Proches aidants en psychiatrie : quelle (in)adéquation entre besoins et offres de soutien ?

INTRODUCTION: Informal caregivers play a vital role in supporting people with severe mental illness. However, this role can leave informal caregivers with significant unmet needs. The aim of this qualitative study is to identify the extent to which the support offered to informal caregivers in adult psychiatry in French-speaking Switzerland meets their needs. METHOD: Individual semi-structured interviews and focus groups were conducted with informal caregivers, mental health professionals, and service providers. The data were analyzed by theme. RESULTS: The need for assistance and the need for information are two themes identified as prevalent among informal caregivers. Despite a consensus on the need for more support and information, informal caregivers, service providers, and health professionals do not assign the same importance to specific aspects of these themes. Suggestions for improving practices at the institutional, socio-political, and civil-society levels are put forward. Given the diversity of viewpoints on the priority needs of informal caregivers, there is a risk of offering support that only partially corresponds to the difficulties encountered by informal caregivers. CONCLUSIONS: Matching support and needs remains a major challenge. Agreeing on a consensual definition of support and information needs and proposing tailored approaches could make it possible to develop support services that meet the actual needs of informal caregivers.

Perspectives of family caregivers, health professionals, and support providers on partnership issues in adult psychiatry / Regards croisés des proches aidants, des professionnels de la santé et des prestataires de soutien concernant les enjeux de partenariat en psychiatrie adulte

Context: Family caregivers play an essential role in the continuity of care for patients with mental health problems. However, the lack of consideration for their role and difficulties in their collaboration with health professionals impact their involvement. Objective: The purpose of this study is to identify the issues underlying the family-professional partnership. Method: A qualitative and exploratory study is used to collect data from providers of support services, family caregivers of patients with psychiatric disorders, and mental health professionals. Semi-structured interviews and focus groups conducted from October 2017 to August 2018 were analyzed to determine key issues surrounding this partnership. Results: A total of thirty-two family caregivers, nine healthcare professionals, and eleven providers participated in the study. The central concerns related to the partnership are information, continuity of care, and the relationship between patients, family members, and professionals. The relational dimension appears to be an important element for all three groups of participants, who nevertheless point out difficulties with regard to their positioning in this tripartite relationship. Discussion/Conclusion: In the context of the current healthcare system, the concept of partnership creates obstacles to family caregivers being able to contribute their expertise while feeling recognized by the other actors.

Contexte: Les proches aidants jouent un rôle essentiel dans la continuité des soins des patients vivant avec des troubles psychiques ; toutefois, les difficultés de collaboration avec les professionnels de la santé impactent leur engagement. Objectif: Cette étude a pour but d'identifier les enjeux qui sous-tendent le partenariat proches- professionnels. Méthode: Un devis qualitatif et exploratoire a permis de collecter les données auprès de prestataires d'offres de soutien, de proches aidants de patients souffrant de troubles psychiatriques et de professionnels en santé mentale. Des entretiens semi-directifs et des focus groups, menés d'octobre 2017 à août 2018, ont été analysés afin de déterminer les enjeux autour du partenariat. Résultats: Au total, 32 proches aidants, 9 professionnels de la santé et 11 prestataires de soutien ont participé à l'étude. L'information, la relation entre patients, proches et professionnels, et la continuité des soins se placent au cœur des préoccupations relatives au partenariat. Discussion/conclusion: Le partenariat est un concept qui engendre des défis dans l'organisation du système de santé actuel afin que les proches aidants puissent apporter leur expertise en se sentant considérés par les autres acteurs.

Physiological effects of Therapeutic Body Wraps in healthy volunteers: An observational study.

INTRODUCTION: The clinical management of severe anxiety is challenging. Along with specific medication, several nonpharmacological treatments exist, among which the Therapeutic Body Wraps (TBW). While TBW is clinically known to be efficient, the absence of objective physiological measurements raised some debates about its harmlessness. AIMS: This observational study investigated TBW in healthy volunteers. METHODS: Measurements were done in 26 participants, who experienced TBW, which consisted of tightly wrapping the body in one layer of wet cold sheets and several warm blankets. These were compared to 13 participants, who rested in supine position. RESULTS: Our results showed increase in the trunk skin temperature by the end of TBW similar to rest. Somatosensory perception as assessed with quantitative sensory testing was stable after both TBW and rest. The heart and breath rates decreased both during TBW and rest. It was accompanied by increase in heart rate variability parameters and decrease in salivary cortisol levels. DISCUSSION: Our data indicate anxiolytic effect of TBW in healthy participants. IMPLICATIONS FOR PRACTICE: The TBW is harmless and might be used in patients, who are unable to relax by themselves and/or without anxiolytic medication. Further studies are necessary to investigate physiological response to TBW in clinical population.

Ability to Care for an Ill Loved One During the First COVID-19 Lockdown: Mediators of Informal Caregivers' Stress in Europe.

Informal caregivers are overlooked, healthcare actors. They are at particular risk of distress and suffer from poor mental health. This study aimed to investigate the perceived stress and modulating factors during the first COVID-19 lockdown in Europe, regardless of the illness that care recipients suffer from. Sociodemographic data, coping resources, and perceived stress level using the Perceived Stress Scale (PSS-10) questionnaire were assessed using a web-based survey in Switzerland, France, and Belgium with 232 informal caregivers. Mediation analyses were used to identify the factors that modulate stress. Higher perceived stress among informal caregivers was associated with a younger age for the care recipient, family relationship with the care recipient, cohabitation, and female sex of the informal caregiver. These associations were partially mediated by the fear of getting ill (age, cohabitation), the conviction that lockdowns had a negative impact on health (age, kinship), and the perceived deterioration of the care recipient's health (gender). The fear of losing the ability to cope with caregiving tasks due to an illness (COVID-19 and/or other) and the negative impact of the lockdown on care recipients' health, particularly on the mental health of young care recipients, increased the stress of informal caregivers. Our results emphasize the importance of informal caregiving support to prevent heightened stress in lockdown conditions, regardless of care recipient illness or kinship.

"It's the First Time I Feel as One". Patients' Experience of Therapeutic Body Wraps in Swiss Public Adult Inpatient Psychiatric Wards.

Many patients suffering from serious mental illness experience severe anxiety, and those with psychosis often report feeling that their bodies are falling apart. Expert opinions reported relational benefits and tranquilizing effects of therapeutic body wraps (TBWs). Yet this adjunct nursing therapy has rarely been studied and the existing knowledge is limited to single clinical cases reported from clinicians' perspectives. This study reports on seven adult patients, whose independent accounts of TBWs were audio-recorded, transcribed and cross-analyzed. It sheds light on a commonly underestimated need among many severely ill psychiatric patients to have their anxiety addressed on a bodily level.