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Fontaine G, Cossette S. Development and Design of E_MOTIV: A Theory-Based Adaptive E-Learning Program to Support Nurses' Provision of Brief Behavior Change Counseling. Comput Inform Nurs 2023; 41:130-141. [PMID: 35796716 DOI: 10.1097/cin.0000000000000942] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Brief counseling, when provided by adequately trained nurses, can motivate and support patient health behavior change. However, numerous barriers can impede nurses' capability and motivation to provide brief counseling. Theory-based interventions, as well as information and communication technologies, can support evidence-based practice by addressing these barriers. The purpose of this study was to document the development process of the E_MOTIV asynchronous, theory-based, adaptive e-learning program aimed at supporting nurses' provision of brief counseling for smoking cessation, healthy eating, and medication adherence. Development followed French's stepwise theory- and evidence-based approach: (1) identifying who needs to do what, differently, that is, provision of brief counseling in acute care settings by nurses; (2) identifying determinants of the provision of brief counseling; (3) identifying which intervention components and mode(s) of delivery could address determinants; and (4) developing and evaluating the program. The resulting E_MOTIV program, guided by the Theory of Planned Behavior, Cognitive Load Theory, and the concept of engagement, is unique in its adaptive functionality-personalizing program content and sequence to each learners' beliefs, motivation, and learning preferences. E_MOTIV is one of the first adaptive e-learning programs developed to support nurses' practice, and this study offers key insights for future work in the field.
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Affiliation(s)
- Guillaume Fontaine
- Author Affiliations: Clinical Epidemiology Program, Ottawa Hospital Research Institute; and Faculty of Medicine, University of Ottawa, Ontario; and Research Centre, Université de Montréal Hospital Centre (Dr Fontaine); and Faculty of Nursing, Université de Montréal; and Montreal Heart Institute Research Center (Dr Cossette), Quebec, Canada
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Cossette S. Un chaleureux mot de bienvenue. Science of Nursing and Health Practices 2022. [DOI: 10.7202/1095196ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Cossette S. Éditorial, spécial Congrès mondial du Secrétariat international des infirmières et infirmiers de l’espace francophone (SIDIIEF) : 16 – 20 octobre 2022, Ottawa, Canada. Science of Nursing and Health Practices 2022. [DOI: 10.7202/1093068ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Côté J, Auger P, Pagé GM, Cossette S, Coronado-Montoya S, Fontaine G, Chicoine G, Rouleau G, Genest C, Lapierre J, Jutras-Aswad D. [French translation, cultural adaptation and assessment of preliminary psychometric properties of the Protective Behavioral Strategies for Marijuana Scale]. Can J Psychiatry 2022; 67:608-615. [PMID: 34160302 PMCID: PMC9301151 DOI: 10.1177/07067437211025216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Young adults (18- to 24-year-olds) constitute the age group with the highest proportion of cannabis users. In the context of legalization, it is important to promote lower-risk cannabis use. The Protective Behavioral Strategies for Marijuana Scale (PBSM-17) identifies strategies used by consumers. However, this scale is not available in French and is not adapted to the Canadian context. This article presents the process that led to the translation, cultural adaptation and evaluation of the preliminary psychometric properties of PBSM-17. METHOD The methodological study was carried out in six steps. The first four steps led to the translation towards French and adaptation of the scale. A validation among 12 young people contributed to establish the criterion equivalency (step 5). The evaluation of psychometric properties (step 6) was carried out among 211 bilingual university students (61 % women; mean age 22 years old). RESULTS The French version presents satisfactory preliminary psychometric properties: internal consistency is acceptable (α = 0.88); criterion equivalency was established between the French and the original English version (t (210) = 1.04, p = 0.30; 95% CI [-0.20, 0.63]). The scores obtained on both versions by the same participant were found to be strongly correlated (r = 0.95, p <0.001). CONCLUSION The results support the use of the French version of PBSM-17. The proposed protective strategies can be used as a measurement tool and represent behaviors that can be targeted in a lower-risk cannabis use context.
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Affiliation(s)
- José Côté
- Professeure, Faculté des sciences infirmières, Université de Montréal (UdeM); Chercheuse, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM); Titulaire, Chaire de recherche sur les nouvelles pratiques de soins infirmiers (CRSI)
| | | | - Gabrielle M Pagé
- Chercheuse, CRCHUM; Professeure, Département d'anesthésiologie et médecine de la douleur, Faculté de Médecine, UdeM
| | - Sylvie Cossette
- Professeure, Faculté des sciences infirmières, UdeM; Chercheuse, Centre de recherche de l'Institut de cardiologie de Montréal
| | | | - Guillaume Fontaine
- Chercheur postdoctoral, Programme d'épidémiologie clinique, Institut de recherche de l'Hôpital d'Ottawa, Faculté de médecine, Université d'Ottawa
| | | | - Geneviève Rouleau
- Coordonnatrice, de Chaire, CRSI; Chercheuse postdoctorale, Women's College Hospital
| | - Christine Genest
- Professeure, Faculté des sciences infirmières, UdeM; Chercheuse, Centre de recherche de l'Institut Universitaire de santé mentale de Montréal, Centre d'étude sur le trauma
| | - Judith Lapierre
- Professeure, Faculté des sciences infirmières, Université Laval
| | - Didier Jutras-Aswad
- Chercheur, CRCHUM; Professeur, Département de psychiatrie et d'addictologie, Faculté de médecine, UdeM
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Richard-Lalonde M, Feeley N, Cossette S, Chlan LL, Gélinas C. Acceptability and Feasibility of a Patient-Oriented Music Intervention to Reduce Pain in the Intensive Care: Protocol for a Randomized Crossover Pilot Trial (Preprint). JMIR Res Protoc 2022; 12:e40760. [PMID: 37163350 DOI: 10.2196/40760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Many patients experience pain in the intensive care unit (ICU) despite receiving pain medication. Research has shown that music can help reduce pain. Music interventions studied so far have not used music streaming to generate playlists based on patient preferences while incorporating recommended tempo and duration. Previous research has focused on postoperative ICU patients able to self-report, which is underrepresentative of the ICU population that might benefit from a music intervention for pain management. We developed a new patient-oriented music intervention (POMI) that incorporates features based on theoretical, empirical, and experiential data intended to be used in the ICU. Such a music intervention should consider the expertise of ICU patients, family members, and nursing staff, as well as the practicality of the intervention when used in practice. OBJECTIVE The primary objectives of this study are to (1) evaluate the acceptability and feasibility of the POMI to reduce pain in ICU patients and (2) evaluate the feasibility of conducting a crossover pilot randomized controlled trial (RCT) for intervention testing in the ICU. A secondary objective is to examine the preliminary efficacy of the POMI to reduce pain in ICU patients. METHODS A single-blind 2×2 crossover pilot RCT will be conducted. Patients will undergo 1 sequence of 2 interventions: the POMI which delivers music based on patients' preferences via headphones or music pillow for 20-30 minutes and the control intervention (headphones or pillow without music). The sequence of the interventions will be inverted with a 4-hour washout period. Timing of the interventions will be before a planned bed turning procedure. Each patient will undergo 1 session of music. Twenty-four patients will be recruited. Patients able to self-report (n=12), family members of patients unable to self-report (n=12), and nursing staff (n=12) involved in the bed turning procedure will be invited to complete a short questionnaire on the POMI acceptability. Data will be collected on the feasibility of the intervention delivery (ie, time spent creating a playlist, any issue related to headphones/pillow or music delivery, environmental noises, and intervention interruptions) and research methods (ie, number of patients screened, recruited, randomized, and included in the analysis). Pain scores will be obtained before and after intervention delivery. RESULTS Recruitment and data collection began in March 2022. As of July 5, 2022, in total, 22 patients, 12 family members, and 11 nurses were recruited. CONCLUSIONS Methodological limitations and strengths are discussed. Study limitations include the lack of blinding for patients able to self-report. Strengths include collecting data from various sources, getting a comprehensive evaluation of the intervention, and using a crossover pilot RCT design, where participants act as their own control, thus reducing confounding factors. TRIAL REGISTRATION ClinicalTrials.gov NCT05320224; https://clinicaltrials.gov/ct2/show/NCT05320224. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40760.
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Cournoyer A, Cavayas YA, Albert M, Segal E, Lamarche Y, Potter BJ, Montigny LD, Chauny JM, Paquet J, Marquis M, Cossette S, Castonguay V, Morris J, Lessard J, Daoust R. Association of Initial Pulseless Electrical Activity Heart Rate and Clinical Outcomes Following Adult Non-Traumatic Out-of-Hospital Cardiac Arrest. PREHOSP EMERG CARE 2022:1-8. [PMID: 35771725 DOI: 10.1080/10903127.2022.2096160] [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] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Studies evaluating the prognostic value of the pulseless electrical activity (PEA) heart rate in out-of-hospital cardiac arrest (OHCA) patients have reported conflicting results. The objective of this study was to evaluate the association between the initial PEA heart rate and favorable clinical outcomes for OHCA patients. METHODS The present post-hoc cohort study used the Resuscitation Outcomes Consortium Cardiac Epidemiologic Registry Version 3, which included OHCA patients in seven US and three Canadian sites from April 2011 to June 2015. The primary outcome was survival to hospital discharge and the secondary outcome was survival with a good functional outcome. For the primary analysis, the patients were separated into eight groups according to their first rhythms and PEA heart rates: (1) initial PEA heart rate of 1-20 beats per minute (bpm); (2) 21-40 bpm; (3) 41-60 bpm; (4) 61-80 bpm; (5) 81-100 bpm; (6) 101-120 bpm; (7) over 120 bpm; (8) initial shockable rhythm (reference category). Multivariable logistic regression models were used to assess the associations of interest. RESULTS We identified 17,675 patients (PEA: 7,089 [40.1%]; initial shockable rhythm: 10,797 [59.9%]). Patients with initial PEA electrical frequencies ≤100 bpm were less likely to survive to hospital discharge than patients with initial shockable rhythms (1-20 bpm: adjusted odds ratio [AOR] = 0.15 [95%CI 0.11-0.21]; 21-40 bpm: AOR =0.21 [0.18-0.25]; 41-60 bpm: AOR =0.30 [0.25-0.36]; 61-80 bpm: AOR =0.37 [0.28-0.49]; 81-100 bpm: AOR =0.55 [0.41-0.65]). However, there were no statistical outcome differences between PEA patients with initial electrical frequencies of >100 bpm and patients with initial shockable rhythms (101-120 bpm: AOR =0.65 [95%CI 0.42-1.01]; >120 bpm: AOR =0.72 [95%CI 0.37-1.39]). Similar results were observed for survival with good functional outcomes (101-120 bpm: AOR =0.60 [95%CI 0.31-1.15]; >120 bpm: AOR =1.08 [95%CI 0.50-2.28]). CONCLUSIONS We observed a good association between higher initial PEA electrical frequency and favorable clinical outcomes for OHCA patients. As there is no significant difference in outcomes between patients with initial PEA heart rates of more than 100 bpm and those with initial shockable rhythms, we can hypothesize that these patients could be considered in the same prognostic category.
