Lucie Vézina

Evaluation of a Prevention Program for Violence in Teen Dating Relationships

Dating violence prevention programs have been implemented since the 1980s but there is still a shortage of studies evaluating these programs. There are even fewer studies for programs targeting teens. The objectives of this study were to evaluate the effectiveness of a primary prevention program on dating violence for teens and to compare two different program formats while carefully observing whether particular individuals such as boys or students with negative attitudes at pretest showed any deterioration in their attitudes. The programs effectiveness was demonstrated with boys (N = 222) and with girls (N = 295) from two different schools.

History of family dysfunction and perpetration of dating violence by adolescent boys: a longitudinal study

PURPOSE To examine whether there is a direct or a mediated association between dysfunctional parental behavior in later childhood and involvement in dating violence in a sample of low socioeconomic-status boys during mid-adolescence. METHODS Subjects were 717 boys who participated in a longitudinal study. Data collected at six time periods, beginning at age 10 years and covering a span of 8 years, were analyzed. Dysfunctional parental behavior patterns were defined as perceived harsh parenting practices, laxness of monitoring, and interparental conflict witnessed by the subject. Perpetrated psychological and physical abuse in dating, measured at ages 16 and 17 years, and delinquency, measured at age 15 years, served as dependent measures. All instruments were self-report questionnaires. Multiple regression analysis was used in data analysis. RESULTS Only two variables contributed independently to dating violence. Boys who perceived laxness of monitoring from their parents in their late childhood and reported antisocial behavior at age 15 years, such as delinquency and substance abuse, were at risk of becoming involved in violent dating relationships at age 16 years. Harsh parenting practices from ages 10 to 12 years were also predictors of dating violence. CONCLUSIONS A direct relationship was found between harsh parenting and antisocial behavior and later dating violence. No support was found for the mediation hypothesis of antisocial behavior, but an indirect influence was noted in association with monitoring.

Impact of an Educational Program on Pain Management in Patients With Cancer Living at Home

PURPOSE/OBJECTIVES To assess the effect of an educational homecare program on pain relief in patients with advanced cancer. DESIGN Quasi-experimental (pretest post-test, nonequivalent group). SETTING Four community-based primary care centers providing social and healthcare services in the Quebec City region of Canada. SAMPLE 80 homecare patients with advanced cancer who were free of cognitive impairment, who presented with pain or were taking analgesics to relieve pain, and who had a life expectancy of six weeks or longer. METHODS The educational intervention included information regarding pain assessment and monitoring using a daily pain diary and the provision of specific recommendations in case of loss of pain control. Pain intensity data were collected prior to the intervention, and reassessments were made two and four weeks later. Data on beliefs were collected at baseline and two weeks. All data were collected by personal interviews. MAIN RESEARCH VARIABLES Patients beliefs about the use of opioids; average and maximum pain intensities. FINDINGS Patients beliefs regarding the use of opioids were modified successfully following the educational intervention. Average pain was unaffected in the control group and was reduced significantly in patients who received the educational program. The reduction remained after controlling for patients initial beliefs. Maximum pain decreased significantly over time in both the experimental and control groups. CONCLUSIONS An educational intervention can be effective in improving the monitoring and relief of pain in patients with cancer living at home. IMPLICATIONS FOR NURSING Homecare nurses can be trained to effectively administer the educational program during their regular homecare visits.

Patient, primary care physician and specialist expectations of primary care physician involvement in cancer care.

In Canada, many health authorities recommend that primary care physicians (PCP) stay involved throughout their patients’ cancer journey to increase continuity of care. Few studies have focused on patient and physician expectations regarding PCP involvement in cancer care. To compare lung cancer patient, PCP and specialist expectations regarding PCP involvement in coordination of care, emotional support, information transmission and symptom relief at the different phases of cancer. Canadian survey of lung cancer patients, PCPs and cancer specialists A total of 395 patients completed questionnaires on their expectations regarding their PCP participation in several aspects of care, at different phases of their cancer. Also, 45 specialists and 232 community-based PCP involved in these patients’ care responded to a mail survey on the same aspects of cancer care. Most specialists did not expect participation of the PCP in coordination of care in the diagnosis and treatment phases (65% and 78% respectively), in contrast with patients (83% and 85%) and PCPs (80% and 59%) (p < 0.0001). At these same phases, the best agreement among the 3 groups was around PCP role in emotional support: 84% and more of all groups had this expectation. PCP participation in symptom relief was another shared expectation, but more unanimously at the treatment phase (p = 0.85). In the advanced phase, most specialists expect a major role of PCP in all aspects of care (from 81% to 97%). Patients and PCP agree with them mainly for emotional support and information transmission. Lung cancer patient, PCP and specialist expectations regarding PCP role differ with the phase of cancer and the specific aspect of cancer care. There is a need to reach a better agreement among them and to better define PCP role, in order to achieve more collaborative and integrated cancer care.BackgroundIn Canada, many health authorities recommend that primary care physicians (PCP) stay involved throughout their patients’ cancer journey to increase continuity of care. Few studies have focused on patient and physician expectations regarding PCP involvement in cancer care.ObjectiveTo compare lung cancer patient, PCP and specialist expectations regarding PCP involvement in coordination of care, emotional support, information transmission and symptom relief at the different phases of cancer.DesignCanadian survey of lung cancer patients, PCPs and cancer specialistsParticipantsA total of 395 patients completed questionnaires on their expectations regarding their PCP participation in several aspects of care, at different phases of their cancer. Also, 45 specialists and 232 community-based PCP involved in these patients’ care responded to a mail survey on the same aspects of cancer care.ResultsMost specialists did not expect participation of the PCP in coordination of care in the diagnosis and treatment phases (65% and 78% respectively), in contrast with patients (83% and 85%) and PCPs (80% and 59%) (p < 0.0001). At these same phases, the best agreement among the 3 groups was around PCP role in emotional support: 84% and more of all groups had this expectation. PCP participation in symptom relief was another shared expectation, but more unanimously at the treatment phase (p = 0.85). In the advanced phase, most specialists expect a major role of PCP in all aspects of care (from 81% to 97%). Patients and PCP agree with them mainly for emotional support and information transmission.ConclusionLung cancer patient, PCP and specialist expectations regarding PCP role differ with the phase of cancer and the specific aspect of cancer care. There is a need to reach a better agreement among them and to better define PCP role, in order to achieve more collaborative and integrated cancer care.

