La démarche qualité, c’est quoi ?Il existe, sur ce concept, souvent une méconnaissance, parfois des idées reçues.Le groupe FORAP médico-social s’est mobilisé pour construire des supports afin de permettre aux ESSMS de s’approprier les principes de la démarche qualité.Nous vous proposons ainsi 2 posters qui s’appuient sur une démarche en 4 étapes « Planifier, Réaliser, Vérifier, Améliorer ». Chacune des étapes est illustrée par des exemples opérationnels afin de faciliter la compréhension et l’appropriation par tous.2 posters sont disponibles en accès libre :- Poster à destination de l’encadrement- Poster à destination des professionnels de terrain et des personnes accompagnées...
Veille : Professionnels de la santé
Effectiveness of interventions to improve health behaviours of health professionals: a systematic review
BMJ Open. 2022 Sep 26;12(9):e058955. doi: 10.1136/bmjopen-2021-058955.
OBJECTIVE: To evaluate the effectiveness of interventions designed to improve the health behaviours of health professionals.
DESIGN: Systematic review.
DATA SOURCES: Database searches: Medline, Cochrane library, Embase and CINAHL.
REVIEW METHODS: This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to compare randomised controlled trials of health professionals, published between 2010 and 2021, which aimed to improve at least one health behaviour such as physical activity, diet, smoking status, mental health and stress. Two independent reviewers screened articles, extracted data and assessed quality of studies and reporting. The quality of articles was assessed using the Effective Public Health Practice Project quality assessment tool and the completeness of intervention reporting was assessed.
OUTCOME MEASURES: The outcome assessed was change in behaviour between intervention and control groups from baseline to follow-up.
RESULTS: Nine studies met the eligibility criteria, totalling 1107 participants. Health behaviours targeted were mental health and stress, physical activity, and smoking cessation, physical activity and nutrition. Six interventions observed significant improvements in the health behaviour in the intervention compared with control groups. Seven of the studies selected in person workshops as the mode of intervention delivery. The quality of the included studies was high with 80% (7/9) graded as moderate or strong.
CONCLUSIONS: Although high heterogeneity was found between interventions and outcomes, promising progress has occurred across a variety of health behaviours. Improving reporting and use of theories and models may improve effectiveness and evaluation of interventions. Further investigation is needed to recommend effective strategies.
PROSPERO REGISTRATION NUMBER: CRD42021238684.
Experiences of suffering among nursing professionals during the COVID-19 pandemic: A descriptive qualitative study
Appl Nurs Res. 2022 Aug;66:151603. doi: 10.1016/j.apnr.2022.151603. Epub 2022 Jun 24.
BACKGROUND AND AIM: Healthcare professionals have played a fundamental role in managing and controlling the COVID-19 health crisis. They are exposed to high levels of suffering, trauma, uncertainty, and powerlessness in the workplace. The objective of this study was to explore and understand experiences of suffering among primary care and hospital care nurses during the COVID-19 health crisis.
DESIGN: This is a descriptive qualitative study. Between March and April 2021, 19 in-depth interviews were carried out with nurses at health and social care facilities and hospitals in southern Spain. ATLAS.ti 9.0 software was used for discourse analysis.
RESULTS: Nurses reported that they had experienced suffering during their work in the pandemic. The main causes suggested were direct contact with patients' suffering and organisational difficulties. The repercussions are in emotional dimension and physical deterioration and social isolation.
CONCLUSION AND IMPLICATIONS: Given the circumstances, programmes to promote healthy, compassion-based behaviours and changes to the way in which professionals' suffering is handled must be implemented by healthcare facility managers. Nursing leaders should consider the management of suffering as a matter of the first order, both from the ethical point of view and the business profitability and make compassionate leadership.
Effectiveness of case scenario-based teaching to transition international Master of Public Health students specialising in health promotion from memorization to critical thinking
Health Promot J Austr. 2022 Jun 17. doi: 10.1002/hpja.631. Online ahead of print.
ISSUE ADDRESSED: Critical thinking is essential to health promotion to overcome increasingly complex health issues. International students from Middle East and Asia are however disadvantaged when required to demonstrate critical thinking mainly because of their previous training in memorisation. This study addresses this need by evaluating the effect of case scenario-based teaching on transition from memorisation to critical thinking among international students in an Australia university.
