INTRODUCTION:Social perceptions of older adults living with dementia substantially influence the care and services provided to this population, such as long-term care facilities (LTCs), which often have a poor, and sometimes even disastrous, reputation. This article aims to answer the following question: How is the dignity of residents in Quebec LTCs maintained in a context of institutionalization? METHODOLOGY:An institutional ethnography was conducted in a long-term care facility. Data generation included participant observation (133 hours), leisure-time interviews with residents living with dementia (n=4), and an analysis of policies and internal documents. RESULTS:The results highlight that dignity is maintained primarily through healthy, reciprocal social relationships and the sharing of past memories, which promote identity within these relationships. DISCUSSION:Beyond cognitive impairments, residents remain capable of actively contributing to the institutional dynamics that shape everyday life in long-term care. These findings invite greater attention to the resources residents mobilize to sustain their dignity and to support a culture of care that values and fosters their capabilities.
INTRODUCTION:Only 10–50% of individuals who attempt suicide attend the outpatient appointment scheduled at emergency discharge, and no specific data are available for individuals with a first suicide attempt. This study aimed to quantify the proportion of individuals with a first suicide attempt who attended their initial outpatient psychiatric appointment and to compare the characteristics of attendees and non-attendees. METHODS:A multicenter retrospective cohort study was conducted using the medical records of individuals with a first suicide attempt who were seen in the psychiatric emergency departments of Dinan and Saint-Brieuc in 2022. RESULTS:Only 21.7% (95% confidence interval: 10.9–36.4) attended the scheduled outpatient appointment. Among the attendees, 70% were men, 80% were aged 18–44 years, 60% had attempted suicide by intentional self-poisoning, and 60% had no prior psychiatric follow-up. Attendance at the first appointment was more frequent among individuals with a first suicide attempt whose appointment was scheduled by a psychiatric emergency healthcare professional before discharge and who had a shorter waiting time than non-attendees. CONCLUSION:These findings among individuals with a first suicide attempt are consistent with the literature on individuals who attempt suicide. The results suggest that first outpatient appointments scheduled before discharge and with a shorter waiting time may be associated with higher attendance rates at the initial outpatient follow-up appointment.
INTRODUCTION:Psychedelic-assisted psychotherapy (PAP) is emerging as a promising approach for treating various treatmentresistant psychiatric disorders. Despite the expansion of this practice, few studies have examined nursing contribution. OBJECTIVES:This review explores nursing contributions to PAP in psychiatry and analyzes the challenges related to nurses’ contributions. METHOD:A scoping review was conducted following the Joanna Briggs Institute methodology, exploring several databases. RESULTS:Twelve publications were included. Their number has increased since 2020, and the publications are predominantly North American. The authors, predominantly nurses, are highly qualified. They describe roles in assessment, preparation, administration, and integration, as well as distinctive strengths such as prolonged therapeutic support. DISCUSSION:Nursing representation in the literature remains limited, and specialized training is lacking. Applying nursing theoretical models to PAP could help demonstrate the added value of the nursing role. Calls for research reveal a desire for greater professional recognition and structuring. Ethical and regulatory challenges require appropriate frameworks. The nursing contribution requires rigorous scientific validation, and advanced practice nurses possess the necessary competencies to contribute to this process.
BACKGROUND:Evidence-based practice (EBP) is now considered the gold standard in healthcare practice. The World Health Organization recommends that clinical decisions be made based on evidence. Nurse educators should train nursing students in EBP and adapt their teaching methods to current evidence within the context of the transition to university-based nursing education. It is therefore necessary to conduct an assessment of EBP practice and teaching in France. OBJECTIVE:To explore the facilitators and barriers to EBP teaching and practice in educational settings. METHODS:An exploratory, multicenter, descriptive qualitative study using focus groups was conducted. Twenty-four nurse educators participated in five focus groups. RESULTS:The facilitators for EBP implementation were: adapted individual conceptions of EBP, a favorable environment, and students’ final theses. However, barriers to implementation were identified, including misperceptions, lack of knowledge, and lack of prioritization of EBP. CONCLUSION:Training nurse educators in EBP could facilitate its implementation and support students in applying EBP in practice. The ongoing transition of nursing education to the university system in France, along with the reform of the nursing curriculum, should serve as levers for its implementation.