Family Physician Involvement in Cancer Care Follow-up: The Experience of a Cohort of Patients With Lung Cancer

PURPOSE There has been little research describing the involvement of family physicians in the follow-up of patients with cancer, especially during the primary treatment phase. We undertook a prospective longitudinal study of patients with lung cancer to assess their family physician’s involvement in their follow-up at the different phases of cancer. METHODS In 5 hospitals in the province of Quebec, Canada, patients with a recent diagnosis of lung cancer were surveyed every 3 to 6 months, whether they had metastasis or not, for a maximum of 18 months, to assess aspects of their family physician’s involvement in cancer care. RESULTS Of the 395 participating patients, 92% had a regular family physician but only 60% had been referred to a specialist by him/her or a colleague for the diagnosis of their lung cancer. A majority of patients identified the oncology team or oncologists as mainly responsible for their cancer care throughout their cancer journey, except at the advanced phase, where a majority attributed this role to their family physician. At baseline, only 16% of patients perceived a shared care pattern between their family physician and oncologists, but this proportion increased with cancer progression. Most patients would have liked their family physician to be more involved in all aspects of cancer care. CONCLUSIONS Although patients perceive that the oncology team is the main party responsible for the follow-up of their lung cancer, they also wish their family physicians to be involved. Better communication and collaboration between family physicians and the oncology team are needed to facilitate shared care in cancer follow-up.

Does a brochure about pathological gambling provide new information

The purpose of the present study is to evaluate whether a brochure on pathological gambling provides new information and knowledge to the general population. A total of 115 randomly chosen people from shopping malls and municipal parks were randomly distributed to control and experimental groups. Results indicated that the brochure provided new information concerning problem gambling, at risk behaviors, and the availability of specialised help.

[Validity 'and Utilities' clinic of a grid observation (PACSLAC-F) to evaluate the pain in seniors with dementia's living in the Long-Term Care ].

This study presents the validation of the French Canadian version (PACLSAC-F) of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Unlike the published validation of the English version of the PACSLAC, which was validated retrospectively, the French version was validated prospectively. The PACSLAC-F was completed by nurses working in long-term care facilities after observing 86 seniors, with severe cognitive impairment, in calm, painful or distressing but non-painful situations. The test-retest and inter-observer reliability, the internal consistency, and the discriminent validity were found to be satisfactory. To evaluate the convergent validity with the DOLOPLUS-2 and the clinical relevance of the PACSLAC, it was also completed by nurses during their work shift, with 26 additional patients, for three days per week during a period of four weeks. These results encourage us to test the PACSLAC in a comprehensive program of pain management targeting this population.

From hospital to home after cardiac surgery: evaluation of a community nursing care management model.

Purpose/objectives This quasi-experimental research aims to (1) evaluate the implementation process of a community nursing care management model and (2) assess the effects of this model on patients followed at home. Primary practice setting Two community healthcare centers had introduced a community nursing care management model in their practice (experimental groups), whereas another health community care center with no experience with such a model served as a control group. The community nursing care management model included clinical pathways designed for a clientele who had been hospitalized for cardiac surgery. Findings/conclusions Even though the implementation process was challenging, the community nursing care management model was found useful enough to be integrated into routine nursing home care practice after cardiac surgery. Although the effects produced by this systematic home care program on the clientele did not differ significantly from those produced by usual nursing care, there was a positive effect for the clientele recorded on all measurement indicators used. Implications for case management practice The introduction of the nursing care management model enabled nurses to structure the care provided and reduced interindividual variation. The application of this program also proved to be an opportunity to initiate and assimilate new professional roles. Additional studies should be conducted to assess its effectiveness in home care for other health problems.