Les grands enjeux actuels de la recherche infirmière / Current issues in nursing research

La profession infirmière est un exemple où la recherche a fait évoluer conjointement, la santé de la population et les pratiques professionnelles dans le monde. "Cette évolution a favorisé l’émergence et l’affirmation d’une culture scientifique au sein du groupe professionnel tout entier". Elle a ainsi fait progresser la pratique fondée sur les preuves et la qualité des soins, tout en prenant en compte l'expertise du patient. Cette démarche demande des compétences spécifiques que les cursus de formations initiales et continues doivent intégrer [leer más en el PDF].(AU)

Reflective writing: Implementation and learning perception from students and teachers of French nursing schools.

To support reflective skills development, French nursing students write analyses of professional situations (Situation Analysis) experienced during their practice. Sixteen nursing schools in Paris have developed a common framework to support and evaluate students on these skills. The aims of the study were to assess and understand the implementation of the Situation Analysis in French nursing schools as well as their effects on students' learning. A quantitative approach was based on two questionnaires: students (n = 1525, 27.6% of participation) and teachers (n = 131, 49.2%). The results showed that there were variations in teaching of situation analysis. There were correlations between the perception of learning and the modalities of implementation. Not always easy to choose, the situations described were authentic for 97.8% of students, concerned mainly their own practice and relationship with patients. Emotional situations were less frequent. Feedback was generally present and encouraging, but not enough on the students' self-evaluation skills. Slightly more than half of students and teachers were satisfied of the situation analysis. Both of them made positive and negative comments. The study highlights what can be improved in teaching to increase student's learning through situation analysis, for example teamdefined objectives.

Characteristics of the skills of caregivers of people with dementia: observational study.

BACKGROUND: Due to demographic change within an aging population as announced by the WHO, the involvement of caregivers is essential. Caregivers are required to change their roles within the family unit. Such life transitions experienced by caregivers to people confronted with dementia-type pathologies are sometimes difficult, necessitating the acquisition and development of certain skills. Few studies have shown that caregivers develop specific and essential skills to promote quality care and safety. To characterize their skills, there is a need to identify the abilities, knowledge, resources, obstacles and constraints that contribute to caregivers' transitions. The research question for this study was: What skills do caregivers use to care for their loved one with dementia? METHODS: Qualitative observational research based on the epistemological paradigm of socioconstructivist knowledge was conducted. The study was carried out in the canton of Geneva and recruitment was carried out through the participation of the Alzheimer's association and the association for the support and assistance of elderly people in medical and social institutions and their families (APAF). Observations and semi-structured interviews were conducted in the homes of 14 family carers caring for their loved one with dementia. The observations were transcribed on observation grids and the interviews were recorded. Subsequently, according to the classic distinction of Denzin (Interpretive interractionism, 2001), we analysed the observation notes and verbatims, then as recommended by Miles et al. (Qualitative data analysis: a methods sourcebook, 2014), two researchers triangulated the results. RESULTS: The results identified five types of situations regularly experienced by caregivers. The study characterized 11 skills that caregivers use to cope with their daily lives. The learning process and maladaptive behaviours in caring for their loved ones with dementia were also highlighted. CONCLUSION: This study was able to point out that today's caregivers have developed more competency than their predecessors. This evolution can be explained by new paradigms of care requiring caregivers to be more involved. Although some caregivers need training, others through their experiences can act upon and provide knowledge. To improve the quality and safety of care for people with dementia, this expertise can be the subject of partnerships between caregivers and health care staff.

Win/win partnerships between Geneva health-related institutions and caregivers of people with dementia: a descriptive cross-sectional study.

BACKGROUND: In the context of an ageing population and an increase in the appearance of chronic diseases, the commitment of caregivers makes it possible for people confronted with disease to remain at home. Over time, they need support to overcome their difficulties. They also show a need for recognition for their participation in the economic maintenance of the health system. To promote this support, so-called "win/win" partnerships are envisaged. Research is needed to identify the building blocks of an innovative intervention. METHODS: A cross-sectional descriptive study was carried out with health institutions in the canton of Geneva to identify the proportion of institutions with a positive opinion on partnership with caregivers. It has also identified potential partnerships with caregivers of people facing dementia and possible compensation in exchange for the provision of their skills. Descriptive statistics are presented according to their frequencies and relative percentages (categorical variables), as well as by their mean, standard deviation and median (continuous variables). Logistic regression models were used to assess the factors associated with a favorable opinion towards win/win partnerships. RESULTS: The proportion of executives of health-related institutions with a positive opinion of partnership with caregivers is high: 74.7% (95% CI: 64.8-83.1%). Several types of potential partnerships have been identified between health institutions and caregivers. Areas in which certain activities have been identified as being able to be carried out by caregivers include governance, care, provision of services, accompaniment and support, training and research. Types of compensation for caregivers have also been highlighted. CONCLUSION: This study shows that some areas activities of health facilities in the canton of Geneva could be the subject of win-win partnerships with caregivers of people with dementia. Positive view of health executives on partnership with caregivers is encouraging. In the future, innovative projects can emerge to meet the needs of each party.

[Determining factors in the use of respite services by caregivers of patients with dementia: Qualitative research using focus groups]. / Déterminants du recours au répit pour les proches aidants de malades atteints de démence.

INTRODUCTION: A changing and aging population contributes to an increase of Alzheimer-type or related dementia. Encouraged by health policies, home care for patients suffering from these conditions is often dependent on their caregivers' contribution. The demands of such a role may weaken the caregivers and cause them a feeling of burden requiring the recourse to periods of respite. An ancillary study of a research program carried out in the Geneva agglomeration, our study aims to characterize, for the caregivers of patients with dementia, the determinants of a recourse to the devices of respite. METHOD: Qualitative research conducted by focus groups of caregivers of patients with dementia. Three focus groups were conducted, with 12 participants in the cities of Geneva (Switzerland) and Rouen (France). RESULTS: Our study notes the concomitance of the evolution of the assisted person's disorder and the emergence of a feeling of burden on the caregiver, related to the duration and the intensity of the aid provided. Our results help to identify the determinants of a recourse to respite periods for the caregiver or institutions and to modelize these determinants. CONCLUSION: Devices of respite must be coordinated and adapted to the needs of caregivers, both in terms of format and quality, in order to facilitate the use of the most vulnerable populations and to avoid too late recourse.

Barriers and enablers in the use of respite interventions by caregivers of people with dementia: an integrative review.

BACKGROUND: Due to the increase in the number of people with dementia, relatives often provide in-home care. This care constitutes a cornerstone of the healthcare system, and maintaining these caregivers' well-being is therefore of paramount importance. Although respite interventions are generally considered an effective support system, they tend to be underutilized. The aim of this integrative literature review is to highlight the factors that promote and impede the use of respite interventions. METHODS: Searches were conducted on the PubMed and CINAHL databases for studies of respite interventions from 1980 to 2016, and they yielded 51 articles of relevance. RESULTS: Analysis of these articles revealed modifiable and immutable factors that influence the use of respite. The most cited topic categories in the literature were attributes of respite services and workload managed by caregivers, which is characterized by the onset of burden. CONCLUSION: The factors promoting or impeding the use of respite interventions identified by our analysis highlight the need to adapt respite service attributes and use caregivers' skills to foster the partnership between healthcare teams and caregivers and to ensure the accompanying dyad's quality and safety.