Michelle Proulx

When Is Knowledge Ripe for Primary Care? An Exploratory Study on the Meaning of Evidence

The objectives of this study were to explore the meaning of scientific evidence as it is understood by primary care physicians. Individual interviews were conducted with actors chosen for their roles in the production and use of knowledge: 22 family physicians, 13 specialist physicians, and 6 researchers. Two situations served as points of reference for these discussions: screening for genetic breast cancer and treatment of hypertension. The results suggest that there may be a misunderstanding between the producers of knowledge and primary care practitioners with respect to what constitutes “evidence”— knowledge ready for integration into the clinical practice of primary care. These potential differences go beyond the issues of how information is disseminated. Rather, many of the questions raised by family physicians concern how knowledge is developed. In the interests of fostering better dissemination of new knowledge and encouraging its adoption, new links should be created between knowledge “producers” and potential users.

Experiences and Decisions that Motivate Women at Increased Risk of Breast Cancer to Participate in an Experimental Screening Program

Although the discovery of mutations on BRCA1 and BRCA2 genes associated with high breast cancer risk has given rise to screening and surveillance initiatives, there is little documentation on why high-risk women choose to enter screening programs. The objective of this qualitative study was to develop a detailed understanding of the experiences and decisions that motivate women with increased risk of hereditary breast cancer to participate in the multicentered Quebec experimental breast screening program. Our study involved 21 participants who were either BRCA carriers or at risk and untested. These women were interviewed while participating in the screening program. Our study demonstrates that intensive screening programs may provide valuable reassurance for women with increased familial risk of hereditary breast cancer, who count on early detection and rapid response from professionals if and when a problem arises. Health professionals must take these and others concerns into account to ensure their interventions are most consistent with women’s needs.

Partenariat entre patients, leaders en soins infirmiers et chercheurs : résultats d’une stratégie web de transfert des connaissances pour planifier le congé d’hôpital et faciliter les transitions au cours des soins oncologiques

Un projet de recherche a reuni des patients partenaires, des leaders en soins infirmiers de six milieux cliniques du Quebec ainsi que des chercheurs en vue de developper et tester un outil web, le Portail d’echange des savoirs (PES), afin d’ameliorer les pratiques de planification des conges et les transitions au cours des soins oncologiques. Le projet a debouche sur la creation d’un PES axe sur l’oncologie ouvert a toute la francophonie. Il en a aussi emerge une strategie novatrice de transfert des connaissances (TC) prenant appui sur le PES et alimentee par le travail collaboratif des differents partenaires, parmi lesquels les patients ont tenu un role essentiel. Les resultats ont mis en lumiere l’importance, pour la recherche en sante, de donner la parole a des patients partenaires dans le cadre d’une etroite collaboration avec des cliniciens et des chercheurs, pour que les pratiques cliniques soient mieux adaptees aux besoins reels des patients et de leurs proches.

Partnership between patients, nurse leaders and researchers: Outcomes of a web-based KT strategy for hospital discharge planning and care transitions in oncology

A research project brought together patient partners, nurse leaders from six clinical settings in Quebec and researchers to develop and test a web technology, the Forum for Knowledge Exchange (FKE), in order to improve discharge planning practices and oncological care transitions. The project led to the creation of a FKE accessible to the oncology sector of the Francophonie. It revealed an innovative strategy of knowledge transfer (KT) based on the FKE and was fed by collaborative work among partners, where the patient partners played a vital role. The results highlighted the importance, for health research, of giving a voice to patient partners in close collaboration with clinicians and researchers so that clinical practices are better adapted to the actual needs of patients and of their relatives.

Towards a better understanding of the impact of the sequelae of TBI on the social participation of seniors

Background: The multiple sequelae caused by traumatic brain injuries (TBIs) can considerably reduce the ability of seniors to resume their activities of daily living and their leisure activities, and to return to meaningful relationships so they can participate in the life of their community.

Expérience de fréquentation des lieux publics par des personnes âgées ayant subi un TCC en présence d'un accompagnateur-citoyen: projet pilote.

ABSTRACT:This pilot project aims to test and see the relevance of the direct observation method to collect data on the barriers and facilitators to attending public places by seniors with TBI. The study is based on the conceptual framework VADA WHO which focuses on the development of friendly built and technological environments for seniors. Three elderly people participated in the study, recruited from an ongoing project, The Citizen Intervention in Community Living (APIC), in the presence of their personalized attendant. The study shows the feasibility of the method in terms of its acceptability and resources mobilized. It shows its relevance to access additional data that would have been difficult to obtain using others methods (e.g., semi-structured interview), such as the identification of the strategies used by the participants to address the obstacles encountered (avoidance, travel planning, use of physical and preventative support of the personalized attendant).RÉSUMÉ:Ce projet pilote vise à examiner la faisabilité et la pertinence de la méthode d’observation directe pour étudier les barrières et facilitateurs à la fréquentation de lieux publics par des aînés ayant un TCC. L’étude repose sur le cadre conceptuel VADA de l’OMS, lequel mise sur le développement d’environnements bâtis et technologiquement accueillants pour les aînés. Trois personnes âgées, recrutées à même un projet en cours d’accompagnement-citoyen personnalisé à l’intégration communautaire (APIC), se sont prêtées à des séances d’observations en présence de leur accompagnateur. Les résultats montrent la faisabilité de la méthode sur le plan de son acceptabilité et des ressources mobilisées. Elle laisse voir sa pertinence pour l’accès à des données complémentaires qui auraient été difficilement perceptibles à l’aide d’autres méthodes (comme les entrevues semi-structurées), notamment l’identification de stratégies utilisées par les participants pour contrer les obstacles rencontrés (évitement, planification des déplacements, recours au soutien physique et préventif de l’accompagnateur).

Comment l’analyse profane du risque peut-elle contribuer à l’avancement des savoirs en santé? (Commentaire)

Since World War II, industrialized Western societies have been making significant public investments that have yielded spectacular improvements in the health status of their populations. Yet despite such considerable strides, it is nonetheless evident that lay peoples are expressing both more scepticism than in the past and greater mistrust toward medical science and biomedicine, even as they show increasing concern about health risks. In this article we intend to discuss some of the broader opportunities that the analysis of lay risk perceptions offers for appreciating the concerns of lay peoples about healthrelated issues as well as to provide new insights in population health.