La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland

OBJECTIVES: The purpose of this study was to identify and synthesize the best available evidence on the perspective of undergraduate nursing students on facilitating elements that contribute to their success with PBL. DESIGN: a qualitative systematic review of the literature according to meta-aggregative methodology using the JBI SUMARI system was conducted. DATA SOURCES: Data was collected across CINAHL, Medline, Embase, Eric, Teacher Reference Center and reference lists. RESEARCH METHODS: Out of 378 articles, 101 were retrieved for examination and eight were retained after methodological analysis. RESULTS: 51 findings, matched with a verbatim, were extracted and aggregated in five categories: 1) in PBL, the nursing tutor models clinical reasoning and leadership skills; 2) the quality of group interactions is critical to the success of nursing students with PBL; 3) nursing students go through the process of learning with PBL; 4) through PBL, nursing students acquire skills that foster clinical reasoning; and 5) when the PBL method is used as intended, nursing students understand its purpose and process. These categories were aggregated in two syntheses worded as recommendation for practice. CONCLUSIONS: The synthesized recommendations are: 1) tutors should be trained to effectively guide the team work of undergraduate nursing students along the PBL process in order for them to achieve its goal; and 2) nursing students should be securely introduced to PBL and experience the development of their clinical reasoning through PBL. Future research should focus on the strategies undergraduate nursing students use to succeed with PBL and the effectiveness of PBL in enhancing critical thinking and collaboration skills.

Gerontological care in nursing homes receives little interest from students and newly qualified nurses alike. Yet, this population does have ever-more complex needs that call for a wide array of nursing competencies. This article highlights the essential contributions of registered nurses in the context of nursing homes and is part of a research study aimed at grasping the nature of caring for elders. The researchers used the methodology inspired from activity analysis using focus groups. Situations identified by the respondents as being disruptive have been looked at in cross-perspective. The results show that the work carried out by the registered nurses constitutes the linchpin of institutional functioning. Their contribution consists of coordinating all the activities that take place, while striving to make them relevant to the caretakers, residents, and their relatives. This key role comprises three fields of activities: organizational and innovative activities; autonomous, person-centered activities; and ethical tension management activities. By helping to meet the daily challenges pertaining to the care and monitoring of very old people and by dealing with situations that are often tragic, they carry out tasks that are stimulating on human, intellectual, and relational levels.

Abstract Objective: Explore the meanings attributed by young individuals about "living as an adolescent with HIV" in a group of patients that acquired the infection at birth and the elements involved with the adherence to antiretroviral treatment. Methods: Qualitative study, involving 20 subjects (aged 13-20 years), followed at services specialized in the treatment of pediatric AIDS in São Paulo, Brazil. Semi-structured interviews were carried out of which script consisted of questions about their personal histories, experiences and difficulties they must face while living with HIV/AIDS. Results: Being "normal" and "different" were central issues voiced by the participants. However, a normal life situation is guaranteed by being responsible with one's health, the condition that the diagnosis be kept secret and concerns about HIV transmission and dissemination to a sexual partner. The answers about treatment show that adherence is a dynamic process and involves moments of greater or lesser interest in relation to care for one's health. The adolescents have plans and projects and although HIV is considered a stressor, positive perspectives for the future prevailed. Conclusions: To live as an adolescent with HIV involves subtle dimensions that need to be recognized and legitimized by professionals who follow the trajectory of these young individuals. It is necessary to allow a space in which the adolescents can reflect and find support regarding issues related to the construction of their sexuality and care of one's own body.

Placer l’expérience vécue des symptômes des personnes atteintes de maladies chroniques à la base du processus de soins infirmiers représente actuellement un enjeu de la pratique infirmière. Structurer et organiser cette pratique avec une théorie intermédiaire est une condition essentielle au développement de la discipline infirmière. Dès 1994, la faculté des Sciences Infirmières de l’Université de Californie à San Francisco a introduit la Symptom Management Theory (SMT) en se basant sur une analyse de quelques modèles et théories existants. L’objectif de cet article est de présenter la traduction française « la théorie de gestion des symptômes (TGS) » et de discuter son applicabilité dans le domaine de la recherche et de la clinique. Les concepts et leurs relations fonctionnelles sont développés et illustrés pour des symptômes ou des groupes de symptômes les plus fréquemment rencontrés lors de maladies chroniques. Des grilles d’évaluation de plusieurs symptômes, disponibles en français sont également proposées. La TGS permettra d’introduire la SMT et de développer la gestion de symptômes en recherche et pratique en Francophonie. Ainsi depuis les premiers travaux portant sur les besoins le tableau se complexifie avec l’essor épidémiologique des maladies chroniques et nécessite l’apport de nouvelles théories pour enrichir la pratique.

OBJECTIVE: Explore the meanings attributed by young individuals about "living as an adolescent with HIV" in a group of patients that acquired the infection at birth and the elements involved with the adherence to antiretroviral treatment. METHODS: Qualitative study, involving 20 subjects (aged 13-20 years), followed at services specialized in the treatment of pediatric Aids in São Paulo, Brazil. Semi-structured interviews were carried out of which script consisted of questions about their personal histories, experiences and difficulties they must face while living with HIV/Aids. RESULTS: Being "normal" and "different" were central issues voiced by the participants. However, a normal life situation is guaranteed by being responsible with one's health, the condition that the diagnosis be kept secret and concerns about HIV transmission and dissemination to a sexual partner. The answers about treatment show that adherence is a dynamic process and involves moments of greater or lesser interest in relation to care for one's health. The adolescents have plans and projects and although HIV is considered a stressor, positive perspectives for the future prevailed. CONCLUSIONS: To live as an adolescent with HIV involves subtle dimensions that need to be recognized and legitimized by professionals who follow the trajectory of these young individuals. It is necessary to allow a space in which the adolescents can reflect and find support regarding issues related to the construction of their sexuality and care of one's own body.

