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Lequin P, Suter C, Mazallon R, Brodard R, Abrahamyan Empson L, Robalo B, Conus P, Nguyen A, Favrod J. Integration of a peer practitioner in a hospital unit for patients with psychotic disorders: an exploratory qualitative study. Front Psychiatry 2023; 14:1244433. [PMID: 37822792 PMCID: PMC10562537 DOI: 10.3389/fpsyt.2023.1244433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction Studies on the integration of peer mental health practitioners (PMHP) in hospitals are sparse, despite significant benefits being reported for patients and professionals. The integration of PMHP requires the consideration of several parameters and a change in the culture of care. This study aims to understand the impact of the integration of a PMHP in a hospital unit caring for patients with psychiatric disorders. Methods A qualitative content analysis of three focus groups with the interdisciplinarity team were conducted. A consulting PMHP was integrated into the entire research process. Results Data analysis revealed five main themes: the importance of integration, benefits for patients linked to the identification process, benefits for the team and institution, potentials risks, and perspectives. Discussion The study was conducted in a hospital setting with patients suffering from severe psychiatric disorders associated with behavioral disturbances. The benefits reported in the results outline the feasibility of PMHP integration in an acute psychiatric care setting. Nevertheless, further formalization of the PMHP role is required to minimize possible areas of tension between respective fields of activity of each professional.
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Affiliation(s)
- Pierre Lequin
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Caroline Suter
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| | - Roxane Mazallon
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Rachèle Brodard
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Lilith Abrahamyan Empson
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Bruno Robalo
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alexandra Nguyen
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| | - Jérôme Favrod
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
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Abt M, Lequin P, Bobo ML, Vispo Cid Perrottet T, Pasquier J, Ortoleva Bucher C. The scope of nursing practice in a psychiatric unit: A time and motion study. J Psychiatr Ment Health Nurs 2022; 29:297-306. [PMID: 34310817 PMCID: PMC9290684 DOI: 10.1111/jpm.12790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: The evaluation of nurse care practices poses many challenges, including the identification of all the aspects of the care given. Few studies have looked at the scope of nursing practice in psychiatry. However, the evaluation of care practices in the mental health field poses many challenges, including the identification of all aspects of care. WHAT THE DOCUMENT ADDS TO EXISTING KNOWLEDGE?: Findings demonstrated that mental health nurses do not invest in all domains of their scope of practice in the same way and the time spent with patients is low. Several factors contributed to this, including the increasing complexity of care, stagnant staffing levels, and a culture of care that continues to be influenced by the medical model. Current models of care still retain the stigma of this past, prioritizing medically delegated tasks rather than promoting a holistic approach to care. Although the professional identity of nurses is evolving and asserting itself, the paradigm shift in practice is still incomplete. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is essential to describe concretely what is actually expected of nurses, to help them allocate their time effectively and to identify opportunities for improvement. The field of practice of nurses is put under stress by a demanding work environment subject to many pressures and constraints. Changing practices so that nurses can use the full scope of nursing practice requires strong nursing leadership and action on education and the organization of care, particularly on clinical assessment. ABSTRACT: Introduction The evaluation of nursing care practices poses many challenges, including identifying all the aspects of the care given. However, few studies have examined the scope of nursing practice in psychiatry. Aim The aim of this study was to describe the intensity of nursing activities on a psychiatric unit based on the adaptation of Déry and D'Amour's (2017, Perspect Infirm Rev Off Ordre Infirm Qué, 14, 51) Scope of Nursing Practice Model. Method This 56-day descriptive observational study used the time and motion method to follow eight nurses. Results 500 h of observations were carried out. The greatest lengths of time were allocated to communication and coordination of care activities and to "non-healthcare" domains. Less time was devoted to activities related to clinical evaluation and therapeutic education. Discussion Findings demonstrated that MHNs do not perform all the possible functions in the domains of their scope of practice in the same way, and time spent with patients was short. Several factors contributed to this, including the fact that nurses are working in increasingly demanding care settings that keep them under constant pressure.
