, une surmédication et une augmentation de l’anxiété. Ces comportements ont aussi des conséquences sur les autres se trouvant dans l’environnement (par exemple, les autres résidents, les proches aidantes, les soignantes). Préoccupée par cette situation et souhaitant augmenter le bien-être des personnes âgées vivant avec la maladie d’Alzheimer, notre équipe de recherche a développé une intervention avec l’aide de soignantes et de proches aidantes de personnes âgées qui manifestaient des comportements vocaux. Cette intervention a pris la forme d’une démarche basée sur les sens des comportements vocaux. Elle met au premier plan la contribution essentielle des proches aidantes et des soignantes. Un aide-mémoire présentant les divers éléments de cette démarche est disponible dans la boîte à outils à la fin de ce manuel (voir outil 1). Le manuel vise à présenter cette démarche d’interventions. Il se divise comme suit. D’abord, il définit les principaux termes rattachés à la démarche afin d’assurer votre compréhension. Ensuite, il présente les grands principes sur lesquels s’appuie cette démarche, ainsi que son déroulement. Puis, il explique chacune des étapes qui la composent. En annexe, divers outils pouvant être utiles lors de la réalisation de cette démarche sont présentés.Item Accès libre Organizational crisis in residential aged care facilitiesm : a scoping reviewLeon Palomino, Cecilia R.; Bourbonnais, Anne; Lavoie-Tremblay, Mélanie; Auclair, Isabelle; Université de Montréal. Faculté des sciences infirmières (2024-10)Item Accès libre A rapid scoping review on transnational families and midwifery care : experiences, challenges and strategies for improving health and wellbeing during pregnancy, childbirth and postpartumMerry, Lisa; Castiglione, Sonia Angela; Gervais, Christine; Bonfert, Lisa; Perreault, Valérie; Barglowski, Karolina; Clar, Monique; Université de Montréal. Faculté des sciences infirmières (2025-04)Background: Transnational families, i.e., those whose family members are geographically distributed and who maintain a sense of collectivity across national borders, is a growing phenomenon. The perinatal period (pregnancy, childbirth and postpartum) is a particularly sensitive phase of life, confronting families with a range of questions and uncertainties; for transnational families, living separated, adds a layer of complexity. The midwifery model of care emphasizes collaboration, anti-oppressive approaches and personalized care, not only for the childbearing person, but also within the family and the community; however, not much is known about how midwives consider and address transnational families’ identities, relationships and practices during the delivery of care. The health and care experiences of transnational families during the perinatal period, and their perspectives on the role of midwives in relation to their transnational family dynamic, has also received little attention. Objectives: This knowledge synthesis addressed the following questions: 1) How do transnational families experience pregnancy, childbirth and postpartum, including care? 2) What are the experiences of midwives and what role do they play (or should they play) when caring for transnational families? Methods: We conducted a rapid scoping review. We searched for literature that provided information about the experiences, practices and perceptions of midwives caring for transnational families in high income countries and/or information about transnational families’ experiences during pregnancy, birth and postpartum in high income countries, including their challenges and expectations of midwifery/perinatal healthcare. We searched seven bibliographic databases and selected websites of midwifery associations worldwide. We considered research, other article types (discussion/theoretical papers) and grey literature, published between 2014 and 2024, and available in English, French, Spanish or German. Data, including literature characteristics, and excerpts of text from the articles, as well as participants’ quotes, that were relevant to the research questions, were extracted and managed in Covidence. To respond to the research objectives, we employed a narrative synthesis approach and organized the findings under themes. Results: The searches yielded a total of 123 articles which describe international migrant women/families’ perinatal experiences and/or the experiences of midwives providing care to migrants; only four articles had an explicit focus on transnational families’ and experiences during the perinatal period, while none directly addressed the topic of transnational families and midwifery care. We identified seven themes: “family separation”; “transnational connections and support”; “being a part of two cultures”; “challenging experiences with midwifery care”; “positive experiences and expectations of midwives”; “midwives’ challenges with transnational families”; and “midwifery care and addressing challenges and promoting health and well-being”.Item Accès libre Development and contribution of a serious game to improve nursing students' clinical reasoning in acute heart failure : a multimethod studyMaheu-Cadotte, Marc-André; Dubé, Véronique; Lavoie, Patrick; Université de Montréal. Faculté des sciences infirmières (Lippincott, Williams and Wilkins, 2023)Clinical reasoning is essential for nurses and nursing students to recognize and intervene when hospitalized