Vivre seule avec d’importantes limites fonctionnelles amène la personne âgée à s’organiser – pratiquement et mentalement – pour se ménager une vie quotidienne en accord avec ses souhaits. Les efforts sont continus, autant pour juguler la douleur physique que pour faire face à la solitude et à la finitude. Cet article s’appuie sur 20 entretiens menés avec des personnes de plus de 80 ans domiciliées dans le canton de Vaud (Suisse) et bénéficiant des services d’aide et de soins à domicile. Les situations concrètes donnent à voir ce que l’« habiter et vieillir » seule à domicile suppose de ressources fonctionnelles et d’astuces, de stratégies pratiques et de raisonnements intimes. En filigrane, les récits évoquent la solitude et l’intégration de la finitude. Les considérations développées sont abordées sous deux angles : la vie qui se déploie entre ses « quatre murs », et habiter son environnement « hors de ses murs ». Nous posons une distinction entre risques vitaux et menaces existentielles, et observons que la prévention des premiers est subordonnée au souci de maintenir à l’écart les secondes. La démarche d’enquête inspirée de l’« entretien d’explicitation » ouvre des perspectives de renouvellement du regard pour les soins et l’aide à domicile.

L’analyse interactionnelle ouvre des perspectives pour la formation des infirmiers. Seize étudiants et trois enseignants ont mené une analyse interactionnelle d’activités soignantes filmées visant à comprendre la pratique du dévoilement de soi en psychiatrie. En quoi l’usage en formation des outils de l’analyse interactionnelle constitue-t-il une ressource pour l’acquisition de compétences professionnelles en psychiatrie ? Nous montrons comment ce dispositif de formation constitue une ressource dans la professionnalisation des infirmiers pour : a) l’acquisition de savoirs théoriques cliniques, b) l’articulation de ces savoirs avec des activités professionnelles projetées, c) une posture descriptive non-jugeante utile à l’observation clinique.

Abstract Purpose Children’s exposure to intimate partner violence (IPV) is a form of child abuse and can have serious detrimental consequences on their health and well-being. Research has shown that a strong relationship with a caring adult, often the mother, is a protective factor against those consequences. For this reason, this study attempts to understand the overall experiences of victimized mothers with perpetrators, professionals, and institutions in the years following IPV disclosure. Methods We conducted 20 semi-structured individual interviews in Switzerland in 2020 with former patients who had been provided with a clinical forensic consultation between 2011 and 2014. The participants had reported IPV between 2011 and 2014 and had at least one minor child at the time. Results Victimized mothers continued to experience harmful behaviors from perpetrators/fathers after IPV disclosure. They reported feeling in danger and that the perpetrators/fathers benefited from a certain level of impunity. In parallel, the mothers were held accountable for the safety and well-being of their children in this context. These overall and multi-year experiences had short-term and long-term negative impacts on the mothers’ and children’s health, financial and administrative situation, relationship, and on school life. In this sample, the years following IPV disclosure were characterized by an enduring sense of ordeal. Conclusions The professional and institutional handling of IPV situations, in relation to both victims and perpetrators, can endanger victimized mothers and their children and put them at risk of adverse consequences after IPV disclosure. Avenues for change to better protect mother and child and to provide relief to the mothers as an important protective factor for their children are discussed.

REVIEW QUESTION/OBJECTIVE The overall objective of this systematic review is to identify and synthesize the best available evidence on the effectiveness of health literacy interventions in socioeconomically disadvantaged people living in the community to improve health-related outcomes. More specifically, the objectives of this systematic review are to identify and synthesize evidence on the effectiveness of single or complex health literacy interventions in enabling socioeconomically disadvantaged people living in the community to access, understand, appraise and apply health information. INCLUSION CRITERIA Types of participants This review will consider studies that include adults aged 18 years or over, male and female, of any ethnicity and cultural group, and who are socially or socioeconomically disadvantaged in the community. PROGRESS factors, including Place of residence, Race/ethnicity - culture - language, Occupation, Gender, Religion, Education, Socio economic status, Social capital or age, will serve to identify “disadvantaged” people and social groups. These are “socially stratifying factors that drive variations in health outcomes” and contribute to disparities in health. For example, people living in rural areas, from a minority group, with low education or low income, are considered as disadvantaged and are at risk of health disparities. In this review, studies considering any or several of these factors will be considered for inclusion. In this review, studies conducted in any community setting will be considered, such as community centers, community preventive services, community-based health promotion settings, community healthcare facilities, primary healthcare centers, homes or worksite settings. Exclusion criteria: studies involving children aged under 18 years TRUNCATED AT 250 WORDS

We use functional Magnetic Resonance Imaging (fMRI) to explore synchronized neural responses between observers of audiovisual presentation of a string quartet performance during free viewing. Audio presentation was accompanied by visual presentation of the string quartet as stick figures observed from a static viewpoint. Brain data from 18 musical novices were obtained during audiovisual presentation of a 116 s performance of the allegro of String Quartet, No. 14 in D minor by Schubert played by the 'Quartetto di Cremona.' These data were analyzed using intersubject correlation (ISC). Results showed extensive ISC in auditory and visual areas as well as parietal cortex, frontal cortex and subcortical areas including the medial geniculate and basal ganglia (putamen). These results from a single fixed viewpoint of multiple musicians are greater than previous reports of ISC from unstructured group activity but are broadly consistent with related research that used ISC to explore listening to music or watching solo dance. A feature analysis examining the relationship between brain activity and physical features of the auditory and visual signals yielded findings of a large proportion of activity related to auditory and visual processing, particularly in the superior temporal gyrus (STG) as well as midbrain areas. Motor areas were also involved, potentially as a result of watching motion from the stick figure display of musicians in the string quartet. These results reveal involvement of areas such as the putamen in processing complex musical performance and highlight the potential of using brief naturalistic stimuli to localize distinct brain areas and elucidate potential mechanisms underlying multisensory integration.

Résumé L’article propose une réflexion sur les liens existant entre accompagnement et soins infirmiers plus spécialement. L’auteur part du postulat qu’il existe une relation d’origine et de substance entre soigner et accompagner. Il s’appuie pour cela sur une approche anthropologique des soins qui développe l’idée que soigner est au carrefour de ce qui permet de vivre et d’exister quelles que soient les sociétés et les cultures, et que les soins sont antérieurs à la maladie. Formé en soins infirmiers mais aussi en sciences sociales et en théologie, il cherche à rendre compte de cette articulation en en montrant les ambiguïtés et les tensions. Dans cette réflexion, la question d’une spécificité de l’accompagnement infirmier est posée et développée à partir d’une certaine vision des soins, tout en restant ouvert. Cet itinéraire s’apparente à une esquisse visant à promouvoir un travail pluridisciplinaire et épistémologique autour des pratiques d’accompagnement, l’entrée ici étant d’abord celle des soins infirmiers.