INTRODUCTION:The perinatal period involves complex care and requires collaboration among multiple healthcare professionals. Nurses play a central role; however, the literature often describes their activities in a fragmented manner. OBJECTIVE:To map the nursing roles and competencies involved in perinatal care. METHODS:A scoping review was conducted following Peters et al. (2020). Five databases and the grey literature were searched for relevant publications (2015-2025; in French and English). Thirty-seven documents were included and analyzed using an inductive thematic approach. RESULTS:Seven roles were identified: direct clinical care, education and support, coordination and collaboration, organization and management, leadership and mentorship, research, and sociopolitical advocacy. These roles are supported by competencies in clinical reasoning, therapeutic communication, educational intervention, humanistic support, interprofessional collaboration, quality and safety, clinical influence, ethical reflection, cultural safety and equity, and the mobilization of best available evidence. DISCUSSION:Roles and competencies vary according to job titles, training, regulatory and organizational frameworks, and families’ needs. Interprofessional role overlap and structural barriers limit the full enactment of nursing roles, particularly in advanced practice settings. CONCLUSION:Greater recognition of nursing competencies and updated training may strengthen the quality and equity of perinatal care.
BACKGROUND:Borderline personality disorder (BPD) is often associated with significant stigma from nurses. The objective of this study was to examine the relationship between the types of knowledge mobilized by nurses and their reflective practice in caring for individuals with BPD experiencing a suicidal crisis. METHODS:A cross-sectional quantitative study was conducted among 34 nurses working in community mental health centers and psychiatric emergency units on Réunion Island. Three types of knowledge were assessed (biomedical, psychopathological, and practical knowledge grounded in nursing sciences), as well as reflective practice. RESULTS:A significant correlation was observed between the overall knowledge score and the reflective practice score. However, no significant independent association was found between reflective practice and any of the three individual knowledge domains. An explanatory model, including several knowledge subdimensions, accounted for 37% of the variance in the reflective practice score. DISCUSSION:These findings suggest that nurses’ reflective practice relies on the cross-cutting integration of various types of knowledge rather than on a single knowledge domain. The results underline the need to reconsider the place of nursing knowledge in initial and continuing education and highlight the need for pedagogical approaches that foster a reflective stance, especially in the context of crisis care.
BACKGROUND:Delirium is a frequent and serious complication in intensive care units (ICUs), with reported incidence rates ranging from 3.6% to 83.3% and affecting up to 40% of ICU patients. It is associated with adverse patient outcomes. Despite the available evidence, implementation in routine clinical practice remains challenging. Publishing this protocol also aims to disseminate evidence-based practices. OBJECTIVES:This study protocol aims to evaluate the effectiveness of a standardized bundle of nonpharmacological interventions in reducing the incidence and duration of delirium among ICU patients. Secondary objectives include the assessment of delirium duration, neuropsychological outcomes at three months, and health-related quality of life one year after ICU discharge. The protocol was developed in accordance with SPIRIT 2025 recommendations, and the trial was registered under the identifier NCT03125252. METHODS:This is a multicenter, cluster- randomized controlled trial involving 14 intensive care units stratified by unit size. Cluster randomization was performed, and the required sample size was estimated at 474 patients in order to detect a 19% reduction in delirium incidence. The intervention group received a bundle including environmental modifications, conversational hypnosis, and patient empowerment techniques, while the control group received regular care. Delirium was assessed twice daily using the validated CAM-ICU tool. EXPECTED RESULTS:This protocol aims to reduce delirium incidence through preventive and patient-centered ICU care. Delirium duration, neuropsychological outcomes, and quality of life will also be evaluated. In addition, this study provides practical evidence-based guidance for healthcare teams to implement specific delirium prevention interventions.
Femininity occupies a particular place in Western conceptions of nursing care. This article examines the ontological dimension of this association. Drawing on a semiotic observation, the notion of "feminine care" is subjected to a phenomenologically oriented analysis aimed at identifying the conditions under which it is constructed in common understanding and at interpreting it as a narrative. This approach leads to considering care as a broader phenomenon than "feminine car", the latter narrowing the very meaning of care by grounding it in a largely mythical origin. A hermeneutic reading, oriented toward the construction of an alternative narrative, makes it possible to envisage an evolution in the ontology of care and, consequently, to advance knowledge by opening up the epistemology of the field of care in a broader and more rigorous manner.