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Affiliation(s)
- Alexis Cournoyer
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada.,Hôpital Maisonneuve-Rosemont, CIUSSS-EIM, Montréal, Québec, Canada.,Corporation d'Urgences-santé, Montréal, Québec, Canada
| | - Yiorgos Alexandros Cavayas
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada.,Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Martin Albert
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Eli Segal
- Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada.,Corporation d'Urgences-santé, Montréal, Québec, Canada.,Université McGill, Montréal, Québec, Canada.,Hôpital général juif, Montréal, Québec, Canada
| | - Yoan Lamarche
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada.,Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Brian J Potter
- Université de Montréal, Montréal, Québec, Canada.,Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | | | - Jean-Marc Chauny
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Jean Paquet
- Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Martin Marquis
- Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Sylvie Cossette
- Université de Montréal, Montréal, Québec, Canada.,Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Véronique Castonguay
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Judy Morris
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Justine Lessard
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Raoul Daoust
- Université de Montréal, Montréal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
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Mailhot T, Cossette S, Lavoie P, Maheu‐Cadotte M, Fontaine G, Bourbonnais A, Côté J. The development of the MENTOR_D nursing intervention: Supporting family involvement in delirium management. Int J Older People Nurs 2022; 17:e12462. [DOI: 10.1111/opn.12462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 02/15/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Tanya Mailhot
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Sylvie Cossette
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Patrick Lavoie
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
- Centre d’innovation en Formation Infirmière Université de Montréal Montréal QC Canada
| | - Marc‐André Maheu‐Cadotte
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
- Research Centre of the Centre Hospitalier de l’Université de Montréal Montréal QC Canada
| | - Guillaume Fontaine
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Anne Bourbonnais
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut Universitaire de Gériatrie de Montréal Montréal QC Canada
| | - José Côté
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Centre Hospitalier de l’Université de Montréal Montréal QC Canada
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Côté J, Cossette S, Auger P, Page G, Coronado-Montoya S, Fontaine G, Chicoine G, Rouleau G, Genest C, Lapierre J, Pedersen ER, Jutras-Aswad D. Psychometric properties of the French and English short form of the Protective Behavioural Strategies for Marijuana Scale in Canadian university students. BMJ Open 2022; 12:e053715. [PMID: 35387810 PMCID: PMC8987794 DOI: 10.1136/bmjopen-2021-053715] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The Protective Behavioural Strategies for Marijuana (PBSM-17) scale serves to identify and measure strategies employed by young adults before, during or after cannabis use. After the adaptation and translation of the PBSM-17 into French, a methodological study was conducted to evaluate the psychometric properties of this French version (FV) and of the original English version (EV) in a sample of bilingual Canadian university students. METHODS A total of 211 cannabis users (mean age=22.1 years) completed a sociodemographic questionnaire, a question on frequency of cannabis use (four categories: 1-3 times a month, once a week, more than once a week, everyday) and both versions (FV and EV) of the PBSM-17. RESULTS Both versions had similar internal reliability (α=0.91; α=0.88). The one-factor solution explained 36.46% of the variance for the FV and 42.26% for the EV. As hypothesised, greater use of protective behavioural strategies was related to lower frequency of cannabis use. One-way ANOVA test results revealed a statistically significant difference in use of strategies by frequency of cannabis use for both the FV (F(3, 207)=27.38, p<0.001) and EV (F(3, 207)=29.32, p<0.001). Post hoc comparisons showed that everyday users employed fewer strategies on average than lower-frequency users. CONCLUSION The FV and EV of the PBSM-17 demonstrated satisfactory psychometric properties. The proposed FV of the PBSM-17 is a reliable instrument that could be used for research and clinical purposes. Protective behavioural strategies can serve as indicator of lower-risk cannabis use and could be targeted in prevention interventions.
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Affiliation(s)
- José Côté
- Centre de Recherche du CHUM, Montreal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | | | | | - Gabrielle Page
- Centre de Recherche du CHUM, Montreal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | | | - Guillaume Fontaine
- Research Center, Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | | | | | - Eric R Pedersen
- University of Southern California, Los Angeles, California, USA
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Fontaine G, Cossette S. A theory-based adaptive E-learning program aimed at increasing intentions to provide brief behavior change counseling: Randomized controlled trial. Nurse Educ Today 2021; 107:105112. [PMID: 34455287 DOI: 10.1016/j.nedt.2021.105112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Unhealthy behaviors are significant contributors to non-communicable diseases. Nurses can support patient health behavior change by providing brief behavior change counseling. However, training programs in brief counseling are generally not personalized, or adapted, to the barriers and theoretical determinants of its provision in clinical practice. OBJECTIVE This study aimed to evaluate the effectiveness of the E_MOTIVA theory-based adaptive e-learning program on nurses' and nursing students' intentions to provide brief counseling for smoking, unhealthy eating habits and medication nonadherence. DESIGN AND METHODS A randomized controlled trial was conducted with nurses and nursing students in Canada. Experimental group participants were allocated to the E_MOTIVA theory-based adaptive e-learning program. Control group participants were allocated to the E_MOTIVB knowledge-based standardized e-learning program. E_MOTIVA was designed to influence the constructs of the Theory of Planned Behavior (e.g., attitude, subjective norms) in relation to brief counseling. Outcomes were improvement in intention to provide brief counseling, improvement in other Theory of Planned Behavior variables, as well as cognitive load and engagement related to e-learning. RESULTS A total of 102 participants were randomized to the experimental (n = 51) and control (n = 51) groups. End of study questionnaires were completed by 27 experimental group and 38 control group participants. Analyses indicated no significant differences between groups in the change of scores for intention to provide brief counseling. However, while not significant, the change of score was greater in the experimental group (10.22 ± 3.34 versus 9.04 ± 2.80; p = 0.787). Scores in both groups improved significantly for attitude, subjective norms, perceived behavioral control, behavioral beliefs, and control beliefs. However, there were no statistically significant differences between groups for these variables as well as for cognitive load and engagement. CONCLUSIONS Both e-learning programs had a similar positive effect on nurses' and nursing students' intentions to provide brief counseling and on Theory of Planned Behavior variables. TRIAL REGISTRATION ISRCTN Registry ISRCTN32603572; http://www.isrctn.com/ISRCTN32603572. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/18894; https://doi.org/10.2196/18894.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada; Montreal Heart Institute Research Center, 5000 Bélanger, Montréal, QC H1T 1C8, Canada.
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada; Montreal Heart Institute Research Center, 5000 Bélanger, Montréal, QC H1T 1C8, Canada.
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Cournoyer A, Chauny JM, Daoust R, Paquet J, Marquis M, Lamarche Y, de Montigny L, Segal E, Cavayas YA, Cossette S. Reply to: Pseudo-PEA: An easily overlooked player in cardiac arrest. Resuscitation 2021; 168:242-243. [PMID: 34509556 DOI: 10.1016/j.resuscitation.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Alexis Cournoyer
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS-EIM, Montréal, Québec, Canada; Corporation d'Urgences-santé, Montréal, Québec, Canada.
| | - Jean-Marc Chauny
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Raoul Daoust
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Jean Paquet
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Martin Marquis
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Yoan Lamarche
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Department of Surgery, Université de Montréal, Montréal, Québec, Canada; Department of Surgery, Service of Cardiac Surgery, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Centre de Recherche de l'Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Department of Surgery, Service of Cardiac Surgery, Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Department of Medicine, Service of Intensive Care Medicine, Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | | | - Eli Segal
- Corporation d'Urgences-santé, Montréal, Québec, Canada; Faculty of Medicine, Department of Emergency Medicine, Université McGill, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital général juif, Montréal, Québec, Canada
| | - Yiorgios Alexandros Cavayas
- Faculty of Medicine, Department of Surgery, Université de Montréal, Montréal, Québec, Canada; Department of Medicine, Service of Intensive Care Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Department of Medicine Service of Internal Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Sylvie Cossette
- Centre de Recherche de l'Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
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Cetin-Sahin D, McCusker J, Ciampi A, Cossette S, Vadeboncoeur A, Vu TTM, Veillette N, Ducharme F, Belzile E, Lachance PA, Mah R, Berthelot S. Front-line emergency department nurses' and physicians' assessments of processes of elder-friendly care for quality improvement. Int Emerg Nurs 2021; 58:101049. [PMID: 34509169 DOI: 10.1016/j.ienj.2021.101049] [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] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 06/10/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Geriatric emergency department (ED) care has gained increasing importance and interest due to increasing visits in seniors. AIM Among ED front-line nurses and physicians, to assess and compare ratings of elder-friendly care process indicators, variability in ratings, and concurrent validity of ratings. METHODS Four Quebec EDs' full-time registered nurses and physicians rated their geriatric care using 9 subscales. Nurse and physician subscale scores were compared. Inter-rater variability within disciplines and variability between nurses and physicians were measured. Associations between the subscale scores and perceived overall quality of care were tested. RESULTS 38 nurses and 36 physicians completed the survey (83% of 89 eligible). Scores differed by discipline for 3 of 9 subscales computed; nurses had higher mean scores on Protocols, Family-Centered Discharge, and Staff Education. Very high variation for Staff Education was found within disciplines. Variations for Family-Centered Discharge differed significantly between nurses and physicians. Almost all subscale scores were significantly positively associated with perceived overall quality of care. CONCLUSIONS ED nurses and physicians rate geriatric care components similarly except for protocols, discharge processes, and continuing education. The subscales have concurrent validity. Results suggest a need for improvement in continuing educational strategies with a particular attention to discharge processes.
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Affiliation(s)
- Deniz Cetin-Sahin
- St. Mary's Research Centre, St. Mary's Hospital Center, 3830 Avenue Lacombe, Suite 4720, Montreal, QC H3T 1M5, Canada; Department of Family Medicine, McGill University, 5858 chemin de la Côte-des-Neiges, Montreal, QC H3S 1Z1, Canada; Center for Research in Aging, Donald Berman Maimonides Geriatric Centre, 5795 Avenue Caldwell, Côte Saint-Luc, QC H4W 1W3, Canada.
| | - Jane McCusker
- St. Mary's Research Centre, St. Mary's Hospital Center, 3830 Avenue Lacombe, Suite 4720, Montreal, QC H3T 1M5, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Avenue des Pins Ouest, Montreal, QC H3A 1A2, Canada.
| | - Antonio Ciampi
- St. Mary's Research Centre, St. Mary's Hospital Center, 3830 Avenue Lacombe, Suite 4720, Montreal, QC H3T 1M5, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Avenue des Pins Ouest, Montreal, QC H3A 1A2, Canada.
| | - Sylvie Cossette
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, QC H1T 1C8, Canada.
| | - Alain Vadeboncoeur
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada; Emergency Department, Montreal Heart Institute, rue 5000 Bélanger, Montreal, QC H1T 1C8, Canada.
| | - T T Minh Vu
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada; Research Centre, Institut universitaire de gériatrie de Montréal, 4545 chemin Queen Mary, Montreal, QC H3W 1W6, Canada; Centre hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, QC H2X 3E4, Canada.
| | - Nathalie Veillette
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada; Research Centre, Institut universitaire de gériatrie de Montréal, 4545 chemin Queen Mary, Montreal, QC H3W 1W6, Canada.
| | - Francine Ducharme
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada; Research Centre, Institut universitaire de gériatrie de Montréal, 4545 chemin Queen Mary, Montreal, QC H3W 1W6, Canada; Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, 2375, chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8, Canada.
| | - Eric Belzile
- St. Mary's Research Centre, St. Mary's Hospital Center, 3830 Avenue Lacombe, Suite 4720, Montreal, QC H3T 1M5, Canada.
| | - Paul-André Lachance
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada; Hôpital Cité-de-la-Santé, 1755 Boulevard René-Laennec, Laval, QC H7M 3L9, Canada.
| | - Rick Mah
- St. Mary's Hospital Center, 3830 Avenue Lacombe, Emergency Department, Montreal, QC H3T 1M5, Canada; Department of Emergency Medicine, Faculty of Medicine, McGill University, 1001, boul. Décarie, D05.2017.2, Montreal, QC H4A 3J1, Canada.
| | - Simon Berthelot
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, 2705, boulevard Laurier, Quebec City, QC G1V 4G2, Canada.