Children's exposure to intimate partner violence (IPV) is a widespread phenomenon that can have detrimental consequences on their health and well-being. This study examined how clinical forensic consultation data of adult victims of IPV might provide information on the potential suffering of children exposed to IPV, the duration of exposure and the knowledge of the situation by the professionals with whom those children were in contact. Data were collected from the consultation files of 112 adult victims of IPV who consulted the Violence Medical Unit at the Lausanne University Hospital (Switzerland) in 2014, and who were parents of children aged 0 through 12. Descriptive quantitative and qualitative analyses were performed. Symptoms of suffering, such as dysregulation of instinctual functions and developmental, behavioral or emotional difficulties, were reported for nearly one-third of the victims' children. Children's exposure to IPV often started around their birth and about four in 10 children had been exposed for three years or more. Health and childhood professionals were unaware of the exposure for the vast majority of the children. Clinical forensic data can be useful in providing information on the suffering and care of children exposed to IPV. Their suffering took the form of a non-specific posttraumatic symptomatology and therefore might be difficult to detect. It is necessary to make professionals and parents aware of the fact that IPV can have a harmful impact on children's health and well-being, and to encourage health professionals to consider the possibility of IPV when facing such symptoms.

Review question/objective The objective of this quantitative systematic review is to identify and synthesize the evidence on the effectiveness of nurse-led healthy aging (HA) strategies for older adults living in the community. More specifically, the objectives of this systematic review are to identify and synthesize the evidence on: 1) The effectiveness of health promotion interventions, delivered or co-delivered by a nurse, on HA outcomes such as wellbeing and/or the physical, mental, spiritual and/or social health of older adults living in the community. 2) The effectiveness of primary prevention interventions, delivered or co-delivered by a nurse, on HA outcomes such as wellbeing and/or the physical, mental, spiritual and/or social health of older adults living in the community. 3) The effectiveness of interventions, combining health promotion and primary prevention, delivered or co-delivered by a nurse, on HA outcomes, such as wellbeing and/or the physical, mental, spiritual and/or social health of older adults living in the community. Background The world's rapidly aging population is leading to an ever greater need for financial, human and material resources.1,2 Caring for older adults has become a major focus of public healthcare services. Interest in the processes of HA has gained momentum. Historically, aging was defined according to chronological stages of life. Nowadays, functional definitions of age identify components of successful aging, such as an active engagement in life, optimal cognitive and physical function, and a low risk of disease.3 Although slowing down, both physically and cognitively, defines the process of aging, healthy older people may adapt to the decline and partially compensate it. This allows them to function optimally within their limitations and continue to be physically, cognitively, socially and spiritually active.4 HA has been defined as “the process of optimizing opportunities for physical, social and mental health to enable older people to take an active part in society without discrimination and to enjoy an independent and good quality of life”.5(p16) Beyond health, quality of life generally represents the distal goal of the process.6 However nurses may prefer to work with the concept of wellbeing.6 This concept has emerged in an attempt to take into account elements specific to individuals and their social environment in addition to socioeconomic dimensions.7 Wellbeing is possible when individuals’ physical, psychological and social resources are sufficient to meet their physical, psychological or social needs.8 Population studies have demonstrated significant health gains for people who have adopted lifelong healthy habits including nutrition, exercise and volunteering.9,10 Lifestyle-related functional decline may decrease or even be reversed.1 Cataldo11 has shown that tobacco cessation improves pulmonary function and positively influences health outcomes, even among people in their 70s. Factors such as the level of control people believe they have over their life, their level of physical activity, and their perceptions of the quality of their social network, all positively influence their life course.12 Healthy aging begins as early as in the fetal stage and it is fostered by a lifelong attitude toward health. However, the transition from an active working life to retirement has become the focus of specific interventions targeting HA.5 Thoughts about this transition often start some years before actual retirement. In several countries, 50 is the operational age for “early old age” interventions.5 According to the Ottawa charter of Health Promotion,13 health improvements can be achieved by targeting five key areas: 1) Building healthy public policy; 2) Reorienting health services; 3) Strengthening community action; 4) Creating supportive environment; and 5) Fostering the development of personal skills. Pender et al. define health promotion as “increasing the level of well-being and self-actualization of a given individual or group”,14(p37) a concept akin to positive psychology. Primary prevention is an epidemiological concept defined as avoiding hazards, substances and behaviors that lead to diseases.15 Although health promotion and primary prevention originate from different theoretical backgrounds, in clinical nursing practice, the interventions tend to overlap.16 Primary prevention interventions may promote health and resilience while impeding the occurrence of health problems. These interventions may target populations that are in good health, just as health promotion interventions may address people living with a chronic illness.17 These interventions may be universal and apply to the general population, selective and apply for a subgroup at risk, or indicated for a person identified as having a specific risk.18 Nursing interventions focus on health processes involving people, defined as individual, family or community, in their environment,19 such as helping caregivers to develop the resources needed to maintain their wellbeing, or fostering the development of cooking skills among older men living alone. Good cooking skills seem to be correlated with better physical health and a more adequate diet among this population.20 According to an integrative review of nurses’ role in health promotion,21 nurses operate through five major functions: 1) Collaboration, including information sharing and referrals with a multidisciplinary team; 2) Communication, including listening skills, empowering attitudes and decision sharing with the patient; 3) Assessment, including the ability to identify health problems and resources as well as their underlying socio-economic and cultural aspects; 4) Ability to implement, including applying knowledge of health issues and of health promotion theories to nursing practice; and 5) Advocacy, including encouraging patient participation and acting as an intermediary. Nursing theory can inform HA processes such as: 1) Fostering developmental transitions;22 2) Protecting wellbeing from stressors and supporting the development of health protective factors;16 or 3) Focusing on developing strengths in aging people and their families to enhance their well-being.23,24 Nursing studies have been conducted on topics such as a midlife women's health assessment clinic,25 or the development of a HA model.26 A study of a nurse-led health promotion intervention among frail elders, conducted during the 80s, prolonged staying at home and increased survival.27 The recent study of three trials of a nurse-led health promotion intervention among frail older adults showed increases in their health-related quality of life.28 Systematic review databases such as Cochrane Central Register of Trials, Best BETS, Campbell Systematic Reviews, JBI Database of Systematic Reviews and Implementation Reports and DARE were examined. However, a preliminary search of literature found no systematic review covered the scope of the present review protocol. Systematic reviews related to specific health behaviors, such as healthy eating,29 involvement in primary care,30 lifestyle interventions on reducing cardiovascular risks,31 medication compliance,32,33 increasing physical activity,34 and preventing social isolation,35 have all been undertaken. Health aging is a recent and encompassing concept, and only one systematic review addressed home-based health promotion for older people by nurses.36 It focused on adults over the age of 65 years receiving regular home visits and was somewhat restricted in its scope. Effectiveness outcomes included mortality, health and functional status. Nurse led interventions have become an important component of a sustainable public healthcare system. Therefore, it is highly pertinent and useful to review the literature for indications on the effectiveness of