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Dive into the research topics where Nathalie Champoux is active.

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Featured researches published by Nathalie Champoux.


BMC Geriatrics | 2005

Prevalence of physical and verbal aggressive behaviours and associated factors among older adults in long-term care facilities.

Philippe Voyer; René Verreault; Ginette M Azizah; Johanne Desrosiers; Nathalie Champoux; Annick Bédard

BackgroundVerbal and physical aggressive behaviours are among the most disturbing and distressing behaviours displayed by older patients in long-term care facilities. Aggressive behaviour (AB) is often the reason for using physical or chemical restraints with nursing home residents and is a major concern for caregivers. AB is associated with increased health care costs due to staff turnover and absenteeism.MethodsThe goals of this secondary analysis of a cross-sectional study are to determine the prevalence of verbal and physical aggressive behaviours and to identify associated factors among older adults in long-term care facilities in the Quebec City area (n = 2 332).ResultsThe same percentage of older adults displayed physical aggressive behaviour (21.2%) or verbal aggressive behaviour (21.5%), whereas 11.2% displayed both types of aggressive behaviour. Factors associated with aggressive behaviour (both verbal and physical) were male gender, neuroleptic drug use, mild and severe cognitive impairment, insomnia, psychological distress, and physical restraints. Factors associated with physical aggressive behaviour were older age, male gender, neuroleptic drug use, mild or severe cognitive impairment, insomnia and psychological distress. Finally, factors associated with verbal aggressive behaviour were benzodiazepine and neuroleptic drug use, functional dependency, mild or severe cognitive impairment and insomnia.ConclusionCognitive impairment severity is the most significant predisposing factor for aggressive behaviour among older adults in long-term care facilities in the Quebec City area. Physical and chemical restraints were also significantly associated with AB. Based on these results, we suggest that caregivers should provide care to older adults with AB using approaches such as the progressively lowered stress threshold model and reactance theory which stress the importance of paying attention to the severity of cognitive impairment and avoiding the use of chemical or physical restraints.


International Journal of Geriatric Psychiatry | 2011

Prevalence and incidence of delirium in long‐term care

Jane McCusker; Martin G. Cole; Philippe Voyer; Johanne Monette; Nathalie Champoux; Antonio Ciampi; Minh Vu; Eric Belzile

(1) To describe the prevalence and 6‐month incidence of delirium in long‐term care facility (LTCF) residents age 65 and over; (2) To describe differences in these measures by resident baseline characteristics.


Journal of Geriatric Psychiatry and Neurology | 2000

Review of Outcome Measurement Instruments in Alzheimer's Disease Drug Trials: Psychometric Properties of Functional and Quality of Life Scales:

Louise Demers; Mark Oremus; Anne Perrault; Nathalie Champoux; Christina Wolfson

The psychometric properties of functional and quality of life outcome measures that were used for the purpose of showing changes in antidementia drug trials for Alzheimers disease are described and critiqued. The seven functional scales reviewed for reliability, validity, and responsiveness to change included the Geriatric Evaluation by Relatives Rating Instrument, the Physical Self-Maintenance Scale, the Instrumental Activities of Daily Living, the Blessed Dementia Scale, Part 1 and its revised version, the Interview for Deterioration in Daily Living with Dementia, the Unified Activities of Daily Living, and the Dependence Scale. The Progressive Deterioration Scale and Quality of Life Assessment were classified as quality of life scales. The majority of the scales were found to exhibit serious limitations, such as incomplete reliability and validity assessment for the intended uses. The most pervasive problem was a lack of data on responsiveness to change. It is recommended that further research be conducted to develop new tools or enhance existing measures for the assessment of both quality of life and functional ability. (J Geriatr Psychiatry Neurol 2000; 13:170-180).


Journal of the American Geriatrics Society | 2002

Suboptimal Duration of Antidepressant Treatments in the Older Ambulatory Population of Quebec: Association with Selected Physician Characteristics

Yola Moride; Guillaume Galbaud du Fort; Johanne Monette; Thierry Ducruet; Jean-François Boivin; Nathalie Champoux; Ralph Crott

OBJECTIVES: To assess the association between selected physician characteristics and suboptimal duration of antidepressant use in the older outpatient population.


Journal of the American Geriatrics Society | 2011

Subsyndromal Delirium in Older Long‐Term Care Residents: Incidence, Risk Factors, and Outcomes

Martin G. Cole; Jane McCusker; Philippe Voyer; Johanne Monette; Nathalie Champoux; Antonio Ciampi; Minh Vu; Eric Belzile

To determine the incidence of, risk factors for, and outcomes of subsyndromal delirium (SSD) in older long‐term care (LTC) residents and, secondarily, to explore the use of a more‐restrictive definition of SSD.