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Maheu-Cadotte MA, Dubé V, Cossette S, Lapierre A, Fontaine G, Deschênes MF, Lavoie P. Involvement of End Users in the Development of Serious Games for Health Care Professions Education: Systematic Descriptive Review. JMIR Serious Games 2021; 9:e28650. [PMID: 34129514 PMCID: PMC8414295 DOI: 10.2196/28650] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND On the basis of ethical and methodological arguments, numerous calls have been made to increase the involvement of end users in the development of serious games (SGs). Involving end users in the development process is considered a way to give them power and control over educational software that is designed for them. It can also help identify areas for improvement in the design of SGs and improve their efficacy in targeted learning outcomes. However, no recognized guidelines or frameworks exist to guide end users' involvement in SG development. OBJECTIVE The aim of this study is to describe how end users are involved in the development of SGs for health care professions education. METHODS We examined the literature presenting the development of 45 SGs that had reached the stage of efficacy evaluation in randomized trials. One author performed data extraction using an ad hoc form based on a design and development framework for SGs. Data were then coded and synthesized on the basis of similarities. The coding scheme was refined iteratively with the involvement of a second author. Results are presented using frequencies and percentages. RESULTS End users' involvement was mentioned in the development of 21 of 45 SGs. The number of end users involved ranged from 12 to 36. End users were often involved in answering specific concerns that arose during the SG design (n=6) or in testing a prototype (n=12). In many cases, researchers solicited input from end users regarding the goals to reach (n=10) or the functional esthetics of the SGs (n=7). Most researchers used self-reported questionnaires (n=7). CONCLUSIONS Researchers mentioned end users' involvement in the development of less than half of the identified SGs, and this involvement was also poorly described. These findings represent significant limitations to evaluating the impact of the involvement of end users on the efficacy of SGs and in making recommendations regarding their involvement.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | | | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | | | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
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Cournoyer A, Chauny JM, Paquet J, Potter B, Lamarche Y, de Montigny L, Segal E, Cavayas YA, Albert M, Morris J, Lessard J, Marquis M, Cossette S, Castonguay V, Daoust R. Electrical rhythm degeneration in adults with out-of-hospital cardiac arrest according to the no-flow and bystander low-flow time. Resuscitation 2021; 167:355-361. [PMID: 34324890 DOI: 10.1016/j.resuscitation.2021.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/30/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
AIMS For out-of-hospital cardiac arrest (OHCA) patients, the influence of the delay before the initiation of resuscitation, termed the no-flow time (NFT), and duration of bystander-only resuscitation low-flow time (BLFT) on the type of electrical rhythm observed has not been well described. The objective of this study is to determine the relationship between NFT, BLFT and the likelihood of a shockable rhythm over time. METHODS Using a North American prospective registry (2005-2015; mostly urban settings), we selected adult (18 years and over) patients who experienced a witnessed OHCA from a suspected cardiac etiology. Patients with an emergency medical services witnessed OHCA were only included in sensitivity analyses. The association between the NFT, BLFT and the presence of a shockable rhythm was evaluated using a multivariable logistic regression adjusting for the registry version, age, sex, and public location. RESULTS A total of 229,632 patients were logged in the registry, 50,957 of whom were included. Of these, 17,704 (34.7%) had an initial shockable rhythm. After the first minute, a significant decrease over time in the occurrence of shockable rhythm is observed but is slower when bystander cardiopulmonary resuscitation (CPR) is provided (each supplemental minute of BLFT: adjusted odds ratio = 0.95, 95 %CI = 0.94-0.95; each supplemental minute of NFT: adjusted odds ratio = 0.91, 95 %CI = 0.90-0.91]). CONCLUSIONS In this large observational study, we were able to demonstrate that longer NFT were associated with lower odds of shockable presenting rhythms. Bystander CPR significantly mitigates the degradation of shockable rhythms over time, strengthening the need to improve bystander CPR rates around the world.
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Affiliation(s)
- Alexis Cournoyer
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS-EIM, Montréal, Québec, Canada; Corporation d'Urgences-santé, Montréal, Québec, Canada.
| | - Jean-Marc Chauny
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Jean Paquet
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Brian Potter
- Faculty of Medicine, Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Department of Medicine, Service of Cardiology, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Yoan Lamarche
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Department of Surgery, Université de Montréal, Montréal, Québec, Canada; Department of Surgery, Service of Cardiac Surgery, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Centre de Recherche de l'Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Department of Surgery, Service of Cardiac Surgery, Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Department of Medicine, Service of Intensive Care Medicine, Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | | | - Eli Segal
- Corporation d'Urgences-santé, Montréal, Québec, Canada; Faculty of Medicine, Department of Emergency Medicine, Université McGill, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital général juif, Montréal, Québec, Canada
| | - Yiorgios Alexandros Cavayas
- Faculty of Medicine, Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Department of Medicine, Service of Intensive Care Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Department of Medicine Service of Internal Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Martin Albert
- Faculty of Medicine, Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Department of Medicine, Service of Intensive Care Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Department of Medicine Service of Internal Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Judy Morris
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Justine Lessard
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Martin Marquis
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Sylvie Cossette
- Centre de Recherche de l'Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Department of Surgery, Service of Cardiac Surgery, Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Department of Medicine, Service of Intensive Care Medicine, Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Department of Emergency Medicine, Université McGill, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital général juif, Montréal, Québec, Canada; Department of Medicine, Service of Intensive Care Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Department of Medicine Service of Internal Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada; Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Véronique Castonguay
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
| | - Raoul Daoust
- Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Department of Emergency Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NIM, Montréal, Québec, Canada
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Maheu-Cadotte MA, Cossette S, Dubé V, Fontaine G, Lavallée A, Lavoie P, Mailhot T, Deschênes MF. Efficacy of Serious Games in Healthcare Professions Education: A Systematic Review and Meta-analysis. Simul Healthc 2021; 16:199-212. [PMID: 33196609 DOI: 10.1097/sih.0000000000000512] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
SUMMARY STATEMENT Serious games (SGs) are interactive and entertaining software designed primarily with an educational purpose. This systematic review synthesizes evidence from experimental studies regarding the efficacy of SGs for supporting engagement and improving learning outcomes in healthcare professions education. Randomized controlled trials (RCTs) published between January 2005 and April 2019 were included. Reference selection and data extraction were performed in duplicate, independently. Thirty-seven RCTs were found and 29 were included in random-effect meta-analyses. Compared with other educational interventions, SGs did not lead to more time spent with the intervention {mean difference 23.21 minutes [95% confidence interval (CI) = -1.25 to 47.66]}, higher knowledge acquisition [standardized mean difference (SMD) = 0.16 (95% CI = -0.20 to 0.52)], cognitive [SMD 0.08 (95% CI = -0.73 to 0.89)], and procedural skills development [SMD 0.05 (95% CI = -0.78 to 0.87)], attitude change [SMD = -0.09 (95% CI = -0.38 to 0.20)], nor behavior change [SMD = 0.2 (95% CI = -0.11 to 0.51)]. Only a small SMD of 0.27 (95% CI = 0.01 to 0.53) was found in favor of SGs for improving confidence in skills.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- From the Faculty of Nursing of the Université de Montréal (S.C., V.D., G.F., A.L., P.L., M.-F.D.); Montreal Heart Institute Research Center (S.C., P.L., T.M.); Research Center of the Université de Montréal Hospital Center (V.D.); CHU Ste-Justine Research Center (AL), Montreal, Quebec, Canada; Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences (T.M.), Boston, MA; and Center for Innovation in Nursing Education (M.-F.D.), Montreal, Quebec, Canada
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15
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Cournoyer A, Grand'Maison S, Lonergan AM, Lessard J, Chauny JM, Castonguay V, Marquis M, Frégeau A, Huard V, Garceau-Tremblay Z, Turcotte AS, Piette É, Paquet J, Cossette S, Féral-Pierssens AL, Leblanc RX, Martel V, Daoust R. Oxygen Therapy and Risk of Infection for Health Care Workers Caring for Patients With Viral Severe Acute Respiratory Infection: A Systematic Review and Meta-analysis. Ann Emerg Med 2020; 77:19-31. [PMID: 32788066 PMCID: PMC7415416 DOI: 10.1016/j.annemergmed.2020.06.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/09/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023]
Abstract
Study objective To synthesize the evidence regarding the infection risk associated with different modalities of oxygen therapy used in treating patients with severe acute respiratory infection. Health care workers face significant risk of infection when treating patients with a viral severe acute respiratory infection. To ensure health care worker safety and limit nosocomial transmission of such infection, it is crucial to synthesize the evidence regarding the infection risk associated with different modalities of oxygen therapy used in treating patients with severe acute respiratory infection. Methods MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from January 1, 2000, to April 1, 2020, for studies describing the risk of infection associated with the modalities of oxygen therapy used for patients with severe acute respiratory infection. The study selection, data extraction, and quality assessment were performed by independent reviewers. The primary outcome measure was the infection of health care workers with a severe acute respiratory infection. Random-effect models were used to synthesize the extracted data. Results Of 22,123 citations, 50 studies were eligible for qualitative synthesis and 16 for meta-analysis. Globally, the quality of the included studies provided a very low certainty of evidence. Being exposed or performing an intubation (odds ratio 6.48; 95% confidence interval 2.90 to 14.44), bag-valve-mask ventilation (odds ratio 2.70; 95% confidence interval 1.31 to 5.36), and noninvasive ventilation (odds ratio 3.96; 95% confidence interval 2.12 to 7.40) were associated with an increased risk of infection. All modalities of oxygen therapy generate air dispersion. Conclusion Most modalities of oxygen therapy are associated with an increased risk of infection and none have been demonstrated as safe. The lowest flow of oxygen should be used to maintain an adequate oxygen saturation for patients with severe acute respiratory infection, and manipulation of oxygen delivery equipment should be minimized.
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Affiliation(s)
- Alexis Cournoyer
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Corporation d'Urgences-santé, Montreal, Quebec, Canada.
| | - Sophie Grand'Maison
- Department of Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Ann-Marie Lonergan
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Justine Lessard
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Jean-Marc Chauny
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Véronique Castonguay
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Martin Marquis
- Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Amélie Frégeau
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Vérilibe Huard
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Zoé Garceau-Tremblay
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Ann-Sophie Turcotte
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Éric Piette
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Jean Paquet
- Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada; Research Center, Institut de Cardiologie de Montréal, Montreal, Quebec, Canada
| | - Anne-Laure Féral-Pierssens
- Charles Lemoyne-Saguenay-Lac-Saint-Jean Research Center on Health Innovations, Université de Sherbrooke, Longueuil, Quebec, Canada; Department of Emergency Medicine, Hôpital Européen Georges Pompidou, Paris, France
| | - Renaud-Xavier Leblanc
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré de santé et de services sociaux de Laval, Hôpital Cité de la Santé, Laval, Quebec, Canada
| | - Valéry Martel
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Raoul Daoust
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; Department of Emergency Medicine, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
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16
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Fontaine G, Cossette S, Gagnon MP, Dubé V, Côté J. Effectiveness of a Theory- and Web-Based Adaptive Implementation Intervention on Nurses' and Nursing Students' Intentions to Provide Brief Counseling: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18894. [PMID: 32734932 PMCID: PMC7473472 DOI: 10.2196/18894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Brief counseling can motivate patients to initiate health behavior change. However, increasing the provision of brief counseling by nurses is difficult due to contextual and practitioner-level factors impeding nurses' motivation and intentions to provide brief counseling (eg, unfavorable attitude toward brief counseling, lack of perceived control linked to barriers). Theory-based implementation interventions could address these practitioner-level factors and support evidence-based practice in the context of brief counseling. Web-based, adaptive e-learning (electronic learning) programs are a novel type of implementation intervention that could address the limitations of current brief counseling training programs, such as accessibility and personalization. OBJECTIVE This paper presents a study protocol for evaluating the effectiveness of the E_MOTIVA implementation intervention-a theory- and web-based adaptive e-learning program-to increase nurses' and nursing students' intentions to provide brief counseling for smoking, an unbalanced diet, and medication nonadherence. METHODS A two-group, single-blind, randomized controlled trial will be conducted with nurses and nursing students enrolled in a Bachelor of Science in Nursing program in Quebec, Canada. Participants in the experimental group will be allocated to the E_MOTIVA intervention-a theory- and web-based adaptive e-learning program-while participants in the active control group will be allocated to the E_MOTIVB intervention, a knowledge- and web-based standardized e-learning program. The E_MOTIVA intervention was designed to influence the constructs of the Theory of Planned Behavior (eg, attitude, subjective norms, and perceived behavioral control) in the context of brief counseling. The Cognitive Load Index and User Engagement Scale will be used to assess participants' cognitive load and engagement related to e-learning. Participants will complete the Brief Counseling Nursing Practices Questionnaire-Abridged Version at baseline and follow-up. All study measures will be completed online. RESULTS The study is ongoing. The results of the study will provide answers to the primary hypothesis (H1) that experimental group participants will demonstrate a greater change in the score of intentions to provide brief counseling between baseline (-T1) and follow-up (T4). Secondary hypotheses include greater improvements in scores of attitude (H2), subjective norms (H3), perceived control (H4), behavioral beliefs (H5), normative beliefs (H6), and control beliefs (H7) regarding brief counseling in the experimental group between baseline and follow-up. We also anticipate lower intrinsic and extrinsic cognitive loads (H8, H9), higher germane cognitive load (H10), and higher engagement (H11, H12) in the experimental group. CONCLUSIONS This study will be among the first in evaluating a novel type of implementation intervention, a theory- and web-based adaptive e-learning program, in nurses and nursing students. This type of intervention has the potential to support evidence-based practice through accessible, personalized training in wide-ranging domains in nursing. TRIAL REGISTRATION ISRCTN Registry ISRCTN32603572; http://www.isrctn.com/ISRCTN32603572. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/18894.
