Sylvie Lauzon

Toward a model of quality of life for family caregivers of stroke survivors.

The important role of family caregivers in maintaining their disabled and elderly members in the community is becoming increasingly recognized. Caregiver research, for the most part, has explored burden and emotional distress as outcomes of the caregiving experience. Although there is a growing consensus among health-care researchers concerning the importance of quality of life (QoL) as an outcome, there is little research examining QoL of family caregivers. The purpose of this paper, therefore, was to construct a conceptual framework from which to study the QoL of family caregivers of stroke survivors. Findings from a review of studies addressing the QoL of these caregivers guided the development of the model. The components of the model include the caregiving situation, characteristics of the caregiver, and environmental factors, and their proposed relationships with QoL. This model provides a framework for investigating how the caregiving experience impacts on the caregivers QoL.

Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

BackgroundIn the many descriptive studies on prescribed psychotropic drug use by community-dwelling older persons, several sociodemographic and other factors associated with drug use receive inconsistent support.MethodEmpirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32) were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Methodological aspects were also examined.ResultsMost reports used probability samples of users and non-users and employed cross-sectional designs. Among variables considered in 5 or more reports, race, proximity to health centers, medical consultations, sleep complaints, and health perception were virtually always associated to drug use. Gender, mental health, and physical health status were associated in about two-thirds of reports. Associations with age, marital status, medication coverage, socioeconomic status, and social support were usually not observed.ConclusionsThe large variety of methods to operationalize drug use, mental health status, and social support probably affected the magnitude of observed relationships. Employing longitudinal designs and distinguishing short-term from long-term use, focusing on samples of drug users exclusively, defining drug use and drug classes more uniformly, and utilizing measures of psychological well-being rather than only of distress, might clarify the nature of observed associations and the direction of causality. Few studies tested specific hypotheses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors.

Health Services for Linguistic Minorities in a Bilingual Setting: Challenges for Bilingual Professionals

We explore in this qualitative research the challenges faced by bilingual health and social services professionals in a Canadian bilingual setting, as well as the strategies used to overcome them. Eight focus groups were conducted with a total of 43 bilingual Francophone professionals who offered services in French in 21 health and social service organizations in eastern Ontario, Canada. We highlight linguistic issues affecting a minority Francophone clientele, the shortage of services in French, and organizational issues within these agencies. The solutions that the professionals adopt for better serving the clients and overcoming these challenges focus on adapting services from linguistic angles. In the long term, such an enhanced approach can affect staff well-being. Ensuring access to services for linguistic minority populations and the active offer of same should not rest solely on the shoulders of such professionals, but rather on organizational strategies.

Enfermería de práctica avanzada: un tesoro oculto

Resumen A traves del mundo entero, los logros de las enfermeras de practica avanzada son numerosos y remarcables. Sin embargo, llegado el tiempo de tomar decisiones en el ambito de las politicas de salud y de las transformaciones del sistema, se nos deja de lado. La ambiguedad sobre la esencia de la enfermeria de practica avanzada y las poco desarrolladas habilidades politicas de las enfermeras pueden ser dos de los factores contribuyentes. Las enfermeras debemos detenernos y pensar sobre estos aspectos con vistas al futuro de la enfermeria de practica avanzada y a la posicion de la profesion dentro del Sistema Canadiense de Salud. Esta reflexion debe tener lugar en un nivel mas elevado al de la discusion sobre titulos, roles, funciones y tareas. En la vanguardia, el desarrollo de un fuerte liderazgo, la adquisicion de poder colectivo, la busqueda de la cohesion dentro de la profesion y un profundo compromiso con el avance de la disciplina son obligaciones para las enfermeras comprometidas con la enfermeria de practica avanzada. Es tiempo de sacar a la luz los logros de las enfermeras de practica avanzada y de demostrar la verdadera valia de nuestras habilidades. Despues de todo, ello iria encaminado al beneficio de una sociedad mas saludable y de un sistema mas eficiente de salud, ya uno de los mejores en el mundo. Que ya habiamos jugado un papel en ello es incuestionable.

Mental health, stress correlates and psychotropic drug use or non-use among aged caregivers to elders with dementia.

The goal of the study was to compare caregivers who used psychotropic drugs with caregivers who were non-users in order to pinpoint differences in coping styles between the two groups. We performed a secondary analysis of a study on the stress and psychological well-being of persons caring for relatives with dementia. We compared elderly caregivers, as either psychotropic drug users ( n = 61) or non-users ( n = 133), over various psychosocial characteristics relating to the care-giving context. Results reveal that users, as compared to non-users were: (a) more disturbed (appraised a greater stress) by the relatives dysfunctional behaviours, after controlling for the frequency of the behaviours; and (b) experienced more conflict during interpersonal interactions, although their appraisal of self-satisfaction with formal and informal support to their care-giving activities did not differ significantly. Strikingly, users combined and called on a greater number of problem-focused and emotion-reducing coping strategies than did non-users. They more frequently used affective regulation and information seeking coping styles. Stress-related measures (especially stress appraisal and conflict) contributed more to the variation in mental distress of users than of non-users. Results provide a theoretical and empirical rationale for therapeutic interventions such as the cognitive behavioural approach.

Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant *

This study aimed at (a) developing a restraint reduction program, (b) describing its implementation in long-term care units, and (c) examining its effects on care staffs perceptions of and knowledge about the use of restraints. The program was composed of three parts: consciousness-raising meetings, staff education, and clinical follow-up. The study was a randomized, controlled clinical trial with eight intervention care units (five nursing homes) and 11 controls (five additional nursing homes). Care staff was surveyed at two time intervals over a 7-month period (pre- and post-test intervention; intervention care units: N = 171 [ T 0 ] and N = 158 [ T 1 ]; controls: N = 181 [ T 0 ] and N = 166 [ T 1 ]). The implementation of the program was successful and results showed significant changes in care staff perceptions of and knowledge about the use of restraints.