International Psychogeriatrics | 2011

Use of nurse-observed symptoms of delirium in long-term care: effects on prevalence and outcomes of delirium.

Jane McCusker; Martin G. Cole; Philippe Voyer; Johanne Monette; Nathalie Champoux; Antonio Ciampi; Minh Vu; Eric Belzile

BACKGROUND Previous studies have reported that nurse detection of delirium has low sensitivity compared to a research diagnosis. As yet, no study has examined the use of nurse-observed delirium symptoms combined with research-observed delirium symptoms to diagnose delirium. Our specific aims were: (1) to describe the effect of using nurse-observed symptoms on the prevalence of delirium symptoms and diagnoses in long-term care (LTC) facilities, and (2) to compare the predictive validity of delirium diagnoses based on the use of research-observed symptoms alone with those based on research-observed and nurse-observed symptoms. METHODS Residents aged 65 years and over of seven LTC facilities were recruited into a prospective study. Using the Confusion Assessment Method (CAM), research assistants (RAs) interviewed residents and nurses to assess delirium symptoms. Delirium symptoms were also abstracted independently from nursing notes. Outcomes measured at five month follow-up were: death, the Hierarchic Dementia Scale (HDS), the Barthel ADL scale, and a composite outcome measure (death, or a 10-point decline in either the HDS or the ADL score). RESULTS The prevalence of delirium among 235 LTC residents increased from 14.0% (using research-observed symptoms only) to 24.7% (using research- and nurse-observed symptoms). The relative risks (and 95% confidence intervals) for prediction of the composite outcome, after adjustment for covariates, were: 1.43 (0.88, 1.96) for delirium using research-observed symptoms only; 1.77 (1.13, 2.28) for delirium using research- and nurse-observed symptoms, in comparison with no delirium. CONCLUSIONS The inclusion of delirium symptoms observed by nurses not only increases the detection of delirium in LTC facilities but improves the prediction of outcomes.


Journal of the American Medical Directors Association | 2012

Detection of delirium and its symptoms by nurses working in a long term care facility.

Philippe Voyer; Sylvie Richard; Jane McCusker; Martin G. Cole; Johanne Monette; Nathalie Champoux; Antonio Ciampi; Eric Belzile

OBJECTIVE To investigate the ability of nurses to recognize delirium and its symptoms and to investigate the factors associated with undetected delirium. DESIGN A prospective, observational study with repeated measurements over a 6-month period. SETTING Seven long term care settings in Montreal and Quebec City, Canada. PARTICIPANTS Residents aged 65 and older, with or without dementia, admitted to long term care (not respite care) and able to communicate in English or French. MEASUREMENTS Delirium and its symptoms were assessed using the Confusion Assessment Method. Ratings of delirium by nurses based on their observations during routine care were compared with delirium ratings by trained research assistants based on a one-time formal structured evaluation (Confusion Assessment Method and Mini Mental State Examination). This procedure was repeated for 10 delirium symptoms. Sensitivity, specificity, and positive and negative predictive values were calculated. The method of generalized estimating equations was used to identify factors associated with undetected delirium. RESULTS Research assistants identified delirium in 43 (21.3%) of the 202 residents. Nurses identified delirium in 51% of the cases identified by the research assistants. However, for cases without delirium according to the research assistants, nurses identified 90% of them correctly. Detection rates for delirium symptoms ranged from 25% to 66.7%. Undetected delirium was associated with lower number of depressive symptoms manifested by the resident. CONCLUSION Detection of delirium is a major issue for nurses. Strategies to improve nurse recognition of delirium could well reduce adverse outcomes for this vulnerable population.


International Psychogeriatrics | 2006

Non-pharmacological interventions for aggressive behavior in older adults living in long-term care facilities

Philippe Landreville; Annick Bédard; René Verreault; Johanne Desrosiers; Nathalie Champoux; Johanne Monette; Philippe Voyer

BACKGROUND Aggressive behavior (AB) is common in institutional settings. It is an important issue because of its consequences on both the person manifesting such behaviors and their caregivers. Although there are numerous studies assessing non-pharmacologic strategies to manage AB in older adults, no extensive review of the literature is available. This review synthesizes the current knowledge on the effectiveness of non-pharmacological interventions in institutional settings. METHOD Papers describing the assessment of a non-pharmacological intervention to manage AB in which participants were at least 60 years old and living in a long-term care facility were selected mainly by searching various databases. RESULTS A total of 41 studies were identified and included in the review. These studies mainly use quasi-experimental designs and include less than 30 participants. Sixty-six percent (27/41) of the studies report either a statistically or behaviorally significant reduction of AB as a result of a non-pharmacological intervention. Staff training programs and environmental modifications appear to be the most effective strategies. CONCLUSION Non-pharmacological interventions seem effective for managing AB. Future studies on the effectiveness of these interventions need to be more rigorous. Development in this field needs to be based on knowledge regarding the determinants of AB in older adults.