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Affiliation(s)
- Maryline Abt
- La Source School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western, Lausanne, Switzerland
| | - Pierre Lequin
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie-Louise Bobo
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | | | - Jérôme Pasquier
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Claudia Ortoleva Bucher
- La Source School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western, Lausanne, Switzerland
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Lequin P, Ferrari P, Suter C, Milovan M, Besse C, Silva B, Golay P, Bonsack C, Favrod J. The Joint Crisis Plan: A Powerful Tool to Promote Mental Health. Front Psychiatry 2021; 12:621436. [PMID: 33815165 PMCID: PMC8017151 DOI: 10.3389/fpsyt.2021.621436] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/09/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose: The Joint Crisis Plan (JCP) has received growing interest in clinical and research settings. JCP is a type of psychiatric advance statement that describes how to recognize early signs of crisis and how to manage crises. The purpose of the present study, to our knowledge the first to be conducted on this topic in the French-speaking context and to include inpatients, was to describe the content of JCPs and how they are perceived by patients and the providers. Methods: The study used an exploratory, mixed, sequential method. Existing JCPs were retrospectively collected in several clinical contexts (hospital, community settings, and sheltered accommodation). Based on their analyses, we conducted semi-structured interviews including some rating scales on the perception of the JCPs among patients and providers in these settings. For the qualitative analyses, content analyses were conducted with a hybrid approach using NVivo 12 software. Data were double-coded and discussed with a third researcher until agreement was reached. Results: One hundred eighty-four JCPs were collected retrospectively and 24 semi-structured interviews were conducted with 12 patients and 12 providers. No relatives could be included in the research process. The content of the studied JCPs was relevant and indicated that patients had good knowledge of themselves and their illness. Improvements in the quality of the therapeutic relationship, respect for patients' choices and wishes, and a greater sense of control of their illness were reported. The JCP was perceived as a very useful tool by patients and providers. Concerning JCP limitations, lack of staff training, difficulties with the shared decision-making process, and the poor availability of the JCPs when needed were reported. Conclusion: The study highlights that JCPs may be used with patients suffering from a large variety of psychiatric disorders in different care settings. The JCP is perceived as very useful by both patients and providers. The promising results of this study support the promotion of the wide use of JCPs with patients who have experienced crises. It is important to continue to research JCPs through impact studies that include family members.
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Affiliation(s)
- Pierre Lequin
- Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Pascale Ferrari
- Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland.,La Source, School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Caroline Suter
- La Source, School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Marion Milovan
- La Source, School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Christine Besse
- Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Benedetta Silva
- Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Philippe Golay
- Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Charles Bonsack
- Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
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Mailhot T, Goulet MH, Maheu-Cadotte MA, Fontaine G, Lequin P, Lavoie P. Methodological reporting in feasibility studies: a descriptive review of the nursing intervention research literature. J Res Nurs 2019; 25:460-472. [PMID: 34394661 DOI: 10.1177/1744987119883404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In reaction to weaknesses in feasibility studies reporting, the Consolidated Standards of Reporting Trials (CONSORT) statement published an extension for feasibility studies in 2016. Aim The aim of this study was to systematically review and appraise the reporting of feasibility studies in the nursing intervention research literature based on the CONSORT statement extension for feasibility studies. Method Papers published prior to January 2018 that described feasibility studies of nursing interventions were retrieved. Components of feasibility studies were coded, and code frequencies were analysed. Results The review included 186 papers. Although most papers (n = 142, 76.3%) included the label 'pilot' or 'feasibility' in their title, reporting for other components generally did not adhere to one or several CONSORT recommendations. Most papers reported objectives (n = 116, 62.4%), designs (n = 95, 51%), or rationales for sample size (n = 165, 88.7%) that were incongruent with the purpose of feasibility studies. Discussion This review results in two main implications for nursing research. First, we noted that the reporting of feasibility studies is weak. While all papers described feasibility studies, almost half focused exclusively on testing the effectiveness of an intervention. Second, we identified rationales for sample size along with key references that could offer guidance in reporting feasibility studies while being coherent with the CONSORT recommendations.
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Affiliation(s)
- Tanya Mailhot
- Postdoctoral Fellow, Bouvé College of Health Sciences, Northeastern University, USA
| | - Marie-Hélène Goulet
- Assistant Professor, Faculty of Nursing, Université de Montréal, Canada; Researcher, Quebec Network on Nursing Intervention Research, Canada
| | - Marc-André Maheu-Cadotte
- Doctoral Candidate, Faculty of Nursing, Université de Montréal, Montreal, Canada; Research Assistant, Montreal Heart Institute Research Center, Canada; Doctoral Student, CHUM Research Center, Canada
| | - Guillaume Fontaine
- Doctoral Candidate, Faculty of Nursing, Université de Montréal, Canada; Research Assistant, Montreal Heart Institute Research Center, Canada
| | - Pierre Lequin
- Clinician Nurse Specialist, Department of Psychiatry, Centre Hospitalier Universitaire, Vaudois, Switzerland
| | - Patrick Lavoie
- Assistant Professor, Faculty of Nursing, Université de Montréal, Canada; Researcher, Montreal Heart Institute Research Centre, Canada
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Conus P, Tripalo C, Vaudan C, Ferrari P, Lequin P, Bonsack C. [Psychiatry]. Rev Med Suisse 2018; 14:90-92. [PMID: 29337459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Children of patients with psychiatric disorders are at higher risk to develop a psychiatric illness. In addition, phases of crisis and hospitalization of the parent are often traumatizing to the children, especially during childhood. Although a specific offer to face these issues is compulsory in some countries, such is not the case in Switzerland. In this paper we describe the implementation of a special offer for children of parents with mental illness (Famille +) in the service of general psychiatry at the Department of psychiatry of the Lausanne University hospital in Switzerland. We will also discuss the development and implementation of the Joint Crisis Plan, a collaborative tool where psychiatric patients and clinicians define the strategies that should be applied in case of crisis, which strengthens the empowerment of patients and their participation to decisions about their treatment.
