Frances Gallagher

The experience of adults with multimorbidity: a qualitative study

Background Findings from several countries indicate that the prevalence of multimorbidity is very high among clients of primary healthcare. A deeper understanding of patients’ experiences from their own perspective can greatly enrich any intervention to help them live as well as possible with multimorbidity. Objective To describe the fundamental structure of adults’ experience with multimorbidity. Design A phenomenological study was undertaken to describe the experiences of 11 adults with multimorbidity. These adults participated in two semi-structured interviews, the content of which was rigorously analyzed. Results At the core of the study participants’ multimorbidity experience are the impression of aging prematurely, difficulties with self-care management, and issues with access to the healthcare system, which contribute to the problems complexity. Despite these issues, participants with multimorbidity report attempting to take control of their situation and adjusting to daily living. Conclusions The description of this experience, through the systemic vision of participants, provides a better understanding of the realities experienced by people with multimorbidity.

Breast Cancer Screening Program: Experiences of Canadian Women and Their Unmet Needs

The aim of this study was to describe the experiences of women waiting for results from the Québec Breast Cancer Screening Program and their need for support. A qualitative analysis of the interviews generated a description of (a) the experiences and emotions of women waiting for mammogram results and (b) the need for services and psychosocial support that were and were not met. The results revealed a “timeline” of the waiting process experienced by the women, and their unmet informational and psychosocial needs (such as a lack of information about the prediagnosis steps, lack of a resource person, and others).

Supporting parents of preschool children in adopting a healthy lifestyle.

BackgroundChildhood obesity is a public health epidemic. In Canada 21.5% of children aged 2–5 are overweight, with psychological and physical consequences for the child and economic consequences for society. Parents often do not view their children as overweight. One way to prevent overweight is to adopt a healthy lifestyle (HL). Nurses with direct access to young families could assess overweight and support parents in adopting HL. But what is the best way to support them if they do not view their child as overweight? A better understanding of parents’ representation of children’s overweight might guide the development of solutions tailored to their needs.Methods/designThis study uses an action research design, a participatory approach mobilizing all stakeholders around a problem to be solved. The general objective is to identify, with nurses working with families, ways to promote HL among parents of preschoolers. Specific objectives are to: 1) describe the prevalence of overweight in preschoolers at vaccination time; 2) describe the representation of overweight and HL, as reported by preschoolers’ parents; 3) explore the views of nurses working with young families regarding possible solutions that could become a clinical tool to promote HL; and 4) try to identify a direction concerning the proposed strategies that could be used by nurses working with this population. First, an epidemiological study will be conducted in vaccination clinics: 288 4–5-year-olds will be weighed and measured. Next, semi-structured interviews will be conducted with 20 parents to describe their representation of HL and their child’s weight. Based on the results from these two steps, by means of a focus group nurses will identify possible strategies to the problem. Finally, focus groups of parents, then nurses and finally experts will give their opinions of these strategies in order to find a direction for these strategies. Descriptive and correlational statistical analyses will be done on the quantitative survey data using SPSS. Qualitative data will be analyzed using Huberman and Miles’ (2003) approach. NVivo will be used for the analysis and data management.DiscussionThe anticipated benefits of this rigorous approach will be to identify and develop potential intervention strategies in partnership with preschoolers’ parents and produce a clinical tool reflecting the views of parents and nurses working with preschoolers’ parents.

Specific needs of families of young adults with profound intellectual disability during and after transition to adulthood: What are we missing?

INTRODUCTION At the age of 21, the trajectory of services offered to youth with profound intellectual disability (ID) change significantly since access to specialised services is more limited. Despite the desire of parents to avoid any impact on their child, several factors can influence the course of this transition. However, there is little research on facilitators and obstacles to the transition to adulthood, and impacts on people with a profound ID. It is therefore difficult to provide solutions that meet their specific needs. OBJECTIVE The study aimed to document the needs of parents and young adults with profound ID during and after the transition to adulthood by exploring their transitioning experience and factors that influenced it. METHOD Using a descriptive qualitative design, two individual semi-structured interviews were conducted with fourteen (14) parents of young adults aged between 18 and 26 with a profound ID. RESULTS At this point, many material, informative, cognitive and emotional needs of young adults and their parents are not met. Obstacles, mainly organisational, persist and result in a particularly difficult transition to adulthood experience. CONCLUSION By knowing the specific needs of these families, it is possible to develop and implement solutions tailored to their reality. WHAT THE PAPERS ADDS?: The transition to adulthood is a critical period for families with young adults with an intellectual disability (ID), a reality observed internationally. Current literature on all levels of ID suggests some barriers to transition that lead to negative impacts on both parents and young adults with ID. However, presently, very little research exists on the reality of families of young adults with profound ID and factors influencing transition to adult life. Most of studies target people with mild to moderate ID. Considering the significant disabilities of people with profound ID, it is possible to imagine that their experience of transition will be even more difficult and they will present specific needs. The lack of understanding of these needs makes it difficult to introduce solutions tailored to their reality. The results of this current study suggest that many needs of young adults with profound ID and their parents are not met despite existent transition planning services. Transition to adulthood seems particularly difficult for these families who face many challenges. Parents in this study proposed different obstacles during transition to adulthood that could be improved for creation of future solutions adapted to their reality.