patients present acute heart failure. Serious games are digital educational interventions that could foster the development of clinical reasoning through an engaging and intrinsically motivating learning experience. However, elements from a playful approach (eg, rewards, narrative elements) are often absent or poorly integrated in existing serious games, which may limit their contribution to learning. Thus, we developed and studied the contribution of a novel serious game on nursing students' engagement, intrinsic motivation, and clinical reasoning in the context of acute heart failure. We adopted a multimethod design and randomized 28 participants to receive two serious game prototypes in a different sequence, one that fully integrated elements of a playful approach (SIGN@L-A) and one that offered only objectives, feedback, and a functional aesthetic (SIGN@L-B). Through self-reported questionnaires, participants reported higher levels of engagement and intrinsic motivation after using SIGN@L-A. However, negligible differences in clinical reasoning scores were found after using each serious game prototype. During interviews, participants reported on the contribution of design elements to their learning. Quantitative findings should be replicated in larger samples. Qualitative findings may guide the development of future serious games.Item Accès libre Donzelot et le gouvernement des familles : une analyse critique des modèles systémiques en sciences infirmièresParadis-Gagné, Etienne; Holmes, Dave; Université de Montréal. Faculté des sciences infirmières (Association de recherche en soins infirmiers, 2019)Cet article a pour but d’effectuer une analyse critique du modèle de Calgary par l’entremise de la théorie du gouvernement de la famille de Jacques Donzelot. Selon Donzelot, la famille est instrumentalisée par le pouvoir (para) médical, et devient un terreau fertile pour des pratiques de gouvernementalité. Ainsi, la famille est invitée et « formée » à jouer un rôle de soignant en plus d’assumer un rôle de proche aidant. Le dispositif (para) médical s’impose dans l’intimité de la famille, en altère le fonctionnement, et y exerce un gouvernement ténu des conduites. La perspective théorique de Donzelot, par son caractère critique et politique, entre cependant en conflit avec les représentations usuelles des soins infirmiers à la famille.Item Accès libre Governing families that care for a sick relative : the contributions of Donzelot's theory for nursingParadis-Gagné, Etienne; Holmes, Dave; Université de Montréal. Faculté des sciences infirmières (Wiley, 2021)According to the literature, the family is now considered to be the most important resource for the care and support of a sick family member. Families are being increasingly invited and trained to play a utilitarian role, not just as family caregivers, but as healthcare agents. Healthcare institutions, based on neoliberal health policies, are encouraging them to perform increasingly complex and professionalized tasks. The burden associated with this expanded healthcare function, however, is significant (fatigue, emotional distress and exhaustion). The aim of this article was to present French sociologist Jacques Donzelot's theoretical perspective on governing through the family. According to Donzelot, such a government is exercised through various power techniques, including the instrumentalization of the family role and the transfer to families of the responsibility for health care. This author describes how healthcare institutions call on the family to perform hospital and biomedical practices within the home. A spin-off of neoliberalism, the practices of governing through families specifically target women, who are considered to be the pillar of the family. Donzelot's perspective is very relevant to nursing, but is still rarely mobilized in the discipline. His critical perspective allows for a re-reading of relations of power and mechanisms of surveillance and control of families, issues that are often overlooked in nursing research.Item Accès libre A critical ethnography of outreach nursing for people experiencing homelessnessParadis-Gagné, Etienne; Pariseau-Legault, Pierre; Villemure , Midori; Chauvette , Simon; Université de Montréal. Faculté des sciences infirmières (Taylor and Francis, 2020)People experiencing homelessness have a high prevalence of substanceabuse and mental and physical problems. Although they have very complexhealth needs, they face many barriers that reduce their access to health careand social services. Several research studies have shown the need to imple-ment adapted nursing interventions to address these crucial access issues. Inthis article, we present the results of a critical ethnography of outreachnurses who work with homeless people (n = 12). Robert Castel’s theoreticalmodel, which focuses on the process of social disaffiliation, provided theconceptual underpinnings for this research. Our qualitative data analysisrevealed four categories, namely 1) the professional role and identity ofnurses; 2) the social function of outreach nursing; 3) clinical realities and 4)disaffiliation and stigmatization. Our findings highlight the need to raiseawareness among health care providers about the ethical, clinical and orga-nizational issues of homelessness, particularly the mechanisms of exclusionand stigmatization in health care settings that affect people experiencinghomelessness.Item