these interventions on HA. This quantitative systematic review will aim to identify and synthesize the best available evidence on nursing interventions fostering HA. Recommendations derived from this review will contribute to: 1) The inclusion of nursing interventions on HA that have been shown to be effective in public health strategies; 2) Fostering comprehensive HA intervention planning; 3) The dissemination among nurses of information on evidence-based health promotion interventions for HA and, 4) Information for the aging population about nursing interventions which may benefit them. Inclusion criteria Types of participants This review will consider studies including male and female adults aged 50 or older, living in the community, and irrespective of the nursing care they may otherwise receive, were offered a nursing intervention for HA. In this review, older people with a terminal illness, hospitalized in-patients, people living in nursing or other institutional living facilities, and older adults with impaired cognition, as measured by Mini Mental State examination,37 that prevents them from taking an active part in society and enjoying independent living will be excluded.4 Types of intervention(s)/phenomena of interest This review will consider studies that evaluate interventions on HA as defined by the Ottawa charter13 and delivered or co-delivered by a nurse. To deliver these interventions, the nurse may operate through one or more of her health promotion functions,19 such as suggesting participation in a ballroom dancing class (collaboration), promoting the use of hearing protection equipment among farmworkers (advocacy) or helping participants to set their own goals (communication), identify their strengths (assessment) and stretch regularly when working on the computer (implementation). Interventions can take place in participants’ homes, community health centers, or other relevant settings. Interventions may include face-to-face delivery, group delivery, tele-nursing or any other relevant method or combination of methods. The interventions may involve one or more sessions and can also vary in duration. A nurse is a person who is legally licensed and/or registered to practice the full scope of nursing in his or her country.† He/she may work in a multidisciplinary team. In this review, intervention focused on the detection, treatment, or prevention of complications due to health problems or interventions on disease self-management without a health promotion component will be excluded. Types of outcomes This review will consider studies that include one or more of the following outcome measures, as defined by the “impact pathway of the health promotion intervention logic model”38 informed by the “Outcomes of interest to the Cochrane Consumers and Communication Review Group”.39 Primary outcomes include: wellbeing that will provide measurements of psychological health, quality of life, activities of daily living, leisure activities, biological parameters of physical health, health-enhancing lifestyle, self-efficacy and other related outcomes. Secondary outcomes include: 1)Knowledge and understanding; 2) Participant decision-making, including decisions made and satisfaction with decision taken; 3) Evaluation of care, including goal attainment; 4) social support that will provide measurements of social health; 5) Skills acquisition; 6) Health behavior including adherence to treatment, screening, or vaccination schedule; and 7) Other relevant outcomes. The term behavior refers not only to directly observable actions but also to the psychological events and feeling states that are only measurable indirectly.40 This review will also consider adverse effect(s) of nursing interventions on HA in the targeted population. † Retrieved from http://www.icn.ch/images/stories/documents/publications/position_statements/A10_Nature_Scope_Practice_Nurse-Midwives.pdf Wellbeing can be measured using Satisfaction with Life Scale.41 Quality of life can be measured using the HRQol which may include a measure of spiritual health.42 Activities of daily living can be measured using the ADL index.43 Leisure activities can be measured using the Leisure Motivation Scale.44 Decision made can be represented by a SMART objective.45 Goal attainment can be measured using the Goal Attainment Scale.46 Other outcomes will be included if they were measured using standardized instruments. In this review, outcomes resulting from Illness or addiction management and prevention of disease complications will be excluded. Types of studies The quantitative component of the review will consider for inclusion any experimental study design including randomized controlled trials, non-randomized controlled trials and quasi-experimental before and after studies. Search strategy Our search strategy aims to find both published and unpublished studies. A three-step search strategy will be used in this review. An initial limited search of MEDLINE and CINAHL will be followed by an analysis of the words contained in the title, abstract, and index terms used to describe the articles. A second search using all identified keywords and index terms will then be undertaken across all included databases. Residual duplicates will be identified using the EndNote X747 Reference Manager and removed. Thirdly, the reference list of all relevant identified reports and articles will be searched for additional studies. Studies published in any language will be considered for inclusion in this review. Assessment for inclusion of papers in languages other than Romance languages (e.g. Spanish, French, Portuguese, Italian) and Germanic languages (e.g. English, German, Dutch) will be based on their English language abstract available. Relevant studies will be translated in English. The review will consider all published studies from inception, for the purpose of assessing their relevance and methodological quality rather than including a study based on the publication date. The search in CINAHL will be performed to filter out articles also published in PubMed. Individual search strategies will be developed for each database to account for any differences across Thesaurus terminology and indexing. Titles and abstracts of studies retrieved will be assessed for relevance against the inclusion and exclusion criteria. Bibliographic details of the studies will be downloaded or manually entered into the EndNote X747 references management database. The databases to be searched include: Australian Clinical Trial Registry (ACTR), CRD Databases (including NHS EED, HTA), CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, ERIC, Health Source: nursing/academic edition, PsycINFO, TRIP, Medline-PubMed and Web of Science. The search for unpublished studies will include: Clinical trial registers, conference proceedings and an internet search on DOAJ, Google, Google Scholar, Mednar, ProQuest Dissertations and Theses, DART-Europe E-theses Portal and WorldCat. Initial keywords to be used will be: 1) Aged [MH] OR Aging [MH] OR Middle Aged [MH]; 2) Health Promotion [Mesh:NoExp] OR Health Education [Mesh:NoExp] OR Health Communication [Mesh:NoExp] OR Primary Prevention [Mesh:NoNoExp]; 3) Nurse's role [Mesh:NoExp] OR Nursing [Mesh:NoExp] OR Community Health Nursing [Mesh:NoExp] OR Public Health Nursing [Mesh:NoExp]; 4) Health literacy [MH] OR Health Knowledge, Attitudes, Practice [MH] OR Health Behavior [MH] OR Quality of Life [MH] OR Self Efficacy [MH] OR Social Support [MH] OR Risk Reduction Behavior [Mesh:NoExp] OR Life style [Mesh:NoExp]. Assessment of methodological quality Quantitative papers selected for retrieval will be assessed independently by two reviewers for methodological validity prior to inclusion in the review using a standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Studies will be included if there is an agreement that seven out of ten criteria are met, in order to control for methodological diversity. The PRISMA flowchart will illustrate the process of including papers.48 Data extraction Upon agreement between the reviewers, quantitative data will be extracted from papers included in the review using the JBI data extraction form for experimental studies (Appendix II). The data will then be transferred to the standardized data extraction tool from JBI-MAStARI. The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives. Authors of primary studies will be contacted for missing information or to clarify unclear data. Data synthesis Quantitative papers will, where possible, be pooled in statistical meta-analysis using the Cochrane Collaboration's Review Manager.49 All results will be subjected to double data entry. Effect sizes will be expressed as odds ratio (OR) for categorical data and weighted mean differences (MD) for continuous data, and their 95% confidence intervals will be calculated for analysis. Heterogeneity will be assessed statistically using the standard Chi-square test. In the absence of clinical and statistical heterogeneity, a fixed-effect model will be applied to pooled data. In the presence of statistical heterogeneity, a random effects model will be applied for meta-analysis. Subgroup analyses, based on the different quantitative study designs included in this review, will be used to explore variations in treatment effects. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate. Conflicts of interest The authors declare that there are no conflicts of interest.

