[Pain assessment for children and adolescents with autism spectrum disorders (ASD): A systematic review]. / Évaluation de la douleur des enfants et adolescents avec troubles du spectre de l'autisme : une revue systématique.

OBJECTIVE: Pain in children and adolescents with autism spectrum disorders remains underdiagnosed due to their inherent communication difficulties. The goal of this review is to identify the most suitable methods for assessing pain in this population and for evaluating the specific perceptions of, or behavioural reactions to, pain whilst considering disorder severity and specifiers (with or without accompanying intellectual impairment, with or without accompanying language impairment). METHOD: A systematic review and analysis of the international literature was conducted. RESULTS: Fourteen studies were selected. No difference was found in pain-related behaviours based on the age or gender of children or adolescents with autism. Three studies showed pain-related behaviours in autism spectrum disorders to be similar to control groups. Other studies showed specific behavioural responses in autism spectrum disorders with a longer physiological and behavioural recovery time associated with an episode of acute pain in this population. Similarly, the three studies that focused on sensory perceptions of pain all showed differences in the autism spectrum disorders population compared to control groups. In hospital or daily life contexts, studies essentially showed idiosyncratic expressions, hypervigilance, motor agitation, negative emotional reactions, or vocalizations. Regarding the association of autism severity with hyposensitivity to pain, the results remain unclear even when language disorders or intellectual disabilities are also present (in conjunction with autism). The Non-Communicative Children Pain Checklist and its translation into French and Italian showed good internal validity and was used by almost half of the studies in hetero-assessment, mostly by parents. Studies recommend the inclusion of parents in the assessment in order to optimise the evaluation process. Similarly, analysis of parent/child/caregiver interviews from the studies highlights the importance of personalizing pain assessment of children and adolescents, taking into account subject-specific characteristics, pathology, and context. CONCLUSION: An integrative and personalized approach to pain assessment appears to be the most appropriate for enhancing the understanding and detection of pain in individuals with autism spectrum disorders. This approach aligns well with a care setting where a nominated professional with a good expertise in autism is responsible for pain assessment. Given the complexity of identifying pain in individuals with autism, further qualitative studies, in conjunction with new pain exploration technologies, are considered necessary as well as a more extensive categorization of the population studies.

Using the Delphi method to develop a clinical skills assessment tool for advanced practice nurses in psychiatry and mental health / Élaboration d'un outil d'évaluation des compétences en stage des étudiants infirmiers en pratique avancée, mention psychiatrie et santé mentale à partir d'une méthode Delphi

Introduction: In France, advanced practice for psychiatric and mental health nurses has been developing since 2019. The acquisition of clinical skills by advanced practice nursing students requires monitoring and evaluation. This article outlines the process for creating an internship logbook. Objective: To develop and verify a tool for assessing the skills of advanced practice nursing students specializing in psychiatry and mental health during the internship stage. Method: The Delphi method described by Hasson was used, with the aim of obtaining a consensus of over 80% of the experts consulted. Results: A panel of ten experts, all internship tutors at partner healthcare establishments of Aix Marseille University, was consulted twice. The internship logbook was composed of 68 items. Discussion: This tool is the product of a multidisciplinary process including nurses and psychiatric nurses. It can be adapted to a variety of learning environments and helps tutors track the acquisition of clinical skills during the internships, both through external and self-assessment. Conclusion: A new Delphi consultation will foster uptake of this tool. Advanced practice nurses in psychiatry and mental health will be included in the group of experts.

Evaluation of the implementation of advanced practice nursing roles in France: A multiple case study.