METHODS: This was a pre and post intervention study and data was collected from a convenience sample of 79 international Master of Public Health students specialising in health promotion in 2019 at the University of Wollongong.
RESULTS: Most of the participants were female (73.4%) and aged 25 years or older (64.6%), predominantly from India (40.5%), Nepal (31.6%), and Saudi Arabia (11.4%). A paired t-test analysis showed that the intervention - case scenario-based teaching - significantly improved the mean post-intervention critical thinking skills (p < 0.001). Case studies improved critical thinking among international students, irrespective of demographic attributes. Multiple regression analyses indicated that critical thinking predicted 78.6 of the total marks, after controlling for demographic attributes. In terms of assessment marks, improved multiple solutions skills yielded better marks for tutorial participations; while improved problem identification skills improved marks for report assessments and exams. Improved communication skills led to better marks for essay assessments.
CONCLUSIONS: Case studies improved critical thinking and was a reliable predictor of student performance among the participants. SO WHAT?: This study makes a strong case for case scenario-based teaching to improve critical thinking among international students. However, given the limitations of this study, including the small, non-representative sample, further testing is required. This article is protected by copyright. All rights reserved.
Professional Quality of Life in Intensive Care Unit Professionals during COVID-19 Pandemic: A Prospective Observational Cross-sectional Study
Indian J Crit Care Med. 2022 May;26(5):604-612. doi: 10.5005/jp-journals-10071-24212.
BACKGROUND AND AIMS: The coronavirus disease-2019 (COVID-19) has significant positive and negative impacts on the professional life of intensive care unit (ICU) professionals. This study was conducted to evaluate compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in ICU professionals and to study demographic and occupational variables related to them.
METHODS: This prospective observational study was undertaken on ICU professionals involved in direct care of critically ill COVID-19 patients. The online questionnaire consisting of demographic, work-related parameters, and professional quality of life scale version 5 (ProQOL 5) was sent to 1,080 ICU healthcare workers. The subgroups of ProQOL 5, CS, BO, and STS were calculated and compared across study parameters. Linear regression was performed to evaluate variables which were independently associated with ProQOL.
RESULTS: The response rate in the present study was 39.8%, and after evaluation, 320 responses were found eligible for final analysis. There was predominance of average levels of CS, BO, and STS. Female gender, contractual job, lesser work experience, greater workload, and COVID-19 infection in close acquittance of participants were factors observed to independently associated with increase in negative aspects of ProQOL (BO and STS). Further, increase in duty hours and COVID-19 infection in close social circle were observed to independently decrease positive aspects (CS).
CONCLUSION: This study shows that despite majority of respondents reporting moderate levels BO and STS, CS is maintained during the COVID-19 crisis. The identification of risk factors is vital to support ICU professionals by targeted interventions.
HOW TO CITE THIS ARTICLE: Kerai S, Doda P, Saxena KN. Professional Quality of Life in Intensive Care Unit Professionals during COVID-19 Pandemic: A Prospective Observational Cross-sectional Study. Indian J Crit Care Med 2022;26(5):604-612.
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La FWPSanté et FBPSanté s’associent pour lancer un groupe Facebook « Promotion de la santé Wallonie-Bruxelles ».
ObjectiveThere is a high prevalence of burnout in nurses. This systematic review investigates the use of music to manage burnout in nurses.Data SourceMEDLINE (Ovid), MEDLINE InProcess/ePubs, Embase, APA PsycINFO, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched.Study Inclusion and Exclusion CriteriaFull-text articles were selected if the study assessed the use of music to manage burnout in nurses. Burnout was defined according to the International Classification of Diseases 11th Revision.Data ExtractionData were extracted using an Excel sheet. The second and third authors independently extracted study characteristics, frequency and type of music engagement, measures of burnout, and burnout outcomes (occupational stress, coping with stress, and related symptoms such as anxiety).Data SynthesisStudy and outcome data were summarized.ResultsThe literature search resulted in 2210 articles and 16 articles were included (n = 1205 nurses). All seven cross-sectional studies reported upon nurses’ self-facilitated use of music including music listening, playing instruments, and music entertainment for coping or preventing stress, supporting wellbeing, or enhancing work engagement. Externally-facilitated music engagement, including music listening, chanting, percussive improvisation, and song writing, was reported in the four randomized controlled trials and five cohort studies with reductions in burnout outcomes.ConclusionsSelf-facilitated and externally-facilitated music engagement can help to reduce burnout in nurses.
