Évaluation d’une intervention éducative numérique visant à soutenir des infirmières dans l’accompagnement à l’autogestion sécuritaire du cannabis : un devis mixte

Abstract

Despite the success of cancer treatments, persistent and disabling symptoms may still be experienced. Some young adults (15–39 years old) diagnosed with cancer are already incorporating cannabis as a self-management strategy for their symptoms (e.g., nausea). While cannabis use may demonstrate beneficial effects, it may also carry risks of side effects (e.g., dizziness). With their holistic approach, nurses could play a key role in supporting the safe use of cannabis. However, they feel inadequately trained, and no interventions currently exist to support them in this regard. This thesis presents the development of a digital educational intervention, Cannabis & Cancer, aimed at enhancing nurses' professional practice to support safe cannabis use by young adults diagnosed with cancer, as well as the evaluation of its preliminary effects and perceived impacts. A digital educational intervention was developed on a virtual learning platform using the Intervention Mapping framework, combining the Theory of Planned Behavior, the Adult Learning Theory, the concept of engagement, and behavior change techniques. A mixed-methods convergent design (quantitative + qualitative) was used to collect and analyze data. In the quantitative design, a pilot randomized controlled study involved 70 oncology nurses to evaluate the preliminary effects of the digital educational intervention on their engagement, knowledge, attitudes, self-efficacy, and intention. In the qualitative design, a descriptive qualitative study was conducted with 12 nurses to explore their perceptions of the acceptability of the digital educational intervention and its perceived impacts. A comparison of quantitative and qualitative results provided a better understanding of how the digital educational intervention enhance nurses professional practice to support safe cannabis use was achieved. The quantitative results show strong engagement with the digital educational intervention, with an increase in the intention of participants in the experimental group to support safe cannabis use by young adults diagnosed with cancer compared to the control group. The qualitative results indicate high acceptability of the digital educational intervention, although some barriers may limit participation. Several perceived impacts on the nurses' professional practices were identified, including: 1) "I am not here to judge anyone, I am here to help and support them"; 2) "It's better for them to have safe self-management to avoid amplifying symptoms"; 3) "Once they have the products and come to ask me how to use them, I’ll be comfortable talking to them"; 4) "It’s something I would like to do more often, but the context is just not there." The mixed-methods results enhanced understanding of how the digital educational intervention has equipped nurses to support safe cannabis use, highlighting the benefits of a diversified and contextualized educational approach. This study demonstrated strong engagement towards participants the digital educational intervention and its positive effects on their intention to support safe cannabis use. It also shows the digital educational intervention’s acceptability and its perceived effect on professional practices. Recommendations are proposed to guide future research on other professional practices and to evaluate the effects of continuing professional development activities.

Despite the success of cancer treatments, persistent and disabling symptoms may still be experienced. Some young adults (15–39 years old) diagnosed with cancer are already incorporating cannabis as a self-management strategy for their symptoms (e.g., nausea). While cannabis use may demonstrate beneficial effects, it may also carry risks of side effects (e.g., dizziness). With their holistic approach, nurses could play a key role in supporting the safe use of cannabis. However, they feel inadequately trained, and no interventions currently exist to support them in this regard. This thesis presents the development of a digital educational intervention, Cannabis & Cancer, aimed at enhancing nurses' professional practice to support safe cannabis use by young adults diagnosed with cancer, as well as the evaluation of its preliminary effects and perceived impacts. A digital educational intervention was developed on a virtual learning platform using the Intervention Mapping framework, combining the Theory of Planned Behavior, the Adult Learning Theory, the concept of engagement, and behavior change techniques. A mixed-methods convergent design (quantitative + qualitative) was used to collect and analyze data. In the quantitative design, a pilot randomized controlled study involved 70 oncology nurses to evaluate the preliminary effects of the digital educational intervention on their engagement, knowledge, attitudes, self-efficacy, and intention. In the qualitative design, a descriptive qualitative study was conducted with 12 nurses to explore their perceptions of the acceptability of the digital educational intervention and its perceived impacts. A comparison of quantitative and qualitative results provided a better understanding of how the digital educational intervention enhance nurses professional practice to support safe cannabis use was achieved. The quantitative results show strong engagement with the digital educational intervention, with an increase in the intention of participants in the experimental group to support safe cannabis use by young adults diagnosed with cancer compared to the control group. The qualitative results indicate high acceptability of the digital educational intervention, although some barriers may limit participation. Several perceived impacts on the nurses' professional practices were identified, including: 1) "I am not here to judge anyone, I am here to help and support them"; 2) "It's better for them to have safe self-management to avoid amplifying symptoms"; 3) "Once they have the products and come to ask me how to use them, I’ll be comfortable talking to them"; 4) "It’s something I would like to do more often, but the context is just not there." The mixed-methods results enhanced understanding of how the digital educational intervention has equipped nurses to support safe cannabis use, highlighting the benefits of a diversified and contextualized educational approach. This study demonstrated strong engagement towards participants the digital educational intervention and its positive effects on their intention to support safe cannabis use. It also shows the digital educational intervention’s acceptability and its perceived effect on professional practices. Recommendations are proposed to guide future research on other professional practices and to evaluate the effects of continuing professional development activities.