[Vitamin D deficiency and suboptimal immunity : A challenge during Covid pandemia]. / Carence en vitamine D et immunité sous-optimale : un défi en période de Covid.

Vitamin D deficiencies are common throughout the world. In Switzerland, this deficiency affects every populations, including therefore people at risk of COVID-19 complications. Several studies demonstrate a correlation between vitamin D deficiencies and some chronic extraosseous pathologies. This literature review shows a correlation between the seriousness of symptoms, the deaths related to COVID-19 and a status of vitamin D deficiency. The effectiveness of a supplementation with vitamin D to improve those pathologies and limit complications due to COVID-19 is not yet clear because of the various methodological bias of the studies. However, the epidemiological extent of a vitamin D deficiency in our societies requires the coordinated actions of all health professionals in order to meet this public health challenge.

La carence en vitamine D (VitD) est fréquente partout dans le monde. En Suisse, elle touche toutes les populations et, par conséquent, aussi les personnes à risque de complications du Covid-19. Des études relèvent une corrélation entre la carence en VitD et certaines pathologiques extraosseuses chroniques. Cette revue de la littérature montre une corrélation entre la gravité des symptômes, les décès liés au Covid-19 et un statut carencé en VitD. L'efficacité ou non d'une supplémentation en VitD pour améliorer ces pathologies et limiter les complications liées au Covid-19 n'est pas encore claire en raison des multiples biais méthodologiques des études. Néanmoins, l'ampleur épidémiologique de la carence en VitD dans nos sociétés nécessite que tous les professionnels de la santé se coordonnent pour répondre à ce défi de santé publique.

The influence of psychosocial factors on the intention to incorporate complementary and integrative medicine into psychiatric clinical practices.

Complementary and integrative medicine (CIM) can be of great support to individuals suffering from psychiatric conditions; however, it is still rarely incorporated into clinical practice. OBJECTIVE: To examine the influences of psychosocial and sociodemographic factors on health-care professionals' intention to use CIM in their psychiatric clinical practice. METHOD: One-hundred-and-five participants completed a questionnaire developed from an adapted version of Triandis' Theory of Interpersonal Behavior (TIB). Intentions to use CIM (yes or no) were analyzed using logistic regression models. RESULTS: The multivariate model retained three main factors: affect, perceived social norms, and conditions facilitating CIM. These predicted health-care professionals' intention to use CIM with an AUC = 94.7%. RESULTS: underlined that positive affective attitudes towards CIM, feeling that CIM was congruent with professional and institutional goals, and having sufficient skills in CIM were essential to ensuring that health-care professionals would integrate CIM into their clinical practice.

Factors influencing diabetes self-management in adults: an umbrella review of systematic reviews.

OBJECTIVE: The objective of this review was to identify and describe the factors influencing diabetes self-management in adults by summarizing the available evidence concerning their types, categories, and relative importance. INTRODUCTION: A wide range of factors, acting simultaneously, influence diabetes self-management and interfere with its actual application by patients. There is a variety of systematic reviews of these factors; however, a more thorough examination of their influences was lacking. INCLUSION CRITERIA: Systematic reviews of qualitative or quantitative literature focusing on factors influencing adult diabetes self-management in general or on individual behaviors (ie, management of oral antidiabetic medication and insulin injections, self-monitoring of blood glucose, foot care, healthy eating, regular exercise, and smoking cessation) will be included. METHODS: We performed an extensive search of 11 bibliographic databases, including gray literature, up to June 2019. Quantitative and qualitative findings were summarized separately and labeled according to their types (eg, facilitator/barrier, strength and direction of association), categories (eg, demographic, social), and frequency of occurrence. RESULTS: We identified 51 types of factors within 114 systematic reviews, which mostly addressed medication-taking behavior. Thirty-two (62.7%) factors were reported in both qualitative and quantitative literature. The predominant influences were psychological factors and behavioral attributes/skills factors. The most frequently reported facilitators of diabetes self-management were motivation to diabetes self-management, a favorable attitude to diabetes self-management, knowledge about the disease, medication and behaviors associated with diabetes self-management, skills, and self-efficacy/perceived behavioral control. The predominant barriers were the presence of depression, and polypharmacy or drug regimen complexity. The demographic factor of female sex was frequently reported for its negative influence on diabetes self-management, whereas older age was a positive factor. The social/cultural and physical environment were the least-studied categories. Other factors such as social support from family, friends, or networks; interventions led by health professionals; and a strong community environment with good social services favoring diabetes self-management were reported as major facilitators of diabetes self-management. CONCLUSIONS: Essential components of interventions to promote effective diabetes self-management should aim to help adults manage the effects of specific factors related to their psychological and practical self-management experience. Screening for depression, in particular, should become an integral part of the support for adult diabetes self-management, as depression is a particular obstacle to the effectiveness of diabetes self-management. Future studies should more deeply examine the influence of factors identified in the sociocultural and physical environment categories. Research should properly consider and invest efforts in strengthening social support and innovative community care approaches, including pharmacist- and nurse-led care models for encouraging and improving adult diabetes self-management. Finally, researchers should examine non-modifiable factors - age, sex, or socioeconomic status - in the light of factors from other categories in order to deepen understanding of their real-world patterns of action on adult diabetes self-management. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018084665.