The quality of healthcare communication can impact both experiences and outcomes. We highlight aspects of communication that can be systematically examined using Conversation Analysis (CA) and provide guidance about how researchers can incorporate CA into healthcare studies. CA is a qualitative method for studying naturally occurring communication by analyzing recurrent, systematic practices of verbal and nonverbal behavior. CA involves examining audio- or video-recorded conversations and their transcriptions to identify practices speakers use to communicate and interpret behavior. We explain what distinguishes CA from other methods that study communication and highlight three accessible CA approaches that researchers can use in their research design, analysis, or implementation of communication interventions. Specifically, these approaches focus on how talk is produced (specific words, framing, and syntax), by whom, and when it occurs in the conversation. These approaches can be leveraged to generate hypotheses and to identify patterns of behavior that inform empirically driven communication interventions.
Midwifery. 2022 May 11;111:103368. doi: 10.1016/j.midw.2022.103368. Online ahead of print.
OBJECTIVE: To explore midwives' skills, knowledge and experiences of supporting women's mental health.
RESEARCH DESIGN AND SETTING: This paper reports the second phase of a larger project, the 'Mothers' Mood Study', which recruited women and midwives to explore their experiences of perinatal mental health and service provision and focuses on midwives' experiences of supporting women with perinatal mental health problems. This paper reports on midwives' experiences through self-administered questionnaires and focus groups. Descriptive statistics were used to analyse questionnaire data and focus group data were thematically analysed.
PARTICIPANTS: All midwives employed at one Health Board in South Wales UK, were eligible to participate. Recruitment took place between February and October 2018. Questionnaires were completed by 145 midwives and 15 attended one of three focus groups.
FINDINGS: Questionnaire data showed the majority of midwives had cared for women with mental health problems, most commonly anxiety (95.0%, n = 138) and depression (87.0%, n = 127). Midwives assessed women's mental health informally by observing or asking questions about mood (99.3%, n = 144), anxiety levels (94.5%, n = 137), levels of support (91.0%, n = 132) and mental health history (95.9%, n = 139). The majority of midwives (82.8%, n = 120) indicated they would make some sort of mental health assessment at least 50% of the time. Around a third of midwives 31.7% (n = 46) reported receiving training relating to perinatal mental health in the previous two years, however only 21.4% (n = 31) of these suggested this had helped them in their practice. Three themes were generated from the focus groups, 1) Conversations 2) Support 3) Knowledge and skills.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: A lack of time and continuity at appointments and a focus on physical health of mother and baby reduced the opportunity for conversations around mental health. In addition a lack of experience reduced midwives' confidence resulting in a low threshold for referring women to other services for support. Midwives' main concerns were a need for training on aspects of day-to-day practice and referral options to support women's mental health. A package of training to improved skills and confidence as well as a clear pathway of care will enable midwives to be better placed to support women's mental health.
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Depuis une cinquantaine d’années, les maisons médicales bâtissent, pierre après pierre, un modèle de santé de première ligne, au plus proche des patients et de leurs réalités. Cette nouvelle série de (...)
Clin J Oncol Nurs. 2022 Jun 1;26(3):318-323. doi: 10.1188/22.CJON.318-323.
Oncology nurses are at risk for compassion fatigue, which is often assessed using the Professional Quality of Life Scale (ProQOL). Nursing researchers and leaders use the ProQOL to determine risk for compassion fatigue or effectiveness of interventions to reduce compassion fatigue. However, the ProQOL was designed for social workers, and research has shown it to be less suitable to assess the work of nurses. This article synthesizes a realist review of the literature about instruments measuring nurses' professional quality of life (QOL). The following three themes emerged: (a) a robust body of literature aimed at defining professional QOL, (b) a limited historical context of the ProQOL instrument, and (c) newer instruments. Findings suggest that the ProQOL-21 and the Risk Factors for Compassion Fatigue Inventory are more specific to nursing and better suited to measure nurses' perceived professional QOL.