Review question/objective The quantitative objective of this review is to identify the effectiveness of nursing interventions on the well-being of people with Parkinson's disease (PWPD) and/or their caregivers living in the community. More specifically, the objectives are to identify: The effectiveness of nursing interventions on the well-being of PWPD living in the community. The effectiveness of nursing interventions on well-being of caregivers of PWPD living in the community. The effectiveness of nursing interventions on well-being of dyads composed of PWPD and their caregiver living in the community. The qualitative objectives are to identify the feasibility, meaningfulness and appropriateness of: nursing interventions on well-being for people with Parkinson's disease and/or their caregivers living in the community. Background Parkinson's disease (PD) is a neurodegenerative chronic disease linked to the disappearance of dopaminergic neurons.1 Parkinson's disease affects about 1% of the population aged 60 or over, and 3% of those aged 80 or over.3 Statistical forecasts point to a 100% increase in the prevalence of PD by the year 2030 in Western Europe.4 Parkinson's disease impacts on all aspects of living including physical, mental and social health. 1) Living with PD affects physical health. Loss of automatic movements leads to motor impairment, including tremors, muscular rigidity and slowness, the first and more visible symptoms of PD.5 However, non-motor symptoms constitute the largest part of the array of symptoms experienced by PWPD.6 Perturbations of the autonomous nervous system impair bodily functions such as balance, sleep urine continence, bowel movements, swallowing, production of saliva and sweat, erectile function and blood pressure.7 Due to insufficient awareness of the link between PD and these symptoms, they may be underreported.8 These symptoms negatively affect PWPD's well-being.9 2) Living with PD affects mental health. The disease generates psychiatric pathologies such as depression or dementia in the later stages of the disease.10 Symptoms of depression seem to correlate with a deterioration of motor disorders and a decrease in well-being. Events generating anxiety such as diagnosis announcement may also bear on the well-being of PWPD.11 3) Living with PD affects social health. Impairment of bodily functions correlates with a decrease in activity level and social participation. Verbal communication difficulties, lack of facial expression and slowness may lead to an under-assessment of cognitive functions as well as social and professional stigmatization. Difficulties in the social sphere may lead PWPD to reduce their participation in activities that involve leaving home, which in turn, intensifies social isolation.12 People with Parkinson's disease experience a decrease in self-esteem and self-image that may lead them to refrain from expressing their care needs.13 Currently, rehabilitation contributes to hinder the progression of functional losses14 and only symptomatic surgical and pharmaceutical treatment is available. If therapeutic adherence is a challenge for people living with a chronic disease, it is even more the case for PWPD who experience motor and cognitive impairments.15 Moreover, a dopamine based pharmaceutical treatment may induce compulsive behaviors such as increased sex drive or internet shopping. These secondary effects unsettle significant others.16 Lack of awareness of the link between these addictions and dopamine dysregulation may lead to under-reporting of symptom.17 As PD affects PWPD in the different dimensions of life, fostering well-being is an essential dimension of care for patients subjected to a degenerative process. Well-being is possible when individuals have the psychological, social and physical resources, to deal with a specific psychological, social or physical challenge18 and may be experienced despite the worsening of symptoms. With the disease leading to decreased autonomy and volition over time, PWPD must increasingly rely on the help of his/her caregiver, who becomes a central resource of care. A caregiver is a person who provides unpaid care because of the close relationship with whom they care for.19 The caregiver participates in care decisions made by the PWPD, performs care giving tasks, seeks and coordinates interventions of formal services, thus contributing to the PWPD's well-being.20 To be a caregiver may negatively impact on one's quality of life. A PWPD's functional status is the main predictor of his caregiver's well-being.9,21 The caregiver's health risks and social isolation increase along the continuum of PD progression and symptoms aggravation.22,23 The lack of support from the formal health sector increases health risks for both caregivers and PWPD.24 When the physical or mental health of the caregiver is affected, it puts the PWPD at a greater risk for symptoms exacerbation and falls. In regards to the needs of PWPD and caregivers, it seems necessary to synthesize the best available literature about nursing interventions addressing the dyad as well as individual needs.25 Interventions for PWPD offered by different health professionals such as physicians, speech therapists, neuropsychologists and physiotherapists, mainly address symptoms management in an effort to reduce the evolution of the disease.26 Although nurses play a central role in PD care, practice guidelines such as NICE only partially describe their role.27 In the realm of chronic disease management, nurses primarily foster self-care through:28 1) acquisition of knowledge and motivation; 2) informed health enhancing choices; and 3) acting according to one's values.29 Only secondarily does the nurse provide assistive care. One of the main goals of nurses' self-care support is to foster well-being in patients. Nurses' competencies in facilitating patients' well-being encompass: 1) collaboration which includes information sharing and referrals with the multidisciplinary team; 2) communication which includes listening skills, empowering attitudes and decision sharing with the patient; 3) assessment which is understood as the ability to identify health problems and resources as well as their underlying socio-economic and cultural aspects; 4) ability to implement which includes applying knowledge of health issues and of health promotion theories to nursing practice; and 5) advocacy which includes encouraging patient participation and acting as an intermediate.30 Currently, no comprehensive systematic review encompasses interventions which foster well-being among PWPD and/or their caregivers in the community that may be provided by a nurse. A review of effectiveness of multidisciplinary interventions on the quality of life among PWPD31 and another one on integrative care for PWPD32 were either inconclusive or of limited evidence. This might point towards the need to include feasibility and appropriateness studies. A systematic review on the effectiveness of empowerment strategies for people living with a chronic disease does not address neurodegenerative diseases.33 Systematic reviews addressing factors associated with recurrent falls among PWPD,21 as well as those on psychosocial interventions for caregivers of older adults34,35 and interventions for caregivers of people living with dementia36 may feed into our topic, but do not cover the scope of this review. A systematic review on rehabilitation interventions for PWPD did not refer to nurses' competencies.37 This study will aim to identify and synthesize the best available evidence on interventions which foster well-being among PWPD and/or their caregiver living in the community that may be performed by a nurse, will form phase one of a part of a larger study. Based on the available evidence, the next phase of this project will involve development of guidelines in consultation with an expert group. These guidelines will then be used to develop a nursing intervention, which will allow for the right strategy for each patient and caregiver in the right way, moving knowledge into action. Inclusion criteria Types of participants The quantitative component of this review will consider studies that include adult and older adult, male and female, of any age diagnosed with PD stages one to three according to Hoehn & Yahr38 and/or caregivers of PWPD. These three stages refer to PWPD that suffer from little cognitive impairment and thus have sufficient cognitive skills to participate in an educational intervention. In the absence of the Hoehn & Yahr stage, studies that include PWPD assessed for cognitive skills by other means will be considered. Caregivers of PWPD will be included regardless of 1) the Hoehn & Yahr PD stage of the person they care for; and 2) their role as caregivers. Exclusion criteria: 1) PWPD with advanced symptoms of dementia according to Hoehn and Yahr or to a similar measure of mental status; and 2) people diagnosed with Parkinson's syndrome. The qualitative component of this review will consider studies that include adult and older adult, male and female, of any age diagnosed with PD at any stage and/or caregivers of PWPD. Caregivers of PWPD will be included regardless of their role as caregivers. Exclusion criteria: People diagnosed with Parkinson's syndrome and their caregivers. Types of intervention(s)/phenomena of interest The quantitative component of the review will consider studies that evaluate interventions which foster well-being among PWPD and/or caregivers as performed by a nurse or another healthcare professional, such as physiotherapists, psychologists, physicians, occupational therapists and others, as long as they relate to one or more of the following nurses' competencies: 1) collaboration with the multidisciplinary team; 2) communication with patient and/or caregiver; 3) clinical assessment; 4) implementation of self-care support such as but not limited to symptoms management, treatment adherence, learning strategies meant to decrease freezing, enhancing communication skills, coping enhancement, counseling or development of meaning; and 5) advocacy such as but not limited to: encouraging participation in a patient organization. Studies evaluating a combination of interventions will also be included. Exclusion criteria: 1) care for dementia; 2) assistive care; and 3) interventions not related to nurses' competences. The qualitative component of this review will consider studies that investigate the following phenomena of interest: 1) meaningfulness: the experiences of well-being among PWPD and/or their caregiver; 2) acceptability: cultural, environmental and socio-economic characteristics of well-being among PWPD and/or their caregivers; and 3) feasibility: competencies and resources in the health system fostering well-being among PWPD and their caregivers. Exclusion criteria: 1) care for dementia; 2) assistive care; and 3) interventions not related to nurses' competencies or intervention with different strategy for fostering well-being. Types of outcomes The quantitative component of this review will consider studies that include one or more of the following outcomes as defined by the impact pathway of the health promotion intervention logic model,39 as informed by, but not limited to, the Outcomes of interest to the Cochrane consumers and communication review group:40 People with Parkinson's disease. Primary outcome: well-being and proximal physical, psychological and social health outcomes such as: quality of life, activities of daily living, leisure activities, health-enhancing lifestyle, self-efficacy, depression and other related outcomes. Secondary outcomes: 1) knowledge and understanding; 2) participant decision-making including decision made and satisfaction with decision taken; 3) evaluation of care including symptoms alleviation and goal attainment; 5) social support; 6) skills acquisition and symptoms control; 7) health behavior including adherence; and 8) other relevant outcomes. Well-being may be measured by PDQ-3941 or related measures of well-being and Health Related Quality Of Life such as PDQL-37.42 Activities of daily living may be measured by the Parkinson's Disease Activities of Daily Living Scale.43 Decision made may be represented by a SMART objective.44 Symptoms alleviation may be measured by the modified Unified Parkinson's Disease Rating Scale.45 Decision made may be represented by a SMART objective.44 Goal attainment may be measured by the Goal Attainment Scale.46 Other outcomes will be considered if measured with standardized instruments. Caregivers. Primary outcome: well-being and proximal physical, psychological and social health outcomes such as quality of life, leisure activities, health-enhancing lifestyle, self-efficacy, depression and other related outcomes. Secondary outcomes: 1) burden of care; 2) knowledge and understanding; 3) decision-making including decision made and satisfaction with decision taken; 4) evaluation of intervention including fatigue alleviation and goal attainment; 5) social support; 6) skills acquisition including stress management or fatigue control; 7) health behavior including attitudes toward caregiving; and 8) other relevant outcomes. Well-being may be measured with PDQ-carer.47 Self-efficacy may be measured with the revised scale of caregiving self-efficacy.48 Burden of care may be measured by the Zarit caregiver burden inventory.49 Other outcomes will be considered if measured with standardized instruments. Types of studies The quantitative component of the review will consider any experimental study design including randomized controlled trials, non-randomized controlled trials, quasi-experimental and before and after studies. The qualitative component of the review will consider studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Exclusion criteria: quantitative data on feasibility. Search strategy The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of MEDLINE and CINAHL will be undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Studies published in any language will be considered for inclusion in this review. Assessment for inclusion of papers in languages other than Romance or Germanic will be based on the English language abstract where available. Studies published up to the present will be considered for inclusion in this review. The databases to be searched include: Australian Clinical Trial Registry (ACTR), Best BETS, Campbell Collaboration Library, CDR Databases (including DARE, EEH, HTA), CINAHL, Cochrane Library, Embase, Eric, Health Source: nursing/academic edition, (SS12) OTSeeker, PEDro, PsycINFO, TRIP, Medline-PubMed and Web of Science. The search for unpublished studies will include: Clinical trial registers, conference proceedings and an internet search on doaj, google, google scholar, mednar and wordcat. Initial keywords to be used will be: 1) Parkinson's disease or caregiver; 2) patient care “[Mesh:NoExp], nursing care, home nursing, needs assessment “[Mesh:NoExp], health promotion”[Mesh:NoExp] or patient education as topic “[Mesh:NoExp] ; 3) Well-being (no Mesh term: see quality of life], quality of life, self-care “[Mesh:NoExp], health knowledge, attitudes and practice, health behavior “[Mesh:NoExp], patient compliance, social support, self-concept or activities of daily living. Assessment of methodological quality Quantitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Qualitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Data collection Quantitative data will be extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI (Appendix II), upon agreement between reviewers. The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives. Qualitative data will be extracted from papers included in the review using the standardized data extraction tool from JBI-QARI (Appendix II), upon agreement between reviewers. The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives. Authors of both quantitative and qualitative primary studies will be contacted for missing information or to clarify unclear data. Data synthesis Quantitative papers will, where possible, be pooled in statistical meta-analysis using Cochrane's Collaboration Review Manager software. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. Random effects models will be used to confirm the presence of heterogeneity. Heterogeneity will then be assessed statistically using the standard Chi-square and also explored using subgroup analyses based on the quantitative study design included in the review. Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate. Qualitative research findings will, where possible be pooled using JBI-QARI. This will involve the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, through assembling the findings rated according to their quality, and categorizing these findings on the basis of similarity in meaning. These categories are then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. Where textual pooling is not possible the findings will be presented in narrative form. The findings of each single-method synthesis included in this review will be aggregated. To our knowledge, there is no software. We will use the methodology described in the JBI reviewers' manual 2014: methodology for JBI mixed methods systematic reviews. This will involve the configuration of the findings to generate a set of statements that represent that aggregation through coding any quantitative data to attribute a thematic description to all quantitative findings; assembling all of the resulting themes from quantitative and qualitative syntheses; and the configuration of these themes to produce a set of synthesized findings in the form of a theoretical framework, set of recommendations or conclusions. Conflicts of interest We declare that there are no conflicts of interest. Acknowledgements This review is funded by the health network of the University of Applied Sciences and Arts Western Switzerland.