Introduction: Schizophrenia is a severe psychiatric disorder, often associated with social stigma, affecting approximately 1% of the French population. The development of community-based care has increased the responsibilities of families, including their role as caregivers, which is essential to recovery but exposes them to emotional, social, and material burdens. Aim: To explore the experiences of families supporting a relative living with schizophrenia, with a view to understanding their experiences, the resources they use, and the obstacles they encounter. Method: A qualitative interpretive phenomenological study was conducted with five people supporting a relative with schizophrenia, recruited in collaboration with the French National Union of Friends and Families of People with Mental Illness (UNAFAM). Data were collected through semi-structured interviews and analyzed using thematic coding and phenomenological interpretation. Results: Four themes emerged from the analysis: isolation and processes of stigmatization reflecting both social and identity disruption; a substantial emotional and material burden, characterized by feelings of guilt and exhaustion; resistance strategies developed by families, grounded in the maintenance of hope and the mobilization of familial and community resources; and the ambivalent nature of support systems, oscillating between recognition of the caregiver role and unmet expectations. Conclusion: The experiences of caregivers reveal a complex reality, situated between suffering and resilience. Recognizing families as partners is essential to reducing the care burden and supporting recovery. Advanced practice nurses play a key role in assessment, psychoeducation, coordination, and the development of partnership-based approaches.
Introduction: Since 2009, French nursing training has been engaged in a process of academic integration in line with the Bologna Accords. This transformation raises questions about the practical modalities of integrating nursing institutes (Ifsis) into the university system. Context: At the time of this study, no nationwide assessment had evaluated the level of university integration of Ifsis. Aims: To provide a national overview of this integration and identify the factors that facilitate or hinder this process. Method: A cross-sectional quantitative survey was conducted from September to December 2022 among the directors of 326 French Ifsis. Results: The survey reveals significant heterogeneity. Geographic distance from universities, regional disparities, and variability in local partnerships constitute the main obstacles. However, some Ifsis located far from university centers demonstrate favorable dynamics, suggesting the existence of compensatory factors. Conclusion: These disparities underscore the need for targeted organizational and regulatory measures (including clarification of responsibilities, enhanced coordination, and dedicated resources), along with further research to assess the impact of these measures on equity and the quality of educational pathways.
Introduction: Emotional intelligence (EI) has been shown to be an important predictor of nurses' effective performance in health care settings, enabling them to acquire new EI-related skills that are necessary for performing their professional tasks. This study examines the relationship between the dimensions of EI and the professional performance of Lebanese nurses. Methods: A convenience sample of 100 nurses was selected. Nurses completed the Wong and Law Emotional Intelligence Scale (WLEIS) and the 6-SDNP, which assesses performance. Results: Statistically significant moderate and high positive correlations were observed between the EI dimensions and the various dimensions of professional performance. Discussion: Emotionally competent nurses are able to self-regulate and manage their emotions, recognize their own emotional state and that of others, and react quickly in an appropriate and balanced manner. These emotional skills enable them to provide empathic care and high-quality support to patients, families, and colleagues. These aspects of EI are considered key components that should be addressed in the training of health care professionals.
Introduction: Improving hospital-to-home care transitions is a major challenge in the context of population aging. However, few studies in France describe the specific nursing interventions delivered in primary care after hospital discharge. This study examines the follow-up and support interventions provided by nurses in primary care to adults aged 75 and older within 30 days of hospital discharge, and identifies factors that facilitate or hinder their implementation. Method: A descriptive qualitative study was conducted with eight nurses providing home-based care. Data were collected through semi-structured interviews. Thematic analysis was performed, and the findings were examined in relation to the components of the transitional care model (TCM). Results: Nurses implemented interventions consistent with the TCM (clinical assessment, coordination, caregiver involvement), as well as actions specific to the French context (technical care, prescription management, care network referrals). Their interventions were influenced by various facilitators (professional commitment, local integration, early intervention) and barriers (fragmented organization, poor communication, limited resources). Discussion: The findings support the development of an integrated nursing model inspired by the TCM and adapted to the French health care context. Further research is needed to evaluate the potential impact of such a model on care trajectories and patient outcomes.
This article develops the concept of the "nursing gaze," which commits nurses to making informed and reasoned clinical decisions. The nursing gaze comprises four structuring elements: the severity of the illness, the assessment of functional difficulties, the patient's experience of the illness, and how the person copes with it. It is developed through a process of clinical reasoning, in which the knowledge mobilized gives meaning to the collected data and informs the formulation of clinical judgments. Based on these clinical judgments, nursing knowledge is used to select relevant interventions and expected outcomes for each individual. To define and explain the nursing gaze and its place in nursing practice, this article aims to develop the concept of the nursing gaze based on Tanner's model of clinical judgment, combined with nursing theories, and its associated evaluation grid.