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Affiliation(s)
- Guillaume Fontaine
- Research Center, Montreal Heart Institute, Montréal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Cossette
- Research Center, Montreal Heart Institute, Montréal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Université Laval, Québec, QC, Canada
- Research Center, CHU de Québec, Québec, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
- Research Center, University of Montreal Hospital Center, Montréal, QC, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
- Research Center, University of Montreal Hospital Center, Montréal, QC, Canada
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Richard-Lalonde M, Gélinas C, Boitor M, Gosselin E, Feeley N, Cossette S, Chlan LL. The Effect of Music on Pain in the Adult Intensive Care Unit: A Systematic Review of Randomized Controlled Trials. J Pain Symptom Manage 2020; 59:1304-1319.e6. [PMID: 31881291 DOI: 10.1016/j.jpainsymman.2019.12.359] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
CONTEXT Multimodal analgesic approaches are recommended for intensive care unit (ICU) pain management. Although music is known to reduce pain in acute and chronic care settings, less is known about its effectiveness in the adult ICU. OBJECTIVES Determine the effects of music interventions on pain in the adult ICU, compared with standard care or noise reduction. METHODS This review was registered on PROSPERO (CRD42018106889). Databases were searched for randomized controlled trials of music interventions in the adult ICU, with the search terms ["music*" and ("critical care" or "intensive care")]. Pain scores (i.e., self-report rating scales or behavioral scores) were the main outcomes of this review. Data were analyzed using a DerSimonian-Laird random-effects method with standardized mean difference (SMD) of pain scores. Statistical heterogeneity was determined as I2 > 50% and explored via subgroup analyses and meta-regression. RESULTS Eighteen randomized controlled trials with a total of 1173 participants (60% males; mean age 60 years) were identified. Ten of these studies were included in the meta-analysis based on risk of bias assessment (n = 706). Music was efficacious in reducing pain (SMD -0.63 [95% CI -1.02, -0.24; n = 10]; I2 = 87%). Music interventions of 20-30 minutes were associated with a larger decrease in pain scores (SMD -0.66 [95% CI -0.94, -0.37; n = 5]; I2 = 30%) compared with interventions of less than 20 minutes (SMD 0.10 [95% CI -0.10, 0.29; n = 4]; I2 = 0%). On a 0-10 scale, 20-30 minutes of music resulted in an average decrease in pain scores of 1.06 points (95% CI -1.56, -0.56). CONCLUSION Music interventions of 20-30 minutes are efficacious to reduce pain in adult ICU patients able to self-report.
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Affiliation(s)
| | - Céline Gélinas
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | - Nancy Feeley
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada
| | - Sylvie Cossette
- Université de Montréal, Montreal Heart Institute, Montreal, Quebec, Canada
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Houle J, Gallani MC, Pettigrew M, Laflamme G, Mathieu L, Boudreau F, Poirier P, Cossette S. Acceptability of a computer-tailored and pedometer-based socio-cognitive intervention in a secondary coronary heart disease prevention program: A qualitative study. Digit Health 2020; 6:2055207619899840. [PMID: 31976078 PMCID: PMC6956605 DOI: 10.1177/2055207619899840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022] Open
Abstract
When developing an innovative intervention, its acceptability to patients, health care professionals and managers must be considered to ensure the implementation into practice. This study aims to identify factors influencing the acceptability of a computer-tailored and pedometer-based socio-cognitive intervention for patients with heart disease. Focus group interviews were conducted in two outlying regions of the province of Quebec (Canada). The Theory of Planned Behavior formed the theoretical basis of the interview guide. Two researchers performed verbatim analysis independently until consensus was achieved. The sample included 44 participants divided into six groups (patients n = 7 + 8, health care professionals n = 8 + 8, managers n = 6 + 7). Health care professionals and managers mentioned benefits concerning partners’ opportunity to improve assessment and monitoring. Patients believed the intervention could be useful to improve adherence to physical activity. Additional benefits indicated were self-monitoring behavior and improved health-related outcomes. However, patients expressed concern about the online security, fearing possible data breach. Some clinicians felt the pedometer may not be able to evaluate physical activities other than walking. With regard to behavioral control, a web application and pedometer must be easy to use and compatible with services already in place. Further barriers include level of literacy, cost and the various difficulties associated with wearing a pedometer. Findings suggest that, to improve the acceptability of a computer-tailored and pedometer-based socio-cognitive intervention, users must be assured of a secure website, validated, affordable and easy-to-use pedometers, and an intervention adapted to their level of literacy.
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Affiliation(s)
- Julie Houle
- Nursing Department, Université du Québec à Trois-Rivières, Canada
| | | | | | | | - Luc Mathieu
- Faculty of Medicine, Université de Sherbrooke, Canada
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Frégeau A, Cournoyer A, Maheu-Cadotte MA, Iseppon M, Soucy N, St-Cyr Bourque J, Cossette S, Castonguay V, Fleet R. Use of tabletop exercises for healthcare education: a scoping review protocol. BMJ Open 2020; 10:e032662. [PMID: 31915165 PMCID: PMC6955537 DOI: 10.1136/bmjopen-2019-032662] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION There is a growing interest in developing interprofessional education (IPE) in the community of healthcare educators. Tabletop exercises (TTX) have been proposed as a mean to cultivate collaborative practice. A TTX simulates an emergent situation in an informal environment. Healthcare professionals need to take charge of this situation as a team through a discussion-based approach. As TTX are gaining in popularity, performing a review about their uses could guide educators and researchers. The aim of this scoping review is to map the uses of TTX in healthcare. METHODS AND ANALYSIS A search of the literature will be conducted using medical subject heading terms and keywords in PubMed, Medline, EBM Reviews (Evidence-Based Medicine Reviews), CINAHL (Cumulative Index of Nursing and Allied Health Literature), Embase and ERIC (Education Resources Information Center), along with a search of the grey literature. The search will be performed after the publication of this protocol (estimated to be January 1st 2020) and will be repeated 1 month prior to the submission for publication of the final review (estimated to be June 1st 2020). Studies reporting on TTX in healthcare and published in English or French will be included. Two reviewers will screen the articles and extract the data. The quality of the included articles will be assessed by two reviewers. To better map their uses, the varying TTX activities will be classified as performed in the context of disaster health or not, for IPE or not and using a board game or not. Moreover, following the same mapping objective, outcomes of TTX will be reported according to the Kirkpatrick model of outcomes of educational programs. ETHICS AND DISSEMINATION No institutional review board approval is required for this review. Results will be submitted for publication in a peer-reviewed journal. The findings of this review will inform future efforts to TTX into the training of healthcare professionals.
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Affiliation(s)
- Amélie Frégeau
- Department of Emergency Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Alexis Cournoyer
- Department of Emergency Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Marc-André Maheu-Cadotte
- Research department, Institut de Cardiologie de Montréal, Montreal, Quebec, Canada
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Massimiliano Iseppon
- Department of Emergency Medicine, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Nathalie Soucy
- Direction of Education and of CHUM Academy, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Julie St-Cyr Bourque
- Emergency Medicine Department, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Sylvie Cossette
- Research and International Development, Institut de Cardiologie de Montréal, Montreal, Quebec, Canada
| | - Véronique Castonguay
- Department of Emergency Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Richard Fleet
- Department of Emergency Medicine, Université Laval, Lévis, Quebec, Canada
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Fontaine G, Cossette S, Maheu-Cadotte MA, Deschênes MF, Rouleau G, Lavallée A, Pépin C, Ballard A, Chicoine G, Lapierre A, Lavoie P, Blondin J, Mailhot T. Effect of implementation interventions on nurses' behaviour in clinical practice: a systematic review, meta-analysis and meta-regression protocol. Syst Rev 2019; 8:305. [PMID: 31806051 PMCID: PMC6896305 DOI: 10.1186/s13643-019-1227-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/11/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Practitioner-level implementation interventions such as audit and feedback, communities of practice, and local opinion leaders have shown potential to change nurses' behaviour in clinical practice and improve patients' health. However, their effectiveness remains unclear. Moreover, we have a paucity of data regarding the use of theory in implementation studies with nurses, the causal processes-i.e. mechanisms of action-targeted by interventions to change nurses' behaviour in clinical practice, and the constituent components-i.e. behaviour change techniques-included in interventions. Thus, our objectives are threefold: (1) to examine the effectiveness of practitioner-level implementation interventions in changing nurses' behaviour in clinical practice; (2) to identify, in included studies, the type and degree of theory use, the mechanisms of action targeted by interventions and the behaviour change techniques constituting interventions and (3) to examine whether intervention effectiveness is associated with the use of theory or with specific mechanisms of action and behaviour change techniques. METHODS We will conduct a systematic review based on the Cochrane Effective Practice and Organization of Care (EPOC) Group guidelines. We will search six databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science) with no time limitation for experimental and quasi-experimental studies that evaluated practitioner-level implementation interventions aiming to change nurses' behaviour in clinical practice. We will also hand-search reference lists of included studies. We will perform screening, full-text review, risk of bias assessment, and data extraction independently with the Covidence systematic review software. We will assess the quality of evidence using the GRADEpro software. We will code included studies independently for theory use (Theory Coding Scheme), mechanisms of action (coding guidelines from Michie) and behaviour change techniques (Behaviour Change Technique Taxonomy v1) with QSR International's NVivo qualitative data analysis software. Meta-analyses will be performed using the Review Manager (RevMan) software. Meta-regression analyses will be performed with IBM SPSS Statistics software. DISCUSSION This review will inform knowledge users and researchers interested in designing, developing and evaluating implementation interventions to support nurses' behaviour change in clinical practice. Results will provide key insights regarding which causal processes-i.e. mechanisms of action-should be targeted by these interventions, and which constituent components-i.e. behaviour change techniques-should be included in these interventions to increase their effectiveness. SYSTEMATIC REVIEW REGISTRATION The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019130446).