Abstract Purpose Children’s experience of parental intimate partner violence (IPV) often coexists with other types of victimization and is associated with negative short- and long-term health and well-being outcomes in both childhood and adulthood. Research on factors that protect against these adverse outcomes is mostly quantitative in nature and limited by the lack of qualitative exploratory work in this area. This paper reports on the resources on which children exposed to IPV have relied, the barriers they have identified to talking about IPV and other victimizations, and their unmet needs. Methods Data were collected in 2022 through semi-structured individual interviews with 20 youth aged 14–28 years who had been exposed to IPV while they were minors, and whose parent had consulted a clinical forensic consultation for IPV between 2011 and 2018. The interviews covered all major areas of the participants’ lives since birth. A thematic content analysis was conducted on the interview transcripts. The study utilized Brofenbrenner’s ecological framework, as adapted by Heise, and the analysis drew on Grych, Hamby and Banyard’s Resilience Portfolio Model to explore children’s resources. Results Participants reported personal strengths and assets known to be particularly important for resilience: meaning making strengths, self-regulatory strengths and interpersonal assets including support from family, and especially from the victimized parent. Engaging in hobbies provided them with various benefits, as did some interactions with various professionals. However, participants rarely discussed IPV and other victimizations with professionals or with family and friends, and barriers to doing so were identified. In terms of unmet needs and advice to parents and professionals, participants argued that violence should stop, and identified their need to be heard and protected, and that IPV should not be a taboo. In their view, professionals need to be particularly attentive to changes in children, and be proactive with them. Involving children in decision-making processes was also identified as important. Finally, the analysis showed that these children’s resources and needs evolve over time. Conclusions Children exposed to IPV use a full range of resources, both personal and external to them, and demonstrate agency to cope with adversity. Professionals need to be aware of each child’s specific resources and needs in order to support them. Results also suggest the need for long-term follow-up. Recommendations address prevention, detection and intervention.