Introduction: In France, the history of psychiatry has largely been written without reference to nurses. The abolition of the psychiatric sector nurse diploma (ISP) in 1992 further reinforced the erasure of a distinct professional identity and its associated knowledge. Objective: This study aims to trace the trajectories of ISP nurses at Sainte-Marie hospital in Clermont-Ferrand from 1969, the year the diploma was created, to 2000, marking the end of collective mobilizations, in order to analyze the forms of professional empowerment that emerged amid institutional change. Method: A "history from below" approach was adopted, combining life stories, institutional archives, personal documents, and professional materials from the field. Zimmerman's framework of psychological empowerment was critically applied to guide the analysis. Results: The findings highlight strategies of affirmation, alternative clinical practices, and collective dynamics that reflect historically situated forms of empowerment closely linked to transformations in French psychiatry. Discussion: These results call into question the relevance of Zimmerman's framework and support a situated interpretation of professional autonomy. Conclusion: This research contributes to the history of nursing in France and offers insights for understanding the current crisis of meaning in psychiatric nursing practice.
Introduction: There is little data available on the scientific and professional communications of operating room nurses (OR nurses). The question addressed concerns the contribution of French OR nurses to the indexed literature. The objective is to identify and characterize publications with an OR nurse as the first author. Method: This descriptive bibliometric performance study was conducted between 2012 and 2022 using PubMed, Cinahl, Embase, and Lissa, applying the "affiliation" filter. Results: The study reveals emerging research activity with 53 research articles and 130 feedback reports published across 14 countries. French OR nurses published three research papers and 87 feedback papers prior to the implementation of the new university curriculum. They rank sixth in research investigations and first in feedback publications. Discussion: The results indicate a discernible publication strategy consistent with other French and Spanish studies. However, the use of the "affiliation" filter may have excluded certain publications. This study, conducted over a 10-year period, demonstrates that French OR nurses are active and publish regularly, notably in the professional journal InterBloc. The results obtained may serve as a reference for future correlational or bibliometric studies.
Introduction: The use of a standardized medication plan is intended to improve pharmaceutical care prior to hospital discharge and to enhance patients' self-management of medications. Objectives: To evaluate the context of a hospital unit regarding barriers and facilitators to implementing a standardized medication plan (objective 1) and to assess the implementation process in terms of acceptability, feasibility, and fidelity (objective 2). Method: An implementation study using a "pre-post" feasibility design. Data were collected from nurses at three time points: before (T0), during (T1), and after implementation (T2), using focus groups and questionnaires. Descriptive statistical analyses and a rapid thematic analysis were performed. Results: Barriers and facilitators to implementation were systematically identified. The standardized medication plan demonstrated added value, but its feasibility remained limited, leading to a low level of fidelity to the intervention. Discussion: Although a standardized medication plan has the potential to support pharmaceutical nursing care before discharge, its implementation in real-world settings requires addressing barriers and adapting its usage procedures.
Background: Strengthening the relational skills of public health professionals is a key element of early prevention within France's Protection maternelle et infantile (Maternal and Child Health Services). The Petits pas, Grands pas (PPGP; "Small step, Big step") training program-based on APR (Approche pr & eacute;ventive centr & eacute;e sur la relation d'aide), a relationship-centered preventive approach (APR)-aims to enhance reflective and relational practices among multidisciplinary teams. Objective: To describe Maternal and Child Health professionals' perceived changes in relational practices following APR training. Method: A cross-sectional descriptive study was conducted from 2022 to 2024 across 21 French departments. Anonymous questionnaires were distributed at three and six months post-training (T1 and T2). Closed-ended questions assessed the frequency and ease of using the four core APR skills (proactivity, deferring, empathy, and valuing parental strengths), while open-ended questions explored perceived changes in relational practices. Quantitative data were analyzed descriptively, and qualitative responses were coded thematically. Results: A total of 820 professionals responded at T1, and 570 responded at T2. Approximately half of the respondents reported increased confidence in relational interactions, particularly in listening and acknowledging parental resources. Qualitative findings highlight greater professional security and an improved understanding of families' needs. Conclusion: The findings suggest that APR training promotes the development of relational and reflective skills among Maternal and Child Health professionals. Further research is needed to assess the sustainability of these effects and their impact on family support.
Introduction: In the context of a lack of consensus on the objectives of controlled alcohol consumption, there is a significant gap between patients' preference for controlled drinking and its acceptance by healthcare providers. This literature review aims to clarify the definitions, benefits, and feasibility of controlled drinking. Method: Articles were retrieved from MEDLINE, LiSSa, and CAIRN databases. The selection of articles focused on the period 2013-2023. Results: Of 619 identified articles, 18 were included. Controlled drinking aims to reduce alcohol consumption to low-risk levels. Its benefits are comparable to those of abstinence, and it is considered feasible. Discussion: A quantitative definition of controlled drinking helps clarify this therapeutic objective. Identifying factors that predict the choice and success of controlled drinking helps healthcare providers set shared goals with patients and recommend appropriate treatments..