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
| | - Marie-France Deschênes
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Center for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Geneviève Rouleau
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
- Faculty of Nursing, Université Laval, Québec, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, CHU Sainte-Justine, Montréal, Canada
| | - Catherine Pépin
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Institute of Public Health Research, Université de Montréal, Montréal, Canada
| | - Ariane Ballard
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, CHU Sainte-Justine, Montréal, Canada
| | - Gabrielle Chicoine
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Université de Montréal Hospital Center, Montréal, Canada
| | - Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center, Montreal Heart Institute, Montréal, Canada
- Center for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Jérémie Blondin
- School of Librarianship and Information Science, Université de Montréal, Montréal, Canada
| | - Tanya Mailhot
- Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, USA
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Fontaine G, Cossette S, Maheu-Cadotte MA, Mailhot T, Heppell S, Roussy C, Côté J, Gagnon MP, Dubé V. Behavior change counseling training programs for nurses and nursing students: A systematic descriptive review. Nurse Educ Today 2019; 82:37-50. [PMID: 31425931 DOI: 10.1016/j.nedt.2019.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/02/2019] [Accepted: 08/04/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES (1) To systematically review the literature on behavior change counseling (BCC) training programs targeting nurses and nursing students; (2) to characterize these training programs according to their content (i.e., targeted health behavior[s], BCC approaches taught, BCC techniques taught), structure, and modes of delivery. DESIGN A systematic, descriptive literature review. DATA SOURCES PubMed, CINAHL and Embase were searched with no time limitation in August 2018. REVIEW METHODS A systematic, descriptive literature review structured according to Paré et al.'s methodology and the PRISMA guidelines. Primary studies were included if they evaluated a BCC training program with nurses or nursing students. Review authors screened studies, extracted data, and assessed study quality using the MERSQI. Data was synthesized through narrative synthesis, descriptive statistics, and content analysis. RESULTS From a pool of 267 articles, we included 25 articles published between 2003 and 2018. Two studies scored as low quality (8%), 18 as moderate quality (72%), and 5 as high quality (20%). Physical activity (n = 14; 56%) and smoking (n = 11; 44%) were the most frequently targeted health behaviors. Eleven BCC approaches were cited (e.g., motivational interviewing), and 48 BCC techniques were identified (e.g., eliciting and scaling change talk). The median number of training sessions was 3 (interquartile range [IQR] 5), the median training program duration was 3 h (IQR 6.25 h), and median training period was 24.5 days (IQR 110 days). Programs were most often delivered as seminars and workshops. CONCLUSIONS High-quality studies reporting the assessment of BCC training programs with nurses and nursing students are scarce. There was significant heterogeneity in terms of the BCC approaches and techniques taught. Current evidence suggests nurses and nursing students learn BCC mainly through active, realistic practice. However, computer-based training programs are rapidly gaining ground. Further research emphasizing theory-based BCC training programs is warranted.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada; Montreal Heart Institute Research Center, 5000 Belanger Street, S-2490, Montreal H1T 1C8, Quebec, Canada.
| | - Sylvie Cossette
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada; Montreal Heart Institute Research Center, Montreal, Quebec, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada; Montreal Heart Institute Research Center, Montreal, Quebec, Canada; University of Montreal Hospital Research Center, Montreal, Quebec, Canada
| | - Tanya Mailhot
- Montreal Heart Institute Research Center, Montreal, Quebec, Canada; Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences, Northeastern University, United States of America
| | - Sonia Heppell
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada; Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - José Côté
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Center, Montreal, Quebec, Canada
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Laval University, Quebec, Quebec, Canada; CHU de Québec Research Center, Quebec, Quebec, Canada
| | - Véronique Dubé
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
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Cournoyer A, Cossette S, Paquet J, Daoust R, Marquis M, Notebaert É, Iseppon M, Chauny JM, Denault A. Association Between the Quantity of Subcutaneous Fat and the Inter-Device Agreement of 2 Tissue Oximeters. J Cardiothorac Vasc Anesth 2019; 33:2989-2994. [DOI: 10.1053/j.jvca.2019.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Indexed: 11/11/2022]
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Yegin Z, Cossette S, Heppel S. MISE À L'ESSAI D'UN COACHING POUR OPTIMISER LA PRATIQUE DE L'EXAMEN PHYSIQUE PAR DES INFIRMIÈRES DANS UN HÔPITAL CARDIOLOGIQUE. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Fontaine G, Cossette S, Maheu-Cadotte MA, Mailhot T, Deschênes MF, Mathieu-Dupuis G, Côté J, Gagnon MP, Dubé V. Efficacy of adaptive e-learning for health professionals and students: a systematic review and meta-analysis. BMJ Open 2019; 9:e025252. [PMID: 31467045 PMCID: PMC6719835 DOI: 10.1136/bmjopen-2018-025252] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 06/10/2019] [Accepted: 07/30/2019] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Although adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding the efficacy of AEEs in improving knowledge, skills and clinical behaviour in health professionals and students. DESIGN Systematic review and meta-analysis. DATA SOURCES CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science from the first year of records to February 2019. ELIGIBILITY CRITERIA Controlled studies that evaluated the effect of an AEE on knowledge, skills or clinical behaviour in health professionals or students. SCREENING, DATA EXTRACTION AND SYNTHESIS Two authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. AEEs were reviewed with regard to their topic, theoretical framework and adaptivity process. Studies were included in the meta-analysis if they had a non-adaptive e-learning environment control group and had no missing data. Effect sizes (ES) were pooled using a random effects model. RESULTS From a pool of 10 569 articles, we included 21 eligible studies enrolling 3684 health professionals and students. Clinical topics were mostly related to diagnostic testing, theoretical frameworks were varied and the adaptivity process was characterised by five subdomains: method, goals, timing, factors and types. The pooled ES was 0.70 for knowledge (95% CI -0.08 to 1.49; p.08) and 1.19 for skills (95% CI 0.59 to 1.79; p<0.00001). Risk of bias was generally high. Heterogeneity was large in all analyses. CONCLUSIONS AEEs appear particularly effective in improving skills in health professionals and students. The adaptivity process within AEEs may be more beneficial for learning skills rather than factual knowledge, which generates less cognitive load. Future research should report more clearly on the design and adaptivity process of AEEs, and target higher-level outcomes, such as clinical behaviour. PROSPERO REGISTRATION NUMBER CRD42017065585.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
| | - Tanya Mailhot
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
- Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | | | - Gabrielle Mathieu-Dupuis
- School of Librarianship and Information Science, Université de Montréal, Montréal, Québec, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Research Center, University of Montreal Hospital Centre, Montréal, Québec, Canada
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Université Laval, Québec City, Québec, Canada
- Research Center, CHU de Québec-Université Laval, Québec City, Québec, Canada
| | - Veronique Dubé
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Research Center, University of Montreal Hospital Centre, Montréal, Québec, Canada
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Kayser JW, Cossette S, Côté J, Tanguay JF, Tremblay JF, Diodati JG, Bourbonnais A, Purden M, Juneau M, Terrier J, Dupuis J, Maheu-Cadotte MA, Fontaine G, Cournoyer D. A web-based tailored nursing intervention (TAVIE en m@rche) aimed at increasing walking after an acute coronary syndrome: Multicentre randomized trial. J Adv Nurs 2019; 75:2727-2741. [PMID: 31225667 DOI: 10.1111/jan.14119] [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] [Received: 09/11/2018] [Revised: 04/13/2019] [Accepted: 04/17/2019] [Indexed: 11/26/2022]
Abstract
AIM Evaluate a web-based tailored nursing intervention, TAVIE en m@rche, on increasing daily steps after an acute coronary syndrome. DESIGN Parallel two-group multicentre randomized trial. METHODS An experimental group receiving TAVIE en m@rche, was compared to a control group receiving hyperlinks to public websites. Acute coronary syndrome patients who were insufficiently active were recruited from three coronary care units. Daily steps at 12 weeks were the primary outcome. Secondary outcomes included self-reported walking and moderate to vigorous physical activity (MVPA). Exploratory outcomes were angina frequency, emergency department visits, hospitalizations and secondary prevention programme attendance. RESULTS Primary data were analysed for 39 participants. No significant effects were found. At 12 weeks 275.9 more daily steps and 1,464.3 more energy expenditure in MVPA were found in the experimental group relative to the control. No effects were found for angina frequency, emergency department visits, hospitalizations and secondary prevention programme attendance. CONCLUSION The lack of effect on our primary result may be explained by the intervention goal that was mismatched to the needs of our mostly sufficiently active sample at randomization, resulting in no meaningful change in daily steps. Although the non-significantly greater increase in self-reported MVPA may represent gains in health among the participants that accessed TAVIE en m@rche, this result should be interpreted with caution. IMPACT From 40%-60% of acute coronary syndrome patients self-report insufficient levels of physical activity. No effect was found on the primary outcome of daily steps. Although not significant, a greater increase in MVPA was found at 12 weeks. The primary outcome can be explained by most of the sample having attained the physical activity recommendation at randomization. Caution in interpreting the non-significant increase in MVPA is warranted due to attrition bias and statistical uncertainty. Future directions may consider the timing of randomization in relation to meeting the needs of insufficiently active acute coronary syndrome patients.
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Affiliation(s)
- John William Kayser
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Jean-Francois Tanguay
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Jean-Francois Tremblay
- Integrated Health and Social Services Centres, l'Est de l'Île de Montréal, Montréal, Quebec, Canada
| | | | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Research Center of the Institut universitaire de gériatrie de Montréal, Montréal, Quebec, Canada
| | - Margaret Purden
- Ingram School of Nursing, McGill University, Montréal, Quebec, Canada.,Jewish General Hospital Centre for Nursing Research, Montréal, Quebec, Canada
| | - Martin Juneau
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Julien Terrier
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Daniel Cournoyer
- Montreal Health Innovations Coordinating Center, Montréal, Quebec, Canada
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Cournoyer A, Cossette S, Potter BJ, Daoust R, de Montigny L, Londei-Leduc L, Lamarche Y, Ross D, Morris J, Chauny JM, Sokoloff C, Paquet J, Marquis M, Albert M, Bernard F, Iseppon M, Notebaert É, Cavayas YA, Denault A. Prognostic impact of the conversion to a shockable rhythm from a non-shockable rhythm for patients suffering from out-of-hospital cardiac arrest. Resuscitation 2019; 140:43-49. [PMID: 31063844 DOI: 10.1016/j.resuscitation.2019.04.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/27/2019] [Accepted: 04/27/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE For patients suffering from an out-of-hospital cardiac arrest (OHCA), having an initial shockable rhythm is a marker of good prognosis. It has been suggested as one of the main prognosticating factors for the selection of patients for extracorporeal resuscitation (E-CPR). However, the prognostic implication of converting from a non-shockable to a shockable rhythm, as compared to having an initial shockable rhythm, remains uncertain, especially among patients that can otherwise be considered eligible for E-CPR. The objective of this study was to evaluate the association between the initial rhythm and its subsequent conversion and survival following an OHCA, for the general population and for E-CPR candidates. METHODS This study used a registry of OHCA in Montreal, Canada. Adult patients suffering from a non-traumatic OHCA for whom the initial rhythm was known were included. The association between the initial rhythm and its subsequent conversion or not and survival to discharge was assessed using a multivariable logistic regression. RESULTS Of 6681 included patients, 1788 (27%) had an initial shockable rhythm, 1749 (26%) had pulseless electrical activity (PEA) and no subsequent shockable rhythm, 295 (4%) had PEA and a subsequent shockable rhythm, 2694 (40%) had asystole and no subsequent shockable rhythm, and 155 (2%) asystole and a subsequent shockable rhythm. As compared to patients having an initial shockable rhythm, patients in all other groups had significantly lower odds of survival to hospital discharge (p < 0.001 for all comparisons). Univariate analyses were performed for E-CPR candidates. Among these 556 (8%) patients, more patients with an initial shockable rhythm survived than patients in all other groups (p < 0.001 for all comparisons). CONCLUSIONS The initial rhythm remains a much better prognostic marker than subsequent rhythms for all patients suffering from an OHCA, including in the subset of potential E-CPR candidates.