BACKGROUND: In Switzerland as in many countries, steady trend is observed in nursing homes to promote writing of advanced directives (ADs). Implementation of ADs reflects the rise in public concern for the persons' right to self-determination and informed decision. The issue of end-of-life conditions is particularly acute in situations with dementia. This article investigates how ADs interventions in nursing homes strive simultaneously to behave in line with the principles of care ethics and with the intention to respond to legally binding instructions. Healthcare to dying residents with dementia in nursing homes is interpreted in light of the Regulation theory. METHODS: Nursing home palliative care reference nurses were contacted through questionnaire. One hundred twenty-one addresses were reached, 69 responses were collected, giving a response rate of 57%. In order to deepen the understanding, 10 semi-directive interviews were conducted in 10 different nursing facilities with 12 palliative nurses. RESULTS: Presently, Swiss nursing homes are lacking a model of AD suitable to people with dementia. The study sheds light on dissimilarities in the purpose assigned to ADs' procedure in the different facilities. Discrepancies in end-of-life care practices reveal more the influence of structural and organisational devices specific to each setting than conflicting views on end-of-life care principles. We analyse the interpretation of the Law and its implementation in the participating NHs as compromises that could be accounted for as a form of social regulation. CONCLUSION: Dementia accentuates the uncertainty inherent to end-of-life trajectories. The implementation of standardised procedures aimed at collecting the wishes of the person deprived of his or her discernment is source of dissonances with regard to the multiple interests involved in these care situations. In this context, the drafting of ADs during end-of-life care in NH correspond to new normative constraints requiring new collective regulation actions.