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Affiliation(s)
- Philippe Conus
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Charlène Tripalo
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Christel Vaudan
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Pascale Ferrari
- Service de psychiatrie communautaire, Département de psychiatrie, CHUV, 1011 Lausanne
- Haute école de santé La Source, 1003 Lausanne
| | - Pierre Lequin
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Charles Bonsack
- Service de psychiatrie communautaire, Département de psychiatrie, CHUV, 1011 Lausanne
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Lequin P, Brisard MA, Skyllakou I, Herrera F, Golay P, Herrgott J, Conus P. [Recovering the capacity to live outside of hospital : results from a specialized inpatient program]. Rev Med Suisse 2017; 13:1610-1613. [PMID: 28949108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
An important number of psychiatric patients have difficulties to live outside of hospital and to stabilize their living situation. This results in long hospitalizations which are in conflict with the current strategies of brief hospital admissions for acute treatment. In order to tackle this issue, the service of general psychiatry of the Department of psychiatry of the CHUV, in Lausanne, Switzerland, has opened in June 2016 a rehabilitation inpatient unit of 18 beds focusing specifically on the development of the minimal abilities required to adapt to living in a flat or in a sheltered accommodation. This paper describes the first 12 months of activity of this unit.
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Affiliation(s)
- Pierre Lequin
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Marie-Anne Brisard
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Ifigeneia Skyllakou
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Fabrice Herrera
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Philippe Golay
- Service de psychiatrie générale et communautaire, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Jacques Herrgott
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Philippe Conus
- Service de psychiatrie générale, Département de psychiatrie, CHUV, 1011 Lausanne
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Viard H, Favre JP, Cayot M, Lequin P, Merland G, Sow M. [Epiphrenic diverticula of the esophagus. Apropos of 16 surgically-treated cases]. Sem Hop 1983; 59:477-81. [PMID: 6302888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The authors report on a series of 14 cases (10 men and 4 women) of epiphrenic diverticula treated surgically over a period of 14 years. Size was variable and the neck was narrow in 7 cases, wide in 5, and very wide in 2. Four patients presented with a double diverticulum. The diverticula are normally found on the right side (9 cases), and underlying dyskinesia is always present, often accompanied by major or minor cardiospasm (11 cases) or reflux from sliding hiatal hernia (3 cases). No manometric exploration was carried out in this series. Management was based on physiopathological considerations - 6 diverticulectomies with 5 myotomies, 6 myotomies with no diverticulectomy. The approach was left thoracic in 7 cases and abdominal in the others. The mortality rate was zero, and functional results are good. They are all the better in that the diverticulectomy, the myotomy and the repair of the gastroesophageal reflux have now been performed.
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Viard H, Favre JP, Cayot M, Lequin P, Merland G, Sow M. [Epiphrenic diverticula of the esophagus. Sixteen cases ]. Ann Chir 1982; 36:411-5. [PMID: 6812479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Bertrand P, Porta JP, Meyer P, Lequin P. [Schwannoma of the rectum (apropos of a case)]. J Med Lyon 1969; 50:399-400. [PMID: 5784249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Bertrand P, Porta J, Meyer P, Lequin P. [Colonic lipoma (apropos of 3 cases)]. J Med Lyon 1969; 50:115-7. [PMID: 5782363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Saubier EC, Gaillard P, Lequin P. [Results of 25 prophylactic anastomoses in portal hypertension]. Arch Fr Mal App Dig 1968; 57:841-2. [PMID: 5758850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Porta JP, Bonnet P, Meyer P, Lequin P. [Malignant tumors of the small intestine (excluding the duodenum)]. Lyon Chir 1968; 64:755-60. [PMID: 5745971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Saubier EC, Lequin P, Gaillard P. [Value of splenectomy in the surgical treatment of portal hypertension]. Arch Fr Mal App Dig 1967; 56:691-702. [PMID: 5618242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Gignoux M, Martin H, Pouyet M, Cajfinger H, Lequin P. [Esophagectomy with colic esophagoplasty for tight peptic stenosis (Belsey's method)]. Ann Otolaryngol Chir Cervicofac 1967; 84:119-21. [PMID: 6056573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Levrat R, Lequin P, Meyer P, Malluret J, Pidoux A, Vauzelle JL, Girard M. [Isolated diffuse lymphomatosis of the colon. Apropos of a case report]. Arch Fr Mal App Dig 1966; 55:1167-1174. [PMID: 5986600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Pouyet M, Lequin P, Cajgfinger H, Porta JP. [Esophagectomy with colic esophagoplasty for tight peptic stenosis (Belsey's method)]. Lyon Chir 1966; 62:869-873. [PMID: 5985747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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