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Affiliation(s)
- Alexis Cournoyer
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.
| | - Sylvie Cossette
- Université de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Brian J Potter
- Université de Montréal, Montréal, Québec, Canada; Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Raoul Daoust
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | | | - Luc Londei-Leduc
- Université de Montréal, Montréal, Québec, Canada; Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Corporation d'Urgences-santé, Montréal, Québec, Canada
| | - Yoan Lamarche
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Dave Ross
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Judy Morris
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Jean-Marc Chauny
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Catalina Sokoloff
- Université de Montréal, Montréal, Québec, Canada; Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Jean Paquet
- Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Martin Marquis
- Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Martin Albert
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Francis Bernard
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Massimiliano Iseppon
- Université de Montréal, Montréal, Québec, Canada; Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
| | - Éric Notebaert
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Yiorgos Alexandros Cavayas
- Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - André Denault
- Université de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada; Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
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Cetin-Sahin D, Ducharme F, McCusker J, Veillette N, Cossette S, Vu TTM, Vadeboncoeur A, Lachance PA, Mah R, Berthelot S. Experiences of an Emergency Department Visit Among Older Adults and Their Families: Qualitative Findings From a Mixed-Methods Study. J Patient Exp 2019; 7:346-356. [PMID: 32821794 PMCID: PMC7410141 DOI: 10.1177/2374373519837238] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Emergency department (ED) visits are critical events for older adults, but little is known regarding their experiences, particularly about their physical needs, the involvement of accompanying family members, and the transition back to the community. Objective To explore experiences of an ED visit among patients aged 75 and older. Methods In a mixed-methods study, a cohort of patients aged 75 and older (or a family member) discharged from the ED back to the community was recruited from 4 urban EDs. A week following discharge, structured telephone interviews supplemented with open-ended questions were conducted. A subsample (76 patients, 32 family members) was purposefully selected. Verbatim transcripts of responses to the open-ended questions were thematically analyzed. Results Experiences related to physical needs included comfort, equipment supporting mobility and autonomy, help when needed, and access to drink and food. Family members required opportunities to provide patient support and greater involvement in their care. At discharge, patients/families required adequate discharge education, resolution of their health problem, information on medications, and greater certainty about planned follow-up medical and home care services. Conclusions Our findings suggest several areas that could be targeted to improve patient and family perceptions of the care at an ED visit.
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Affiliation(s)
- Deniz Cetin-Sahin
- St. Mary's Research Centre, Montreal, Quebec, Canada.,McGill University, Montreal, Quebec, Canada.,Center for Research in Aging, Donald Berman Maimonides Geriatric Centre, Montreal, Quebec, Canada
| | - Francine Ducharme
- University of Montreal, Montreal, Quebec, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada
| | - Jane McCusker
- St. Mary's Research Centre, Montreal, Quebec, Canada.,McGill University, Montreal, Quebec, Canada
| | - Nathalie Veillette
- University of Montreal, Montreal, Quebec, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada
| | - Sylvie Cossette
- University of Montreal, Montreal, Quebec, Canada.,Montreal Heart Institute Research Center, Montreal, Quebec, Canada
| | - T T Minh Vu
- University of Montreal, Montreal, Quebec, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada.,Centre hospitalier de l'université de Montréal, Montreal, Quebec, Canada
| | - Alain Vadeboncoeur
- University of Montreal, Montreal, Quebec, Canada.,Emergency Medicine Services, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Paul-André Lachance
- University of Montreal, Montreal, Quebec, Canada.,Hôpital de la Cité-de-la-Santé, Laval, Quebec, Canada
| | - Rick Mah
- St. Mary's Hospital Center, Montreal, Quebec, Canada
| | - Simon Berthelot
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Canada
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Mailhot T, Cossette S, Fontaine G, Maheu-Cadotte MA. TRANSLATION, CULTURAL ADAPTATION AND VALIDATION OF THE FRENCH VERSION OF THE FAMILY-CONFUSION ASSESSMENT METHOD. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mailhot T, Cossette S, Maheu-Cadotte MA, Fontaine G. RISK FACTORS AND COMPLICATIONS RELATED TO SUB-SYNDROMAL DELIRIUM FOLLOWING CARDIAC-SURGERY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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30
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Fontaine G, Cossette S, Heppell S, Roussy C, Maheu-Cadotte MA, Mailhot T. TRAINING NURSES IN HEALTH BEHAVIOUR CHANGE COUNSELING: A NARRATIVE REVIEW OF CURRENT APPROACHES. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Mailhot T, Cossette S, Lambert J, Beaubien-Souligny W, Cournoyer A, O'Meara E, Maheu-Cadotte MA, Fontaine G, Bouchard J, Lamarche Y, Benkreira A, Rochon A, Denault A. Delirium After Cardiac Surgery and Cumulative Fluid Balance: A Case-Control Cohort Study. J Cardiothorac Vasc Anesth 2018; 33:93-101. [PMID: 30122614 DOI: 10.1053/j.jvca.2018.07.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 12/20/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess a novel hypothesis to explain delirium after cardiac surgery through the relationship between cumulative fluid balance and delirium. This hypothesis involved an inflammatory process combined with a hypervolemic state, which could lead to venous congestion reaching the brain. DESIGN Retrospective case-control (1:1) cohort study. SETTING University-affiliated tertiary cardiology center. PARTICIPANTS Cardiac surgery intensive care unit (ICU) patients. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Cumulative fluid balance was evaluated at 3 times: (1) upon arrival at the ICU after surgery, (2) 24 hours post-ICU arrival, and (3) 48 hours post-ICU arrival. A generalized estimated equation was used to model the association between cumulative fluid balance and delirium occurrence 24 hours later. Covariates were selected based on the statistical differences between cases and controls on delirium risk factors and clinical characteristics. The cohort included 346 patients, of which 39 (11%), 104 (30%), and 142 patients (41%) presented delirium at 24, 48, and 72 hours post-ICU arrival, respectively. The effect of time had an odds ratio (OR) of 2.14, 95% confidence interval (CI) 1.603 to 2.851, and a p value < 0.001. The cumulative fluid balance was associated with delirium occurrence (OR 1.20, 95% CI: 1.066-1.355, p = .003). History of neurological disorder, having both hearing and visual impairment, type of procedure, perioperative cerebral oximetry, mean pulmonary artery pressure pre-cardiopulmonary bypass (CPB), and mean arterial pressure post-CPB also contributed to delirium in the model. CONCLUSION Delirium is associated with a cumulative fluid balance, but the extent through which this plays an etiologic role remains to be determined.
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Affiliation(s)
- Tanya Mailhot
- Faculty of Nursing, Faculty of Medicine, Université de Montréal, Montreal Heart Institute Research Center, 5000 Bélanger St, S-2490, Montreal, Quebec, H1T 1C8, Canada.
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal Heart Institute Research Center, Montreal, Canada
| | - Jean Lambert
- School of Public Health, Department of Preventive Medicine, Montreal Heart Institute Research Center, Montreal, Canada
| | | | - Alexis Cournoyer
- Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, Canada
| | - Eileen O'Meara
- Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, Canada
| | | | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal Heart Institute Research Center, Montreal, Canada
| | - Josée Bouchard
- Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, Canada
| | - Yoan Lamarche
- Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, Canada
| | - Aymen Benkreira
- Faculty of Medicine, Université de Sherbrooke, Montreal Heart Institute Research Center, Montreal, Canada
| | - Antoine Rochon
- Faculty of Medicine, Department of Anesthesiology, Université de Montréal, Montreal Heart Institute, Montreal, Canada
| | - André Denault
- Faculty of Medicine, Department of Anesthesiology, Université de Montréal, Montreal Heart Institute, Montreal, Canada
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Cournoyer A, Notebaert É, de Montigny L, Ross D, Cossette S, Londei-Leduc L, Iseppon M, Lamarche Y, Sokoloff C, Potter BJ, Vadeboncoeur A, Larose D, Morris J, Daoust R, Chauny JM, Piette É, Paquet J, Cavayas YA, de Champlain F, Segal E, Albert M, Guertin MC, Denault A. Impact of the direct transfer to percutaneous coronary intervention-capable hospitals on survival to hospital discharge for patients with out-of-hospital cardiac arrest. Resuscitation 2018; 125:28-33. [DOI: 10.1016/j.resuscitation.2018.01.048] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/11/2018] [Accepted: 01/29/2018] [Indexed: 01/22/2023]
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Maheu-Cadotte MA, Cossette S, Dubé V, Fontaine G, Mailhot T, Lavoie P, Cournoyer A, Balli F, Mathieu-Dupuis G. Effectiveness of serious games and impact of design elements on engagement and educational outcomes in healthcare professionals and students: a systematic review and meta-analysis protocol. BMJ Open 2018; 8:e019871. [PMID: 29549206 PMCID: PMC5857654 DOI: 10.1136/bmjopen-2017-019871] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Serious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals' and students' education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students. METHODS AND ANALYSIS A systematic search of the literature will be conducted using a combination of medical subject headings terms and keywords in Cumulative Index of Nursing and Allied Health, Embase, Education Resources Information Center, PsycInFO, PubMed and Web of Science. Studies assessing SGs on engagement and educational outcomes will be included. Two independent reviewers will conduct the screening as well as the data extraction process. The risk of bias of included studies will also be assessed by two reviewers using the Effective Practice and Organisation of Care criteria. Data regarding DEs in SGs will first be synthesised qualitatively. A meta-analysis will then be performed, if the data allow it. Finally, the quality of the evidence regarding the effectiveness of SGs on each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION As this systematic review only uses already collected data, no Institutional Review Board approval is required. Its results will be submitted in a peer-reviewed journal by the end of 2018. PROSPERO REGISTRATION NUMBER CRD42017077424.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute Research Center, Montreal, Canada
| | - Tanya Mailhot
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Patrick Lavoie
- William F Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Alexis Cournoyer
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Resident in Medicine, Clinician-Scientist Program, Université de Montreal, Montréal, Montreal, Canada
- Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
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Fraser V, Cossette S, Mailhot T, Brisebois A, Dubé V. Evaluation of an Intervention With Nurses for Delirium Detection After Cardiac Surgery. Worldviews Evid Based Nurs 2017; 15:38-44. [DOI: 10.1111/wvn.12266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Vanessa Fraser
- Faculty of Nursing, Université de Montréal; Montreal Heart Institute Research Centre; Montreal, Quebec Canada
| | - Sylvie Cossette
- Professor, Faculty of Nursing, Université de Montréal, and Researcher, Montreal Heart Institute Research Centre; Montreal, Quebec Canada
| | - Tanya Mailhot
- Faculty of Nursing, Université de Montréal; Montreal Heart Institute Research Centre; Montreal Quebec Canada
| | - Anie Brisebois
- Clinical Nurse Specialist; Montreal Heart Institute; Montreal Quebec Canada
| | - Véronique Dubé
- Assistant Professor, Faculty of Nursing, Université de Montréal, and Researcher; CHUM Research Centre; Montreal Quebec Canada
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Fontaine G, Cossette S, Maheu-Cadotte MA, Mathieu-Dupuis G. EFFECTIVENESS OF ADAPTIVE E-LEARNING ENVIRONMENTS ON KNOWLEDGE, COMPETENCE AND BEHAVIOUR IN HEALTH PROFESSIONALS AND STUDENTS: A SYSTEMATIC REVIEW PROTOCOL. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Fontaine G, Cossette S, Maheu-Cadotte MA. DEVELOPMENT AND EVALUATION OF AN INTELLIGENT LEARNING ENVIRONMENT FOR THE ASSESSMENT AND MANAGEMENT OF CARDIOMETABOLIC RISK BY ACUTE CARE NURSES: A RESEARCH PROTOCOL. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Mailhot T, Denault A, Cossette S, Lambert J, Benkreira A, Beaubien-Souligny W, Alexis C, Bouchard J, Lamarche Y, Rochon A, O'Meara E, Fontaine G, Maheu-Cadotte M. POST-CARDIAC SURGERY DELIRIUM: VENOUS CONGESTION REACHING THE BRAIN? Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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McCusker J, Minh Vu TT, Veillette N, Cossette S, Vadeboncoeur A, Ciampi A, Cetin-Sahin D, Belzile E. Elder-Friendly Emergency Department: Development and Validation of a Quality Assessment Tool. J Am Geriatr Soc 2017; 66:394-400. [PMID: 28960240 DOI: 10.1111/jgs.15137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/30/2022]
Abstract
OBJECTIVES To develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care. DESIGN Four-step study: (1) Content development of tool by a multidisciplinary panel, (2) survey of ED lead physicians and nurses, (3) development of subscales using principal component analysis and clinical judgment, (4) reliability and validity assessment. SETTING Province of Quebec, Canada. PARTICIPANTS Lead ED nurses and physicians at 76 Quebec EDs who participated in a 2013/14 survey (66% of 116 adult nonpsychiatric EDs in the province). MEASUREMENTS Geriatric care items (n = 62) grouped into seven preliminary content areas (screening and assessment, clinical protocols, discharge planning, staffing, physical environment, continuing education, quality assessment), lead nurse and physician perceptions of the quality of ED geriatric care, institutional prioritization of geriatric care, and ED type. RESULTS Thirteen subscales were developed; most were associated with ED type and quality indicators. CONCLUSION Thirteen subscales for geriatric ED services are proposed for evaluation in various ED settings.