Journal of the American Medical Directors Association | 2009

Assessment of Visual Function in Institutionalized Elderly Patients

Guillaume Carcenac; Marie-Ève Hérard; Marie-Jeanne Kergoat; Yvette Lajeunesse; Nathalie Champoux; Allan Barsauskas; Hélène Kergoat

OBJECTIVE To describe the visual function and ocular health of frail elderly patients institutionalized in a tertiary care university-affiliated geriatric hospital. DESIGN Retrospective file review. SETTING A university-affiliated geriatric hospital. PARTICIPANTS 440 patient files. MEASUREMENTS The archived clinical files of patients from the long-term care beds of the Institut universitaire de gériatrie de Montréal, who had died between April 2000 and 2004 were reviewed. Pertinent medical and visual characteristics were extracted and entered into a database for analysis. RESULTS The age of the patients ranged from 65 to 104 years. The major ocular conditions observed were cataract, pseudophakia, conjunctivitis-blepharitis, age-related macular degeneration, and glaucoma. Of the 231 patients referred for a partial or full eye examination, visual acuity was available in 178. Visual impairment was considered absent in 87 patients; mild in 52; moderate in 17; and 22 patients were legally blind. Of the 105 patients referred for a full eye examination, an evaluation of the refraction, visual acuity, and ocular health was possible in 89, irrespective of their cognitive status. CONCLUSION These data demonstrate that the vast majority of severely disabled elderly patients examined retained good visual acuity into advanced age. The most prevalent ocular conditions observed are treatable, thereby emphasizing the importance of regular eye care for the institutionalized frail elderly. The results clearly demonstrate that it is possible to perform a complete evaluation of visual function and ocular health in the elderly institutionalized patient, independent of age, cognitive status, or communication disorders.


BMC Nursing | 2015

Recognizing acute delirium as part of your routine (RADAR): a validation study

Philippe Voyer; Nathalie Champoux; Johanne Desrosiers; Philippe Landreville; Jane McCusker; Johanne Monette; Maryse Savoie; Sylvie Richard; Pierre-Hugues Carmichael

BackgroundAlthough detection of delirium using the current tools is excellent in research settings, in routine clinical practice, this is not the case. Together with nursing staff, we developed a screening tool (RADAR) to address certain limitations of existing tools, notably administration time, ease-of-use and generalizability. The purpose of this study was not only to evaluate the validity and reliability of RADAR but also to gauge its acceptability among the nursing staff in two different clinical settings.MethodsThis was a validation study conducted on three units of an acute care hospital (medical, cardiology and coronary care) and five units of a long-term care facility. A total of 142 patients and 51 residents aged 65 and over, with or without dementia, participated in the study and 139 nurses were recruited and trained to use the RADAR tool. Data on each patient/resident was collected over a 12-hour period. The nursing staff and researchers administered RADAR during the scheduled distribution of medication. Researchers used the Confusion Assessment Method to determine the presence of delirium symptoms. Delirium itself was defined as meeting the criteria for DMS-IV-TR delirium. Inter-rater reliability, convergent, and concurrent validity of RADAR were assessed. At study end, 103 (74%) members of the nursing staff completed the RADAR feasibility and acceptability questionnaire.ResultsPercentages of agreement between RADAR items that bedside nurses administered and those research assistants administered varied from 82% to 98%. When compared with DSM-IV-TR criterion-defined delirium, RADAR had a sensitivity of 73% and a specificity of 67%. Participating nursing staff took about seven seconds on average, to complete the tool and it was very well received (≥98%) overall.ConclusionsThe RADAR tool proved to be efficient, reliable, sensitive and very well accepted by nursing staff. Consequently, it becomes an appropriate new option for delirium screening among older adults, with or without cognitive impairment, in both hospitals and nursing homes. Further projects are currently underway to validate the RADAR among middle-aged adults, as well as in newer clinical settings; home care, emergency department, medical intensive care unit, and palliative care.

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Minh Vu

Université de Montréal

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