AIMS: The aims of the study were to describe the processes used to introduce advanced practice nursing roles and factors that facilitated or hindered role implementation, examine the time advanced practice nurses (APNs) spend in role activities and how these activities relate to domains of advanced practice nursing and examine how implementation processes influenced APN integration within healthcare teams. DESIGN: A multiple case study was conducted. METHODS: Five cases were included, representing the four population areas approved for advanced practice nursing in France. Data were collected from January to March 2021 using observation, interview and document analysis methods. Data were examined using thematic analysis. RESULTS: Participants included APNs (n = 5), nurses/allied health providers (n = 5), physicians (n = 5), managers (n = 4) and decision-makers (n = 4). Stakeholder engagement and leadership provided by decision-makers, managers, physicians and APNs facilitated role implementation. Poor stakeholder role understanding, uncertain role funding, and the COVID-19 pandemic hindered role implementation. APNs spent the most time in clinical activities. Participants perceived the integration of APNs within the healthcare team and their impact on patient care to be positive. CONCLUSION: Stakeholder engagement and organizational and APN leadership facilitated the implementation of the roles, especially related to team-based patient care. Further efforts are needed to strengthen APN involvement in non-clinical activities and address role barriers. IMPLICATIONS FOR NURSING AND PATIENT CARE: Systematic and system-wide approaches are needed to improve role clarity, role autonomy and health systems integration of APNs. Research should examine patient perspectives about APNs in France. IMPACT: The results highlight how policies can create favourable conditions for advanced practice nursing role implementation in France. Internationally, this study serves as a reminder to APNs and nurse leaders about the strategies for and importance of implementation evaluation to support the optimal development of advanced practice nursing roles. REPORTING METHOD: The study reporting followed the Consolidated Criteria for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Information concerning the application to become an associate professor in the nursing sciences section of the French Conseil national des universités des disciplines de santé (National Council of Universities for Health Disciplines) / Éléments d'informations concernant le dossier de qualification à la fonction de maître de conférences à la section « Sciences infirmières ¼ du Conseil national des universités des disciplines de santé

In 2019, the nursing sciences section of the Conseil national des universités des disciplines de santé was created. One of its missions is to evaluate the applications of candidates wishing to qualify as university professors and associate professors. Qualification authorizes the applicant to apply a competitive examination for the position of university professor or assistant professor at a French university offering a position. The members of the section must assess whether the requirements in terms of research, teaching, and expertise have been met by the candidate so that they can sit the competitive examination. As a result, there are a number of requirements, which it is useful to reiterate in order to enhance the quality of future applications. Only those requirements relating to qualification as a associate professor will be covered here.

En 2019, la section « Sciences infirmières ¼ du Conseil national des universités pour les disciplines de santé a été créée. Parmi ses missions, elle évalue chaque année les dossiers de demande de qualification de maîtres de conférences et de professeurs des universités. La qualification autorise la personne à candidater à un concours de recrutement au poste de maître de conférences ou de professeur des universités dans une université française proposant un poste. Les membres de la section doivent apprécier si les requis en termes de recherches, d'enseignements et d'expertises sont suffisants pour pouvoir présenter le concours. De ce fait, certaines exigences sont attendues, qu'il paraît nécessaire de rappeler pour favoriser un gain en qualité des futurs dossiers de candidature. Seules les exigences relatives à la qualification aux fonctions de maître de conférences seront traitées ici.

Development, evaluation and adaptation of a critical realism informed theory of procedural pain management in preterm infants: The PAIN-Neo theory.

AIM: To present the development, evaluation and adaptation of the PAIN-Neo theory. DESIGN: Theory development. DATA SOURCES: A review of literature was conduct from 1980 to 2021. RESULTS: Using a critical realism paradigm, this paper presents the PAIN-Neo theory, which was developed from an analysis of existing theoretical perspectives on paediatric procedural pain, empirical studies conducted with preterm infants, and the research team's pain management expertise. The theory was then empirically tested and fine-tuned. IMPLICATIONS FOR NURSING: The PAIN-Neo theory highlights that the neonatal nurse is part of a larger picture as she is influenced by factors related to her unit, hospital and country of practice. This theory emphasizes the importance of parental involvement in pain management, which is consistent with family-centred nursing practices. CONCLUSION: The PAIN-Neo theory reflects the complexity of pain management nursing. This theory is innovative and specific enough to guide practice, structure research projects and contribute to the body of knowledge in the discipline of nursing.

[Role of the advanced practice nurse in the management of patients with coronary artery disease]. / Rôle de l'infirmière en pratique avancée dans la prise en charge des patients atteints de maladie coronarienne.

Cardiovascular disease is the leading cause of death in the world and the second leading cause of death in France. Patients with coronary artery disease have a high risk of recurrence. Nevertheless, by acting on health determinants and secondary prevention, it is possible to reduce the risks. With the development of advanced nursing practice, a new professional with specific skills can take charge of and accompany people with this pathology. This player works in an interdisciplinary manner to provide holistic and optimal patient care.

Nurses' Perception of Preterm Infants' Pain and the Factors of Their Pain Assessment and Management.

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.

Work environment and mental health in nurse assistants, nurses and health executives: Results from the AMADEUS study.