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Affiliation(s)
- Jane McCusker
- St. Mary's Research Centre, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - T T Minh Vu
- Faculté des sciences infirmières, Université de Montréal, Montreal, Canada.,Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.,Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Nathalie Veillette
- Faculté des sciences infirmières, Université de Montréal, Montreal, Canada.,Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - Sylvie Cossette
- Faculté des sciences infirmières, Université de Montréal, Montreal, Canada.,Research Centre, Montreal Heart Institute, Montreal, Canada
| | - Alain Vadeboncoeur
- Faculté des sciences infirmières, Université de Montréal, Montreal, Canada.,Center for Research in Aging, Donald Berman Maimonides Geriatric Centre, Montreal, Canada
| | - Antonio Ciampi
- St. Mary's Research Centre, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Deniz Cetin-Sahin
- St. Mary's Research Centre, Montreal, Quebec, Canada.,Emergency Medicine Services, Montreal Heart Institute, Montreal, Canada
| | - Eric Belzile
- St. Mary's Research Centre, Montreal, Quebec, Canada
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Cossette S, Côté J, Rouleau G, Robitaille M, Heppell S, Mailhot T, Fontaine G, Cournoyer C, Gagnon MP, Gallani MC, Tanguay JF, Dupuis J, Nigam A, Guertin MC. A Web-Based Tailored Intervention to Support Illness Management in Patients With an Acute Coronary Syndrome: Pilot Study. JMIR Cardio 2017; 1:e4. [PMID: 31758758 PMCID: PMC6834220 DOI: 10.2196/cardio.7342] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 07/06/2017] [Accepted: 07/12/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Illness management after an acute coronary syndrome (ACS) is crucial to prevent cardiac complications, to foster participation in a cardiac rehabilitation (CR) program, and to optimize recovery. Web-based tailored interventions have the potential to provide individualized information and counseling to optimize patient's illness management after hospital discharge. OBJECTIVE We aimed to assess the feasibility and acceptability of a Web-based tailored intervention (TAVIE@COEUR) designed to improve illness management in patients hospitalized for an ACS. Illness management outcomes were operationalized by self-care, medication adherence, anxiety management, cardiac risk factors reduction, and enrollment in a CR program. METHODS This posttest pilot study was conducted with one group (N=30) of patients hospitalized for an ACS on the coronary care unit of a tertiary cardiology center. TAVIE@COEUR comprises three Web-based sessions, with a duration ranging from 10 to 45 min and is structured around an algorithm to allow the tailoring of the intervention to different pathways according to patients' responses to questions. TAVIE@COEUR includes 90 pages, 85 videos, and 47 PDF documents divided across session 1 (S1), session 2 (S2), and session 3 (S3). These sessions concern self-care and self-observation skills related to medication-taking (S1), emotional control and problem-solving skills (S2), and social skills and interacting with health professionals (S3). Throughout the videos, a virtual nurse (providing the intervention virtually) guides the participants in the acquisition of self-care skills. Patients completed S1 of TAVIE@COEUR before hospital discharge and were asked to complete S2 and S3 within 2 weeks after discharge. Feasibility indicators were extracted from the TAVIE@COEUR system. Data regarding acceptability (satisfaction and appreciation of the platform) and preliminary effect (self-care, medication adherence, anxiety management, risk factor reduction, and CR enrollment) were assessed through questionnaires at 1 month following discharge. Preliminary effect was assessed by comparing baseline and 1-month illness management variables. RESULTS Of the 30 participants, 20 completed S1, 10 completed S2, and 5 completed S3. Good acceptability scores were observed for ease of navigation (mean=3.58, standard deviation [SD]=0.70; scale=0-4), ease of understanding (mean=3.46, SD=0.63; scale=0-4), and applicability (mean=3.55, SD=0.74; scale=0-4). The lowest acceptability scores were observed for information tailoring (mean=2.93, SD=0.68; scale=0-4) and individual relevance (mean=2.56, SD=0.96; scale=0-4). With regard to preliminary effect, we observed an overall self-care at 1 month following discharge score higher than at baseline (mean at 1 month=54.07, SD=3.99 vs mean at baseline=49.09, SD=6.92; scale-0-60). CONCLUSIONS Although participants reported general satisfaction and appreciation of TAVIE@COEUR, acceptability and feasibility results show the need for further development of the Web-based intervention to enhance its tailoring before undertaking a full-fledged randomized controlled trial. This may be accomplished by optimizing the adaptability of TAVIE@COEUR to patients' knowledge, needs, interests, individual capabilities, and emotional and cognitive responses during session completion.
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Affiliation(s)
- Sylvie Cossette
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Research Chair in Innovative Nursing Practices, Montréal, QC, Canada
| | - Geneviève Rouleau
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Research Chair in Innovative Nursing Practices, Montréal, QC, Canada.,Faculty of Nursing, Laval University, Quebec City, QC, Canada
| | | | - Sonia Heppell
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
| | - Tanya Mailhot
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Guillaume Fontaine
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | | | | | | | - Jean-Francois Tanguay
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Anil Nigam
- Montreal Heart Institute Research Center, Montréal, QC, Canada
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Cournoyer A, Notebaert É, Iseppon M, Cossette S, Londei-Leduc L, Lamarche Y, Morris J, Piette É, Daoust R, Chauny JM, Sokoloff C, Cavayas YA, Paquet J, Denault A. Prehospital Advanced Cardiac Life Support for Out-of-hospital Cardiac Arrest: A Cohort Study. Acad Emerg Med 2017. [PMID: 28646584 DOI: 10.1111/acem.13246] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Out-of-hospital advanced cardiac life support (ACLS) has not consistently shown a positive impact on survival. Extracorporeal cardiopulmonary resuscitation (E-CPR) could render prolonged on-site resuscitation (ACLS or basic cardiac life support [BCLS]) undesirable in selected cases. The objectives of this study were to evaluate, in patients suffering from out-of-hospital cardiac arrest (OHCA) and in a subgroup of potential E-CPR candidates, the association between the addition of prehospital ACLS to BCLS and survival to hospital discharge, prehospital return of spontaneous circulation (ROSC), and delay from call to hospital arrival. METHODS This cohort study targets adult patients treated for OHCA between April 2010 and December 2015 in the city of Montreal, Canada. We defined potential E-CPR candidates using clinical criteria previously described in the literature (65 years of age or younger, initial shockable rhythm, absence of ROSC after 15 minutes of prehospital resuscitation, and emergency medical services-witnessed collapse or witnessed collapse with bystander cardiopulmonary resuscitation). Associations were evaluated using multivariate regression models. RESULTS A total of 7,134 patients with OHCA were included, 761 (10.7%) of whom survived to discharge. No independent association between survival to hospital discharge and the addition of prehospital ACLS to BCLS was found in either the entire cohort (adjusted odds ratio [AOR] = 1.05 [95% confidence interval {CI} = 0.84-1.32], p = 0.68) or among the 246 potential E-CPR candidates (AOR = 0.82 [95% CI = 0.36-1.84], p = 0.63). The addition of prehospital ACLS to BCLS was associated with a significant increase in the rate of prehospital ROSC in all patients experiencing OHCA (AOR = 3.92 [95% CI = 3.38-4.55], p < 0.001) and in potential E-CPR candidates (AOR = 3.48 [95% CI = 1. 76-6.88], p < 0.001) compared to isolated prehospital BCLS. Delay from call to hospital arrival was longer in the ACLS group than in the BCLS group (difference = 16 minutes [95% CI = 15-16 minutes], p < 0.001). CONCLUSIONS In a tiered-response urban emergency medical service setting, prehospital ACLS is not associated with an improvement in survival to hospital discharge in patients suffering from OHCA and in potential E-CPR candidates, but with an improvement in prehospital ROSC and with longer delay to hospital arrival.
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Affiliation(s)
- Alexis Cournoyer
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
- Institut de Cardiologie de Montréal; Montréal Québec Canada
| | - Éric Notebaert
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
| | - Massimiliano Iseppon
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
| | | | - Luc Londei-Leduc
- Université de Montréal; Montréal Québec Canada
- Corporation d'Urgences-santé; Montréal Québec Canada
- Centre Hospitalier de l'Université de Montréal; Montréal Québec Canada
| | - Yoan Lamarche
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
- Institut de Cardiologie de Montréal; Montréal Québec Canada
| | - Judy Morris
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
| | - Éric Piette
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
| | - Raoul Daoust
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
| | - Jean-Marc Chauny
- Université de Montréal; Montréal Québec Canada
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
| | - Catalina Sokoloff
- Université de Montréal; Montréal Québec Canada
- Centre Hospitalier de l'Université de Montréal; Montréal Québec Canada
| | | | - Jean Paquet
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec Canada
| | - André Denault
- Université de Montréal; Montréal Québec Canada
- Institut de Cardiologie de Montréal; Montréal Québec Canada
- Centre Hospitalier de l'Université de Montréal; Montréal Québec Canada
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Fontaine G, Cossette S, Maheu-Cadotte MA, Mailhot T, Deschênes MF, Mathieu-Dupuis G. Correction of: Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2017; 6:e131. [PMID: 30578209 PMCID: PMC6305069 DOI: 10.2196/resprot.8377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/07/2017] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Sylvie Cossette
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Tanya Mailhot
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Marie-France Deschênes
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Center for Innovation in Nursing Education, Université de Montréal, Montreal, QC, Canada
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Fontaine G, Cossette S, Maheu-Cadotte MA, Mailhot T, Deschênes MF, Mathieu-Dupuis G. Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2017; 6:e128. [PMID: 28679491 PMCID: PMC5517824 DOI: 10.2196/resprot.8085] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 06/17/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adaptive e-learning environments (AEEs) can provide tailored instruction by adapting content, navigation, presentation, multimedia, and tools to each user's navigation behavior, individual objectives, knowledge, and preferences. AEEs can have various levels of complexity, ranging from systems using a simple adaptive functionality to systems using artificial intelligence. While AEEs are promising, their effectiveness for the education of health professionals and health professions students remains unclear. OBJECTIVE The purpose of this systematic review is to assess the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. METHODS We will follow the Cochrane Collaboration and the Effective Practice and Organisation of Care (EPOC) Group guidelines on systematic review methodology. A systematic search of the literature will be conducted in 6 bibliographic databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed, and Web of Science) using the concepts "adaptive e-learning environments," "health professionals/students," and "effects on knowledge/skills/behavior." We will include randomized and nonrandomized controlled trials, in addition to controlled before-after, interrupted time series, and repeated measures studies published between 2005 and 2017. The title and the abstract of each study followed by a full-text assessment of potentially eligible studies will be independently screened by 2 review authors. Using the EPOC extraction form, 1 review author will conduct data extraction and a second author will validate the data extraction. The methodological quality of included studies will be independently assessed by 2 review authors using the EPOC risk of bias criteria. Included studies will be synthesized by a descriptive analysis. Where appropriate, data will be pooled using meta-analysis by applying the RevMan software version 5.1, considering the heterogeneity of studies. RESULTS The review is in progress. We plan to submit the results in the beginning of 2018. CONCLUSION Providing tailored instruction to health professionals and students is a priority in order to optimize learning and clinical outcomes. This systematic review will synthesize the best available evidence regarding the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. It will provide guidance to policy makers, hospital managers, and researchers in terms of AEE development, implementation, and evaluation in health care.
