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1.  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.
INTRODUCTION :
Des milliers de personnes souffrent actuellement de douleur chronique (DC) pour laquelle la prise en charge s’avère souvent inadéquate. Au Québec, les infirmières qui oeuvrent dans les Groupes de médecine de famille (GMF) jouent un rôle clé dans le suivi des personnes aux prises avec des problèmes de santé chroniques dont la DC.
OBJECTIFS :
Cette étude a pour objectifs de décrire les activités réalisées par les infirmières œuvrant en GMF en lien avec la gestion de la douleur chez la clientèle souffrant de DC, ainsi que les barrières à ces activités.
MÉTHODE :
Un dispositif descriptif corrélationnel transversal de type enquête postale a été utilisé. La population accessible à l’étude comprend les infirmières qui figurent sur la liste des membres de l’Ordre des infirmières et infirmiers du Québec travaillant en GMF. L’ensemble des infirmières figurant sur cette liste ayant consenti à être contactées à leur domicile pour des fins de recherche ont été contactées. Un questionnaire postal auto-administré (Pain Management Activities Questionnaire) a été complété par 53 infirmières travaillant en GMF.
RÉSULTATS :
Les trois activités le plus souvent réalisées par les infirmières sont d’établir une relation thérapeutique avec le client; de discuter avec le médecin de l’efficacité des mesures thérapeutiques et de faire un enseignement personnalisé au client. Les infirmières ont la perception qu’elles rencontrent en moyenne 2,68 personnes par semaine qui souffrent de DC. La méconnaissance des interventions possibles en douleur (71,7%) et la non-disponibilité de l’information sur la gestion de la douleur (52,8%) constituent les principales barrières selon les infirmières sondées.
CONCLUSION :
Les infirmières au sein des GMF font actuellement peu d’activités en gestion de la DC probablement en raison du manque de reconnaissance de la DC.
PMCID: PMC4391437  PMID: 25848847
Douleur chronique; Soins infirmiers; Soins primaires; Chronic pain; Nursing; Primary care
2.  Supporting parents of preschool children in adopting a healthy lifestyle 
BMC Nursing  2012;11:12.
Background
Childhood 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/design
This 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.
Discussion
The 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.
doi:10.1186/1472-6955-11-12
PMCID: PMC3489519  PMID: 22852762
Overweight; Childhood; Preschool; Parental opinion; Health promotion; Action research
3.  Nurses joining family doctors in primary care practices: perceptions of patients with multimorbidity 
BMC Family Practice  2010;11:84.
Background
Among the strategies used to reform primary care, the participation of nurses in primary care practices appears to offer a promising avenue to better meet the needs of vulnerable patients. The present study explores the perceptions and expectations of patients with multimorbidity regarding nurses' presence in primary care practices.
Methods
18 primary (health) care patients with multimorbidity participated in semi-directed interviews, in order to explore their perceptions and expectations in regard to the involvement of nurses in primary care practices. Interviews were audio-recorded and transcribed. After reviewing the transcripts, the principal investigator and research assistants performed thematic analysis independently and reached consensus on the retained themes.
Results
Patients with multimorbidity were open to the participation of nurses in primary care practices. They expected greater accessibility, for both themselves and for new patients. However, the issue of shared roles between nurses and doctors was a source of concern. Many patients held the traditional view of the nurse's role as an assistant to the doctor in his or her various duties. In general, participants said they were confident about nurses' competency but expressed concern about nurses performing certain acts that their doctor used to, notwithstanding a close collaboration between the two professionals.
Conclusion
Patients with multimorbidity are open to the involvement of nurses in primary care practices. However, they expect this participation to be established using clear definitions of professional roles and fields of practice.
doi:10.1186/1471-2296-11-84
PMCID: PMC2987912  PMID: 21050443
4.  Empowerment interventions, knowledge translation and exchange: perspectives of home care professionals, clients and caregivers 
Background
Few studies have examined empowerment interventions as they actually unfold in home care in the context of chronic health problems. This study aims to document the empowerment process as it plays out in interventions with adults receiving home care services.
Methods/design
The qualitative design chosen is a fourth generation evaluation combined with case studies. A home care team of a health and social services center situated in the Eastern Townships (Québec, Canada) will be involved at every step in the study. A sample will be formed of 15 health care professionals and 30 of their home care clients and caregiver. Semi-structured interviews, observations of home care interventions and socio-demographic questionnaires will be used to collect the data. Nine instruments used by the team in prior studies will be adapted and reviewed. A personal log will document the observers' perspectives in order to foster objectivity and the focus on the intervention. The in-depth qualitative analysis of the data will illustrate profiles of enabling interventions and individual empowerment.
Discussion
The ongoing process to transform the health care and social services network creates a growing need to examine intervention practices of health care professionals working with clients receiving home care services. This study will provide the opportunity to examine how the intervention process plays out in real-life situations and how health care professionals, clients and caregivers experience it. The intervention process and individual empowerment examined in this study will enhance the growing body of knowledge about empowerment.
doi:10.1186/1472-6963-8-177
PMCID: PMC2528009  PMID: 18713474

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