Accès libre Experiences of family violence committed by relatives with severe mental illness : a grounded theoryParadis-Gagné, Etienne; Holmes, Dave; Perro, Amélie; Université de Montréal. Faculté des sciences infirmières (Lippincott, Williams and Wilkins, 2020)In forensic psychiatry, family violence perpetrated by a loved one suffering from severe mental illness is a significant problem thought to affect nearly half of families. To examine this poorly documented issue, a qualitative study using a grounded theory research strategy was conducted with family members who have experienced violence committed by a relative with severe mental illness. Semistructured interviews were conducted with 14 participants who had experienced this type of violence. The works of poststructuralist thinkers Jacques Donzelot and Michel Foucault inform the theoretical framework. Qualitative analysis of the data led to the emergence of five major themes: medicolegal apparatus, experience of violence, family's responsibility toward the violent relative, exclusion and stigmatization, and suffering and resilience. The main results of this qualitative study indicate that families are governed through specific mechanisms, including instrumentalization of the family's role and transfer of the violent person's care to the family. Obstacles preventing families from being included in their relative's care were also raised. This research contributes to nursing by shedding light on clinical interventions and health policy in family care. It also offers insight into the provision of appropriate quality care in particularly complicated family situations.Item Accès libre Perceptions of mobile and acute healthcare services among people experiencing homelessnessParadis-Gagné, Etienne; Kaszap, Myriam; Ben Ahmed, Houssem Eddine; Pariseau-Legault, Pierre; Jacques, Marie-Claude; Potcoava, Stephanie; Université de Montréal. Faculté des sciences infirmières (Wiley, 2022)Objectives: This paper presents findings from our collaborative research on the perceptions and preferences of people experiencing homelessness regarding outreach nursing services. Objectives: This paper presents findings from our collaborative research on the perceptions and preferences of people experiencing homelessness regarding outreach nursing services. Method: We conducted qualitative research using a critical ethnography approach. Sample: A total of 15 participants were interviewed individually (n = 12 people experiencing homelessness) and in focus groups (n = 3 care providers). We also conducted direct observation. Results: This paper focuses on one of the core categories that emerged from the data analysis "Perception of Health Care." This category emerged from the following three subcategories, which we will present in this paper: (1) Conflicting Relationships with Institutional Health Services; (2) Perception of Outreach Services; (3) Recommendations from Mobile Clinic Users. Conclusion: There are a range of perceptions of health services among people experiencing homelessness. Some are satisfied with the care received in the public health system, while many have experienced dehumanizing practices. Overall, outreach services are a promising strategy to reach people who are not served by the traditional modes of care delivery. Based on our findings, we suggest several key practices to personalize and adapt healthcare services and foster inclusive environments to better serve people experiencing homelessness.Item Accès libre Caring for a violent relative with severe mental illness : a qualitative studyEtienne, 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.Item Accès libre Critical research and qualitative methodologies : theoretical foundations and contribution to nursing researchParadis-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.Item Accès libre Les apports méthodologiques et théoriques de l’analyse critique du discours pour la recherche en sciences infirmièresParadis-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.Item Accès libre Psychiatry, risk and vulnerability : the significance of Robert Castel's work for nursingParadis-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.Item Accès libre Judiciarization of people suffering from mental illness : a critical analysis of the psychiatric-judicial interfaceParadis-Gagné, Etienne; Jacob, Jean Daniel; Université de Montréal. Faculté des sciences infirmières (Wiley, 2020-06)Item Accès libre Implementation of the mental health nurse practitioner role in forensic settings : a case reportParadis-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.Item Accès libre Gilles Deleuze's societies of control: Implications for mental health nursing and coercive community careParadis-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.Item Accès libre Apprentissage coopératif et jugement clinique : perspective d’infirmiers et d’infirmières expertes en soins critiquesDastous, 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.Item Accès libre Covert administration of medication in nursing homes : a scoping reviewThériault, 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)Item Accès libre Nurturing clinical decision-making through simulation : highlighting the value of the human experience amidst the rise of technologyLavoie, Patrick; McDermott, Donna; Université de Montréal. Faculté des sciences infirmières (Elsevier, 2023-11-14)