AIM: This study aimed to explore work environment and mental health in nurse assistants, nurses and health executives in a national large-scale study. BACKGROUND: We have data for physicians but not for other health care workers categories. METHODS: A total of 6935 participants were recruited between May and June 2021 by professional mailings and professional networks. RESULTS: All professional categories reported high rates of high psychological demand (>90%), low social support (>60%), burnout (50% to 60%), exposure to potentially morally injurious events (>40%) and depression (approximately 30%). Surgery nurses reported the highest exposure to potentially morally injurious events. Major depression was identified in approximately 30% of participants in all categories, but less than 10% reported consuming antidepressants. A total of 31% to 49% of participants reported sleep disorders and 16% to 21% reported consuming regularly hypnotics. Physicians reported high hazardous drinking behaviour and nurse assistant high smoking rates. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: Our results suggest that preventing burnout and depression in health care workers is a priority. To reach this goal, nursing managers could develop some interventions to reduce psychological demand and increase personal accomplishment and social support between colleagues, and prevent sustained bullying at the workplace and health risk behaviours. These interventions should be further developed and evaluated.

[Influence of the work environment on burn-out and depression in nurses]. / Influence de l'environnement de travail sur le burn-out et la dépression des infirmiers.

Burn out is defined as a state of psychological exhaustion in the face of an unfavourable work environment. In the health sector, this includes, among other things, an excessive care burden, the lack of autonomy or control over work, the vicious circle of absenteeism, the lack of support, moral and sexual harassment, discrimination or the Covid-19 health crisis. Burn-out also increases the risk of depression among care workers.

French translation and preliminary psychometric validation of a skin-to-skin contact instrument for nurses (SSC-F).

PURPOSE: To translate and conduct the preliminary psychometric validation of a skin-to-skin contact instrument in French (SSC-F) with a sample of nurses from Quebec and France working in neonatal intensive care units. METHODS: The 20 items of the SSC instrument containing four subscales (knowledge, attitudes and beliefs, training and education and implementation), developed by Vittner et al. (2017), was translated into French. The methodological steps used for psychometric validation included assessment of the item and subscale normality distributions, assessment of reliability using internal consistency, and assessment of validity using inter-item and inter-scale correlations and principal component analysis. RESULTS: The preliminary psychometric validation showed that all four subscales of the French version had adequate internal consistency (0.61-0.77), supporting the calculation of a total score for each subscale based on the English version of the instrument. The structural validity was supported by principal component analysis findings. PRACTICE IMPLICATIONS: Based on the findings of the preliminary psychometric validation of our study, the SSC-F instrument could be used in research with French-speaking neonatal nurses in Western countries, but gathering more evidence about its reliability and validity is warranted for clinical practice.

French Translation, Adaptation, and Initial Validation of the Nurses' Attitudes and Perceptions of Pain Assessment in Neonatal Intensive Care Questionnaire (NAPPAQ).

PURPOSE: The purpose of this study was to translate, adapt and conduct initial psychometric validation of the French version of the Nurses' Attitudes and Perceptions of Pain Assessment in neonatal intensive care Questionnaire (NAPPAQ) developed by Polkki in 2010. BACKGROUND: Assessing nurses' perceptions, attitudes and knowledge about pain management in preterm infants is important to improve neonatal practices. METHODS: A sample of French-speaking nurses (n = 147) from Quebec and France working in neonatal intensive care was selected to validate the 46-item questionnaire. A French translation of the NAPPAQ, which includes Part I and II, was undertaken prior to its administration. The FIPM questionnaire was added as a Part III. Internal consistency and instrument structure were examined using Cronbach's alphas, inter-item and inter-scale correlations and exploratory factor analysis. RESULTS: The NAPPAQ-FIPM is divided into three parts. Part I of the French version had a Cronbach's alpha of 0.64 and was composed of five factors. Part II had good total internal consistency (0.79) and adequate structure, established by inter-item correlations. Part III had good total internal consistency (0.76), and factor analysis findings suggested the presence of five factors. CONCLUSIONS: The NAPPAQ-FIPM can be used for research purposes. Parts II and III obtained adequate psychometrics results. However, further refinement of Part I could improve its content and internal structure.

[An exploratory study of hospital stakeholders' perceptions on the introduction of advanced practice nurses]. / Étude exploratoire de la perception des parties prenantes hospitalières vis-à-vis de l'implantation des infirmiers en pratique avancée.

