[L'impossible quête des préposées aux bénéficiaires pour actualiser la bientraitance visée dans les politiques publiques du Québec.The impossible quest of health care aides to actualize the good treatment targeted in Quebec's public policies.]

Notre recherche visait à mettre en lumière les pratiques bientraitantes des préposées aux bénéficiaires en milieux d'hébergement pour aînés au Québec. L'objet de l'article est de faire ressortir la dichotomie entre les définitions de la bientraitance et son opérationnalisation. Dans la première partie, la notion de bientraitance dans le cadre de deux politiques gouvernementales québécoises est présentée. Ensuite, il est question du travail des préposées aux bénéficiaires en tant que vectrices de cette bientraitance dans la pratique. La troisième partie présente les résultats de notre recherche qui viennent soulever trois constats remettant en cause l'applicabilité des politiques publiques en cette matière : l'absence de reconnaissance d'un métier par définition bientraitant; les injonctions normatives à l'encontre du sens attribué à la bientraitance, et les obstacles organisationnels et sociopolitiques à la bientraitance. Ces constats sont réexaminés à la lumière des écrits dans la discussion, laquelle ouvre sur la notion de maltraitance organisationnelle.

[Le programme Participe-présent auprès d'aînés vivant avec une problématique de santé mentale ou des difficultés psychosociales affectant leur participation communautaire : résultats d'une étude pilote sur sa faisabilité].

Les aînés qui vivent avec des problèmes de santé mentale ou des difficultés psychosociales sont souvent isolés et marginalisés. Le programme Participe-présent a été développé dans le but de promouvoir leur participation communautaire. Les objectifs de cette étude étaient de 1) décrire la pertinence, l'acceptabilité, et la faisabilité du programme lors de sa mise à l'essai et 2) d'explorer les bienfaits et les effets à court-terme du programme pour les participants. Vingt-trois aînés, quatre animateurs et trois responsables provenant de quatre organismes ont participé à l'étude. Les aînés ont été satisfaits de leur expérience de participation au programme et ont rapporté une meilleure connaissance des ressources et une plus grande satisfaction à l'égard de leur vie sociale. Les animateurs et les responsables d'organismes ont souligné l'adaptabilité de Participe-présent aux besoins de leur clientèle et à leur contexte de pratique, et ont identifié les facilitateurs et les obstacles à sa mise en œuvre. D'autres études mèneront à des recommandations favorisant le succès de la mise en œuvre de Participe-présent dans différents contextes.

'Good Treatment' in Residential Care Settings in Quebec: Meanings, Practices and Conditions.

The concept of 'bientraitance'(good treatment) of older adults was introduced in Quebec policy a few years prior to the pandemic, and its significance from the perspectives of those directly involved in care remains underexplored. Centring these perspectives, this article presents findings from a study of the meanings, practices and conditions of good treatment. Data was collected at three different residential care settings through world cafés with residents, staff, management, volunteers and family members (n = 61) and through interviews with care aides (n = 13). The study results indicate that those directly involved in care identify good treatment as fundamentally oriented towards developing and maintaining good relationships with residents; as contingent upon interpersonal, material, and organizational factors; and as requiring (more) time. Given the need for radical reform within Quebec's residential care settings revealed by the pandemic, it is imperative that these perspectives inform the changes introduced.

Sexual Assault Policing and Justice for People With Developmental Disabilities.

The Services and Supports to Promote Social Inclusion of Persons With Developmental Disabilities Act that passed in 2008 was intended to improve services and supports for persons with developmental disabilities in Ontario, Canada. This legislation introduced a new mandatory police reporting policy for any suspected abuse, including sexual assault. While heralded as a significant advancement, questions remain about the policy and the Canadian criminal justice system's capacity to effectively respond to abuse of people with developmental disabilities. Drawing on qualitative interview data with police investigators and Victim Crisis Services employees in Ontario, this article examines how police respond to these reports. The findings highlight the need for more clearly defined protocols and training on these types of sexual assault investigations and increased provision and coordination of appropriate support for victims/survivors with developmental disabilities.

Conceptualizing structural violence in the context of mental health nursing.

This article explores how the intersections of gendered, racialized and neoliberal dynamics reproduce social inequality and shape the violence that nurses face. Grounded in the interviews and focus groups conducted with a purposeful sample of 17 registered nurses (RNs) and registered practical nurses (RPNs) currently working in Ontario's mental health sector, our analysis underscores the need to move beyond reductionist notions of violence as simply individual physical or psychological events. While acknowledging that violence is a very real and disturbing experience for individual nurses, our article casts light on the importance of a broader, power structure analysis of violence experienced by nurses in this sector, arguing that effective redress lies beyond blame shifting between clients/patients and nurses. Our analysis illustrates how assumptions about gender, race and care operate in the context of global, neoliberal forces to reinforce, intensify and create, as well as obscure, structural violence through mechanisms of individualization and normalization.

Profiling the multidimensional needs of new nursing home residents: evidence to support planning.

INTRODUCTION: Nursing home (NH) residents have various needs that affect the care they require. This article describes the diverse needs that new NH residents have, emphasizing the proportion of people with milder needs in multiple areas. METHODS: Research was conducted on all older adults newly admitted to not-for-profit NHs in the Winnipeg Health Region, between April 1, 2005, and March 31, 2007, provided that they were assessed using the Resident Assessment Instrument Minimum Data Set (RAI/MDS 2.0) within 30 days of admission (n = 1061). Using the Activities of Daily Living (ADL) Hierarchy scale, residents were first defined as low, intermediate, or high ADL dependent. Residents' needs were also defined using the RAI/MDS 2.0 cognitive performance (CPS) and pain scales, by their degree of behavioral problems and visual challenges, and by their frequency of bladder and bowel incontinence. Cluster analysis was used to create subgroups of residents by their severity of clinical challenges. RESULTS: Of our cohort, 26.8% were low ADL dependent. Although some of these residents had moderate to severe needs in another area, many (46.8% of low ADL-dependent residents; 12.5% of our entire cohort) had milder needs across all clinical domains. Conversely, about one-third of our cohort was high ADL dependent; 31.7% of these residents had moderate to severe challenges in one clinical domain, and 35.5% had moderate to severe comorbid challenges. CONCLUSIONS: Overall, 12.5% of our cohort had lower needs, demonstrating the capacity for community-based programs to offset NH demands. Also, the diversity of residents' needs highlights the importance of having both the appropriate resources and strategies available to provide quality NH care. Future research is discussed for both low- and higher-need NH residents.