Examining the Constructs of Burnout, Compassion Fatigue, Secondary Traumatic Stress in Physicians Using Factor Analyses
Front Public Health. 2022 May 6;10:893165. doi: 10.3389/fpubh.2022.893165. eCollection 2022.
BACKGROUND: Adverse affective experiences have been well-documented in healthcare providers. Research describes them under a variety of terms, including burnout, secondary traumatic stress (STS), and compassion fatigue (CF). The present study evaluates conflicting models of STS, CF, and burnout constructs in physicians.
METHODS: Surveys were mailed to all allopathic physicians with active Rhode Island medical licenses. Three hundred and seventy-five complete responses were received. The survey included common measures of STS, CF, and burnout. Confirmatory Factor Analysis (CFA) was used to evaluate discriminant validity of the three constructs and test 5 a priori (1-, 2-, and 3-factor) theoretical models, and Exploratory Factor Analysis (EFA) was planned assess underlying factor structure in the case that CFA did not provide evidence supporting any existing model.
RESULTS: By CFA, all five a priori models of burnout, CF, and STS fail to demonstrate adequate model fit (Standardized Root Mean Square Residual >0.10, Tucker-Lewis Index <0.90). EFA with parallel analysis extracts four factors underlying the three burnout, STS, and CF measures. The four factors describe 54.3% of variance and can be described as (1) depressive mood; (2) primary traumatic stress-like symptoms; (3) responses to patients' trauma; and (4) sleep disturbances.
CONCLUSION: In spite of abundant discussion surrounding burnout, CF, and STS in physicians, measures of these constructs did not uphold their theoretical factor structures in the present study. Future research might explore other constructs and measures that may describe adverse affective physician experiences.
Perspectives on an exhausted medical radiation practitioner workforce: emotional labour and the impact of compassion fatigue
Aust Health Rev. 2022 May 20. doi: 10.1071/AH22042. Online ahead of print.
As the COVID-19 pandemic in Australia reaches its peak, medical radiation practitioners (MRPs) are at capacity both physically and emotionally. High workloads and stress impact the mental wellbeing of MRPs, with suppression of feelings and emotions resulting in experiences of compassion fatigue. From a MRP workforce perspective, the long-term cost of the pandemic has yet to be realised. MRPs need to be supported to prevent unintended health consequences. Robust management interventions will be required to support the MRP workforce to manage and hopefully mitigate compassion fatigue transitioning out of the pandemic.
Le temps du paternalisme médical, où le savoir était l’apanage des seuls médecins, semble aujourd’hui révolu : les patients sont de plus en plus nombreux à revendiquer une expertise que n’ont pas les médecins, les chercheurs et les décideurs publics ou privés. Et leur connaissance empirique de la maladie est de mieux en mieux reconnue, si […]
The Relationship between Social Support and Secondary Posttraumatic Growth among Health Care Providers Working with Trauma Victims-The Mediating Role of Cognitive Processing
Int J Environ Res Public Health. 2022 Apr 20;19(9):4985. doi: 10.3390/ijerph19094985.
BACKGROUND: Individuals, who help trauma victims as part of their professional responsibilities, may experience positive effects of their work, occurring in the form of Secondary Posttraumatic Growth (SPTG). Its determinants include environmental factors such as social support, and individual characteristics, particularly cognitive processing of the trauma. The purpose of this study was to determine the associations between SPTG and social support and cognitive processing of trauma, also considered as a mediator, in a group of medical personnel exposed to secondary trauma.
METHODS: The results of 408 participants, paramedics and nurses, were analyzed. Three measurement tools were used: the Secondary Posttraumatic Growth Inventory, the Social Support Scale measuring four sources of support and the Cognitive Trauma Processing Scale to assess five cognitive coping strategies.
RESULTS: The results indicated that SPTG was positively related to social support and cognitive coping strategies. Cognitive coping strategies act as a mediator in the relationship between social support and SPTG.
CONCLUSIONS: Despite their exposure to secondary traumatization, paramedics and nursing staff experience positive consequences of their work related to helping injured people. In order to promote growth after trauma, it is advisable to encourage medical representatives to use social support and primarily positive coping strategies.