Introduction : One solution proposed by the authorities to address public health issues is to deploy a new category of professionals with a greater range of skills : advanced practice nurses (APNs). The literature identifies the complexity of the deployment projects of these professionals. The PEPPA model approved by the International Council of Nurses is the reference model for the introduction of APNs. The objectives of this study were to explore various stakeholders' perceptions on the introduction of APNs into health institutions, in order to propose recommendations to support the institutions.Method : A multicenter qualitative study was conducted in France's Provence-Alpes-Côte d'Azur region with physicians, managers, nurses, patients, and advanced practice students.Results : APNs are beneficial for patients and the health system, but their introduction into health institutions brings with it risks, primarily linked to their integration. APN introduction projects need to be well planned and should prioritize their integration.Discussion : Results consistent with the PEPPA model identified seven recommendations to facilitate the successful introduction of APNs into hospitals.Conclusion : This work needs to be continued with studies related to the out-of-hospital setting and the evaluation of the successfulness of APNs' introduction.

The creation and implementation of advanced practice nursing in France: Experiences from the field.

AIM: This paper describes the characteristics of the new advanced practice nursing roles in France, as well as their challenges and perspectives, and compares the French model with the recommendations of the International Council of Nurses. BACKGROUND: Advanced practice nursing is particularly well established in English-speaking countries. Since 2018, France has become the second French-speaking region to legalize and regulate advanced practice nurses. SOURCE OF EVIDENCE: The International Council of Nurses and French government websites, and scientific databases (PubMed, CINALH, Cochrane Library) were explored. Feedback from French nursing academics was also requested. DISCUSSION: The advanced practice nursing model in France is described according to the scope and conditions of professional practice. The educational program leads to a State diploma with master's degree, which it is mandatory to be a registered nurse. Remuneration depends on the sector of practice in the public hospital, primary care or private sector. Although there is no national strategy for the implementation of advanced practice nursing roles, research projects are being initiated to guide and evaluate the practice. Based on concordance analysis with the recommendations of the International Council of Nurses, the French advanced practice nursing model appears to be similar to the nurse practitioner model. CONCLUSION: Adjustments in the scope of practice and education can be expected as the implementation of these roles is evaluated. IMPLICATIONS FOR NURSING PRACTICE: This is a historical evolution of the nursing profession in France, for which communication with patients and healthcare professionals is essential. IMPLICATIONS FOR NURSING POLICY: The implementation of advanced practice nursing roles in clinical settings requires the development of national strategies to support initiatives and ensure the sustainability of these roles.

'Adolescents are reckless': Representations at stake in the construction of the relationship of trust in paediatric diabetology.

A total of 10 focus groups were held with adolescents living with diabetes, their parents and health professionals in order to explore their needs in therapeutic education. The analysis showed that the relationship of trust was a central concern for a number of participants. Several adults were divided between a feeling of confidence inspired by the need to empower adolescents to cope with the chronic condition and a sense of distrust inspired by the idea of carelessness and irresponsibility thought to characterize adolescence. Adolescents, for their part, seemed relatively clear-sighted about how they can be perceived, and blamed adults for not trusting them. These findings emphasize the importance of considering the representations at stake in the dynamics of the therapeutic relationship in order to better understand the construction of the relational climate.

Étude exploratoire de la perception des parties prenantes hospitalières vis-à-vis de l'implantation des infirmiers en pratique avancée.

Introduction : One solution proposed by the authorities to address public health issues is to deploy a new category of professionals with a greater range of skills : advanced practice nurses (APNs). The literature identifies the complexity of the deployment projects of these professionals. The PEPPA model approved by the International Council of Nurses is the reference model for the introduction of APNs. The objectives of this study were to explore various stakeholders' perceptions on the introduction of APNs into health institutions, in order to propose recommendations to support the institutions.Method : A multicenter qualitative study was conducted in France's Provence-Alpes-Côte d'Azur region with physicians, managers, nurses, patients, and advanced practice students.Results : APNs are beneficial for patients and the health system, but their introduction into health institutions brings with it risks, primarily linked to their integration. APN introduction projects need to be well planned and should prioritize their integration.Discussion : Results consistent with the PEPPA model identified seven recommendations to facilitate the successful introduction of APNs into hospitals.Conclusion : This work needs to be continued with studies related to the out-of-hospital setting and the evaluation of the successfulness of APNs' introduction.