Les modes de prise en charge de la vieillesse ont connu de considérables changements au cours du temps. Les mesures sociales et sanitaires mises en place pour répondre aux problématiques soulevées par le sort des personnes âgées sont principalement déterminées par les images sociales prégnantes de cette catégorie de la population. Il s’agit d’examiner la manière dont ses besoins spécifiques sont appréhendés, en fonction des caractéristiques socioéconomiques des individus et de leur état de santé. Par l’analyse de l’histoire des représentations sur le grand âge dans le canton de Vaud (Suisse romande) entre la fin du xixe siècle et le début du xxie siècle, cet article vise à étudier les transformations des rapports entre la société et ses aînés. Cette évolution renvoie à des modifications sociales, culturelles, économiques et politiques qui permettent de réfléchir aux problématiques actuelles relatives au vieillissement démographique et aux enjeux concernant le devenir des systèmes sanitaires.

The most frequent dialysis modality in Switzerland is hemodialysis. Patients need a proper vascular access for this modality. There are three types of vascular access for hemodialysis : arteriovenous fistula, arteriovenous graft and central venous catheters. In this article, we will discuss the most important parameters that need to be taken into account when choosing the most appropriate access. We present the advantages and disadvantages of each vascular access, as well as their main local (thrombosis, infection, steal syndrome) and systemic (heart failure, pulmonary hypertension) complications, which may also be encountered by primary care physicians.

Le but de cette étude pilote était de tester la faisabilité et l’acceptabilité de la version française d’un programme animé par des pairs sur le dévoilement à autrui d’informations sur sa maladie pour des personnes atteintes de troubles psychiatriques. Honnête, ouvert, prêt (HOP) est un programme court qui invite les participants à échanger sur la problématique du dévoilement de la maladie psychique. Trente et une personnes souffrant de troubles psychiatriques ont été recrutées dans trois institutions psychosociales pour tester ce programme. Les résultats montrent que le programme est faisable et acceptable pour les participants. La participation aux sessions pourrait conduire à une réduction de l’auto-stigmatisation. Le programme HOP offre une opportunité aux personnes atteintes de troubles psychiques d’échanger et de réfléchir sur le dilemme du dévoilement de la maladie psychique. This pilot study aims to assess the feasibility and acceptability of a short program about disclosure of mental illness for people with psychiatric disorders. The participants with a diagnosis of a severe psychiatric disorder were recruited in three psychosocial institutions in French-speaking Switzerland to attend 4 one-hour group sessions of the program Honest, Open, Proud. The sessions were led by a peer practitioner and a psychiatric nurse, using the program guide and the exercise manual shared with the participants. These documents were developed by the team of Patrick Corrigan and are available online. Session 1 invites the participants to consider the advantages and disadvantages of disclosing a mental illness. The costs and benefits are also put into perspective according to different contexts and the potential short- and long-term consequences. Session 2 presents different ways to disclose, from social avoidance to openly spreading one's experience. Session 3 allows participants to learn how to tell their own story. One month after session 3, participants attend a recall session to review their intentions to disclose or not after attending the program and if they have done so, talk about this experience. Self-stigma was measured with the Internalized Stigma of Mental Illness scale, comprising five dimensions; alienation, stereotype adherence, perceived discrimination, social withdrawal and resistance to stigmatization. Acceptability of the program for participants was measured by a 11-item self-reported questionnaire, open questions, attendance rate and drop out. Feasibility was assessed through its operational (training, accessibility, human resources), economics and legal (translation rights ethical considerations) dimensions. The results are based on data from a sample of 31 participants, aged 43 on average (SD 11.85) with a disease duration of 12.3 years (SD 8.77). The participation rate for HOP sessions was at 93.5%. Most of participants (23/29) attended all sessions, five participants attended three sessions and two participants attended two sessions. Most of participants (84%) appreciated the facilitation by a mental health peer practitioner and having the opportunity to talk about something they could not address elsewhere (73%). For 92% of them, elements of HOP could be applied in their daily lives and all are unanimous when recommending HOP to other people with psychiatric disorders. The HOP program is designed to be facilitated by peer practitioners, yet in Switzerland, their number and integration into care settings is still limited. The program has been feasible with a peer-practitioner only, in three institutions. The program is available freely for peer-practitioners and without cost for the participants and was adapted to the cultural context and was led in four sessions. It was accepted by the ethical committee for human being research and the original authors gave the right to translate it into French. Participants ask for a longer intervention with more practical exercises. In pretest, the average self-stigmatization score for the sample was 2.10 (SD 0.40), with a theoretical maximum of 4. The sub-dimension alienation shows an average score (2.32, SD 0.58) higher than the others. sub-dimensions, and adherence to the stereotype the lowest average score (1.87, SD 0.38). In post-test, the total self-stigma score decreased by 0.16, an average of 1.94 (SD 0.41). All the means of the sub-dimension scores also decreased, most importantly for the alienation (0.267). Internalized Stigma of Mental Illness scale total score was significantly improved at post-test (t(22) = 2.08, P = 0.049). This pilot study shows that the HOP program is acceptable and feasible for people with mental health disorders and achievable in psychosocial institutions. The results at the self-stigma scale show a reduction of self-stigma total score.

En Suisse, le nouveau droit de la protection de l’adulte donne une force contraignante aux directives anticipées. Il s’ensuit la nécessité de constituer des directives anticipées pour chaque nouveau résident en institution pour personnes âgées. Cet article présente une analyse des discours des infirmières exerçant dans les établissements du Canton de Vaud en Suisse romande sur la manière dont elles s’enquièrent des volontés des personnes en fin de vie. Nous montrons que l’intérêt de leur démarche réside dans la communication réalisée au fil de la prise en charge des résidents et des contacts établis avec leurs proches. Ce travail, à l’interface entre la sphère des soins et du social, possède la faculté de rassembler les acteurs concernés et, ce faisant, de re-socialiser la mort et le mourir. Les professionnelles remplissent un rôle pivot dans l’accueil de la mort, en rupture avec le traitement individuel et intrafamilial antérieur.