The Effects of Hand Massage on Stress and Agitation Among People with Dementia in a Hospital Setting: A Pilot Study.

Agitation in people with dementia is a growing concern as it causes distress for both patients and their nurses and may contribute to relational disorders. Previous studies involving patients with dementia living in long-term care facilities have reported decreased agitation following massage. The objective of this pilot study was to investigate the effect of hand massage on agitation and biological markers of stress in patients with dementia hospitalized in an acute geriatric psychiatry service. In this randomized controlled trial we included 40 agitated patients with dementia with an intervention group and a control group. The study is designed to test the effect of seven hand massages over three continuous weeks on agitation and levels of salivary cortisol (sC) and alpha-amylase (sAA). Compared to the control group, the intervention group exhibited larger increases in sC and sAA at week 1 from before to after the massage, but larger decreases at week 2 and 3, with a significant group effect for sAA at week 2. Agitation scores were not significantly different between the groups but tended to decrease more in the intervention group than the control group. This study provides first encouraging results suggesting that hand massage might have beneficial effects on stress and agitation in hospitalized patients with dementia. It also highlights the challenges associated with conducting such studies with this complex patient population. Further studies are needed to confirm these findings and the benefits of hand massage as part of routine care for patients with dementia.

[Scoping review on the concepts of touch and massage and their effects on agitation and stress in aged hospitalized patients suffering from dementia] / Examen de la portée des connaissances sur les concepts du toucher et du massage et de leurs effets sur l'agitation et le stress des personnes âgées hospitalisées atteintes de démence.

This scoping review examines the effects of touch/massage on agitation and stress in aged hospitalized patients suffering from dementia. This intervention is multidimensional, at the edges of medical neurosciences, nursing sciences, and social sciences. This review is primarily supported by a biological model of social relations, describing the interconnection between cognition, affect, and endocrine aspects of attachment modes. It is also guided by nursing sciences conceptualizations which anchors touch/massage in the heart of nursing practice. The importance of touch/massage and its emotional regulation capacity is discussed in the light of these conceptualizations. The needs for that kind of contact in aged demented inpatients appears to be related to sensory loss and to a lack of emotional and social contacts. Evidence of the benefits of touch/massage is synthesized and indicate that this intervention is sometimes difficult to provide for agitated patients. Finally, proposals are made to develop a scientific agenda in clinical settings in order to continue the development of evidence and thus contribute to better inform nursing practice.

[Agitation in people with dementia : Scoping review and putting the phenomenon into perspective using the comfort theory and the concept of attachment]. / L'agitation chez les personnes atteintes de démence : examen de la portée des connaissances et mise en perspective du phénomène selon la théorie du confort et le concept de l'attachement.

Agitation in hospitalized demented patients is troublesome and disruptive for both patients and caregivers. The literature indicates that agitation is strongly related to physical or psychological discomfort and its recent definition includes the additional relation to emotional distress. Hospitalization associated with major cognitive difficulties further activates the need for attachment and security to which caregivers must pay attention. This synthesis review first deals with the evidence related to agitation in people with dementia and its relationship with discomfort. A description of the difficulties with which caregivers must cope follows. The need to primarily use nonpharmacological approaches during agitation to meet the underlying needs causing discomfort is then developed. Recommended approaches generally involve a relational contact, even if facing the risk of mobilizing frequently unsecured and anxious attachment patterns in this population. A conceptual positioning supported by the Kolcaba comfort theory will position this knowledge. A particular point of this theory, based on previous experiences of patients, will be analyzed based on attachment characteristics of people with dementia.

[The use of touch with a demented elderly resident: multifaceted evidence]. / Toucher un résident âgé atteint de démence: une évidence aux multiples facettes.

BACKGROUND: The use of touch and simple massage are first-line non-pharmacological interventions used in the comprehensive care for the elderly with dementia (EWD). CONTEXT: These acts have positive effects on both the level of anxiety and self-esteem of EWD. Nevertheless, they are not carried out by all caregivers in the same manner. OBJECTIVES: This study seeks to describe the representations of EWD's caregivers and their perceptions of practice of touch with this population. It will also highlight their ways of coping with any difficulties encountered. METHOD: It is based on a qualitative analysis of 31 semi-structured interviews (17 nurses and 14 health care assistants) conducted with caregivers working primarily with elderly patients with dementia. RESULTS: The results indicate that touch, although well integrated in all activities of personal care, is not considered as a care intervention in itself. It is subject to multiple influences. Indeed, on the one hand, the representations those caregivers have of the elderly patient with dementia overlap with those of their roles and skills and change the type of touch and their intentions when they touch. On the other hand, the emotions generated by the "dirty" work and the aggressiveness of the elderly patient with dementia sometimes make it difficult to touch them. DISCUSSION: The perspective of caregivers is essentially self-referenced and touch does not appear as an indicator of institutional norms.