Scoping review of social participation of individuals with profound intellectual disability in adulthood: What can I do once I finish school?

ABSTRACT Background: After 21 years of age, adults with a profound intellectual disability (PID) have limited access to specialised services. An important concern that emerges is the potential decrease in their social participation. Knowing the benefits of social participation for adults with PID, it is relevant to address this issue. Method: This scoping review examined the literature on the social participation of people with PID in young adulthood and its influential factors. Results: Results suggest a significant lack of information concerning social participation of these adults. During adulthood, people with PID have currently two main choices to occupy their days: activities in daily activities centre and leisure in community organisation. Few options to maintain their capabilities are available, and this situation has significant impacts on young adults and their families. Conclusion: Future studies focusing specifically on adults with PID and their caregivers are needed to understand their reality when entering adulthood.

How to report professional practice in nursing? A scoping review

BackgroundNursing professional practice in different contexts of care has been widely described in evidence-based literature. Currently, there is no consensus on a common structure for these descriptions. Understanding and comparing similar practices is made difficult by the varying nature of descriptions provided in scientific literature. Purpose of the study: 1) to report research methods found in the scientific literature that were used to describe the practice of different health professionals; 2) to report on the main concepts used to describe the practice of these health professionals; 3) to propose a structure for the description of the practice in nursing.MethodsA scoping review following a five-stage approach: 1) identifying the research question; 2) identifying relevant studies; 3) selecting studies; 4) charting data; 5) reporting results. The Medline, CINAHL, psychARTICLES, psyCRITIQUES, psycEXTRA, Psychology and Behavioral Science Collection and psycINFO databases were searched. Each study was analyzed and extracted data were classified by categories and structures used to describe the health professional practices.ResultsForty-nine studies were included. In these studies, quantitative, qualitative or mixed methods were used to describe professional practice in different health disciplines. Three major concepts were reported most frequently in describing professional practice: roles, domains and activities. The concepts varied greatly among authors. We found that to define roles or to characterize a professional practice, activities must be described and organized on the basis of different domains.ConclusionsA promising structure for describing nursing professional practice is proposed by the authors of this review. The structure facilitates the accurate description of all domains and activities performed by nurses in different contexts of practice, and will contribute to the development of knowledge about nursing practice in different contexts based on shared concepts.

Gestion de la douleur chronique par les infirmières des Groupes de médecine de famille

Family medicine groups have recently been implemented in Quebec and represent a new organizational model for the provision of health care. These multidisciplinary groups are central to the treatment of chronic health conditions, including chronic pain. This questionnaire-based survey was conducted in Quebec to determine the roles of nurses working in family medicine groups with regard to the treatment of patients with chronic pain, and aimed to identify barriers to performing these roles.

Validity as a social imperative for assessment in health professions education: a concept analysis

Assessment can have far‐reaching consequences for future health care professionals and for society. Thus, it is essential to establish the quality of assessment. Few modern approaches to validity are well situated to ensure the quality of complex assessment approaches, such as authentic and programmatic assessments. Here, we explore and delineate the concept of validity as a social imperative in the context of assessment in health professions education (HPE) as a potential framework for examining the quality of complex and programmatic assessment approaches.

Knowledge and Beliefs about Chronic Non Cancer Pain Management for Family Medicine Group Nurses.

To provide effective care for chronic pain sufferers, nurses must have a knowledge of chronic pain management. In Quebec, nurses working in Family Medicine Groups (FMGs) could play a major role in helping patients with chronic noncancer pain (CNCP); however, the extent of their knowledge about CNCP management is unknown. The primary goal of this study was to explore the knowledge and beliefs of FMG nurses about CNCP management. The secondary goal was to explore the obstacles seen by these nurses as preventing them from performing CNCP management. We used a mixed-methods design with quantitative preponderance. Fifty-three FMG nurses answered a self-administered mail-in questionnaire. A rigorous data collection method was used. FMG nurses have suboptimal knowledge about CNCP management. They identify their lack of training and lack of knowledge as major obstacles to conducting pain management interventions. There is a need for pain management training specifically designed around the realities of FMG nursing.

Nursing Activities for Patients With Chronic Disease in Primary Care Settings: A Practice Analysis

Background Nurses in primary care organizations play a central role for patients with chronic disease. Lack of clarity in role description may be associated with underutilization of nurse competencies that could benefit the growing population of patients with chronic disease. Objective The purpose of the research was to describe nursing activities in primary care settings with patients with chronic disease. Methods A Web-based survey was sent to nurses practicing in Family Medicine Groups in the Canadian Province of Québec. Participants rated the frequency with which they carried out nursing activities in five domains: (a) global assessment, (b) care and case management, (c) health promotion, (d) nurse–physician collaboration, and (e) planning services for patients with chronic disease. Findings were summarized with descriptive statistics (means, standard deviations, and ranges). Results The survey was completed by 266 of the 322 nurses who received the survey (82.6%). Activities in the health promotion and global assessment of the patient domains were carried out most frequently. Planning services for patients with chronic disease were least frequently performed. Discussion This study provides a broad description of nursing activities with patients with chronic disease in primary care. The findings provide a baseline for clinicians and researchers to document and improve nursing activities for optimal practice for patients with chronic disease.