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Affiliation(s)
- Guillaume Fontaine
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Sylvie Cossette
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Tanya Mailhot
- Montreal Heart Institute Research Center, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Marie-France Deschênes
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Center for Innovation in Nursing Education, Université de Montréal, Montreal, QC, Canada
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Kayser JW, Cossette S, Côté J, Bourbonnais A, Purden M, Juneau M, Tanguay JF, Simard MJ, Dupuis J, Diodati JG, Tremblay JF, Maheu-Cadotte MA, Cournoyer D. Evaluation of a Web-Based Tailored Nursing Intervention (TAVIE en m@rche) Aimed at Increasing Walking After an Acute Coronary Syndrome: A Multicenter Randomized Controlled Trial Protocol. JMIR Res Protoc 2017; 6:e64. [PMID: 28450272 PMCID: PMC5427251 DOI: 10.2196/resprot.6430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 02/01/2017] [Accepted: 02/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the health benefits of increasing physical activity in the secondary prevention of acute coronary syndrome (ACS), up to 60% of ACS patients are insufficiently active. Evidence supporting the effect of Web-based interventions on increasing physical activity outcomes in ACS patients is growing. However, randomized controlled trials (RCTs) using Web-based technologies that measured objective physical activity outcomes are sparse. OBJECTIVE Our aim is to evaluate in insufficiently active ACS patients, the effect of a fully automated, Web-based tailored nursing intervention (TAVIE en m@rche) on increasing steps per day. METHODS A parallel two-group multicenter RCT (target N=148) is being conducted in four major teaching hospitals in Montréal, Canada. An experimental group receiving the 4-week TAVIE en m@rche intervention plus a brief "booster" at 8 weeks, is compared with the control group receiving hyperlinks to publicly available websites. TAVIE en m@rche is based on the Strengths-Based Nursing Care orientation to nursing practice and the Self-Determination Theory of human motivation. The intervention is centered on videos of a nurse who delivers the content tailored to baseline levels of self-reported autonomous motivation, perceived competence, and walking behavior. Participants are recruited in hospital and are eligible if they report access to a computer and report less than recommended physical activity levels 6 months before hospitalization. Most outcome data are collected online at baseline, and 5 and 12 weeks postrandomization. The primary outcome is change in accelerometer-measured steps per day between randomization and 12 weeks. The secondary outcomes include change in steps per day between randomization and 5 weeks, and change in self-reported energy expenditure for walking and moderate to vigorous physical activity between randomization, and 5 and 12 weeks. Theoretical outcomes are the mediating role of self-reported perceived autonomy support, autonomous and controlled motivations, perceived competence, and barrier self-efficacy on steps per day. Clinical outcomes are quality of life, smoking, medication adherence, secondary prevention program attendance, health care utilization, and angina frequency. The potential moderating role of sex will also be explored. Analysis of covariance models will be used with covariates such as sex, age, fatigue, and depression symptoms. Allocation sequence is concealed, and blinding will be implemented during data analysis. RESULTS Recruitment started March 30, 2016. Data analysis is planned for November 2017. CONCLUSIONS Finding alternative interventions aimed at increasing the adoption of health behavior changes such as physical activity in the secondary prevention of ACS is clearly needed. Our RCT is expected to help support the potential efficacy of a fully automated, Web-based tailored nursing intervention on the objective outcome of steps per day in an ACS population. If this RCT is successful, and after its implementation as part of usual care, TAVIE en m@rche could help improve the health of ACS patients at large. TRIAL REGISTRATION ClinicalTrials.gov NCT02617641; https://clinicaltrials.gov/ct2/show/NCT02617641 (Archived by WebCite at http://www.webcitation.org/6pNNGndRa).
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Affiliation(s)
- John William Kayser
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Sylvie Cossette
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - José Côté
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Anne Bourbonnais
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Research Center of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Margaret Purden
- McGill University, Ingram School of Nursing, Montréal, QC, Canada.,Jewish General Hospital Centre for Nursing Research, Montréal, QC, Canada
| | - Martin Juneau
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Jean-Francois Tanguay
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Marie-Josée Simard
- Integrated Health and Social Services Centres, l'Est de l'Île de Montréal, Montréal, QC, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | | | | | - Marc-André Maheu-Cadotte
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Daniel Cournoyer
- Montreal Health Innovations Coordinating Center, Montréal, QC, Canada
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Mailhot T, Cossette S, Côté J, Bourbonnais A, Côté MC, Lamarche Y, Denault A. A post cardiac surgery intervention to manage delirium involving families: a randomized pilot study. Nurs Crit Care 2017; 22:221-228. [PMID: 28371230 DOI: 10.1111/nicc.12288] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/28/2016] [Accepted: 01/23/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND As many delirium manifestations (e.g., hallucinations or fears) are linked to patients' experiences and personality traits, it is suggested that interventions should be tailored to optimize its management. The inclusion of family members, as part of an intervention, has recently emerged as a solution to developing individualised patient care, but has never been assessed in post-cardiac surgery intensive care unit where almost half of patients will present with delirium. AIMS To assess the feasibility, acceptability and preliminary efficacy of an nursing intervention involving family caregivers (FC) in delirium management following cardiac surgery. DESIGN A randomized pilot study. METHODS A total of 30 patient/FC dyads were recruited and randomized to usual care (n = 14) or intervention (n = 16). The intervention was based on the Human Caring Theory, a mentoring model, and sources informing self-efficacy. It comprised seven planned encounters spread over 3 days between an intervention nurse and the FC, each including a 30-min visit at the patient's bedside. During this bedside visit, the FC used delirium management strategies, e.g. reorient the person with delirium. The primary indicator of acceptability was to obtain consent from 75% of approached FCs. The preliminary effect of the intervention on patient outcomes was assessed on (1) delirium severity using the Delirium Index, (2) occurrence of complications, such as falls, (3) length of postoperative hospital stay and (4) psycho-functional recovery using the Sickness Impact Profile. The preliminary effect on FC outcomes was assessed on FC anxiety and self-efficacy. Data were analysed using descriptive statistics, ANCOVAs and logistic regressions. RESULTS The primary indicator of obtaining consent from FC was achieved (77%). Of the 14 dyads, thirteen (93%) dyads received all seven encounters planned in the experimental intervention. Intervention group patients presented better psycho-functional recovery scores when compared with control group patients (p = 0·01). Mean delirium severity scores showed similar trajectories on days 1, 2 and 3 in both groups. CONCLUSION The mentoring intervention was acceptable and feasible and shows promising results in improving patients and FC outcomes. RELEVANCE TO CLINICAL PRACTICE Nurses should involve, if willing, FC to participate in activities that optimise patient well-being FC to use recognized delirium management strategies like reorientation and reassurance.
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Affiliation(s)
- Tanya Mailhot
- Montreal Heart Institute Research Center S-2490, University of Montreal, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - Sylvie Cossette
- University of Montreal, Montreal Heart Institute Research Center S-2510, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - José Côté
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, University of Montreal, PO Box 6128, Downtown Branch, Montréal (Québec) H3C 3J7, Canada
| | - Anne Bourbonnais
- University of Montreal, Chair of the Desjardins Research, Chair in Nursing Care for Older People and their Families, Centre de recherche de l'Institut universitaire de gériatrie de Montréal, PO Box 6128, Downtown Branch, Montréal (Québec) H3C 3J7, Canada
| | - Marie-Claude Côté
- Department of Psychosomatics, Montreal Heart Institute, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - Yoan Lamarche
- Department of Cardiac Surgery, Montreal Heart Institute, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - André Denault
- Department of Anesthesiology, Montreal Heart Institute, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
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McCusker J, Vadeboncoeur A, Cossette S, Veillette N, Ducharme F, Minh Vu TT, Ciampi A, Cetin‐Sahin D, Belzile E. Changes in Emergency Department Geriatric Services in Quebec and Correlates of These Changes. J Am Geriatr Soc 2017; 65:1448-1454. [DOI: 10.1111/jgs.14818] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/21/2016] [Accepted: 12/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Jane McCusker
- St. Mary's Research Centre Montreal Canada
- McGill University Montreal Canada
| | - Alain Vadeboncoeur
- Université de Montréal Montreal Canada
- Emergency Medicine Services Montreal Heart Institute Montreal Canada
| | - Sylvie Cossette
- Université de Montréal Montreal Canada
- Montreal Heart Institute Research Center Montreal Canada
| | - Nathalie Veillette
- Université de Montréal Montreal Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal Montreal Canada
| | - Francine Ducharme
- Université de Montréal Montreal Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal Montreal Canada
| | - Thien Tuong Minh Vu
- Université de Montréal Montreal Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal Montreal Canada
- Centre hospitalier de l'Université de Montréal Montreal Canada
| | - Antonio Ciampi
- St. Mary's Research Centre Montreal Canada
- McGill University Montreal Canada
| | - Deniz Cetin‐Sahin
- St. Mary's Research Centre Montreal Canada
- Center for Research in Aging Donald Berman Maimonides Geriatric Centre Montreal Canada
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Lavoie P, Pepin J, Cossette S. Contribution of a reflective debriefing to nursing students' clinical judgment in patient deterioration simulations: A mixed-methods study. Nurse Educ Today 2017; 50:51-56. [PMID: 28012979 DOI: 10.1016/j.nedt.2016.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/21/2016] [Accepted: 12/08/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND While reflection is a hallmark of debriefing, there is little understanding of how it contributes to nursing students' clinical judgment. OBJECTIVES The aim of this study was to describe how nursing students perceived that the Reflective dEbriefing after a PatieNt Deterioration simulation (REsPoND) fostered learning and how it contributed to their clinical judgment in patient deterioration simulations. DESIGN A sequential explanatory mixed-methods study. PARTICIPANTS Nineteen students who showed the greatest clinical judgment score variation in a randomized controlled trial of the effectiveness of REsPoND. METHODS Students participated in interviews on their learning experience in REsPoND. Data were subjected to thematic analysis and themes were contrasted according to students' score variations. RESULTS Through guided exchanges with their peers, students configured a causes-observations-interventions framework that embodied their understanding of the patient's situation. They evaluated their own simulation performance based on that framework. The contribution of REsPoND to students' clinical judgment differed depending on (1) the value placed on the review of the simulation through a systematic assessment approach; (2) their focus on anticipating the situation or on performing in the simulation; and (3) their preference for who participated more in debriefing. CONCLUSION Clinical judgment might be improved when a systematic assessment approach is used to structure debriefing. The relationship between reflection and self-assessment during debriefing remains to be disentangled.
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Affiliation(s)
- Patrick Lavoie
- William F. Connell School of Nursing, Boston College, Boston, USA.
| | - Jacinthe Pepin
- Faculty of Nursing, Université de Montréal, Montréal, Canada.
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Montreal Heart Institute, Montréal, Canada.
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Maheu-Cadotte M, Cossette S, Beaulieu V, Massé M. Predictors of Emergency Department Revisits According to Gender in Cardiac Patients: A Research Protocol. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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48
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Cournoyer A, Denault A, Cossette S, Fortier A, Daoust R, Iseppon M, Chauny JM, Notebaert E. Reproducibility, interchangeability of measures, time to measure stabilization, and reference values of two tissue oximeters in healthy volunteers. J Biomed Opt 2016; 21:97003. [PMID: 27637007 DOI: 10.1117/1.jbo.21.9.097003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/30/2016] [Indexed: 06/06/2023]
Abstract
This study aimed to compare two tissue oximeters, the INVOS 5100c and the Equanox 7600, in terms of their reproducibility and the interchangeability of their measures. In a randomized order, three measurements were taken at six different sites on both sides of the body in 53 healthy volunteers. Intraclass correlation coefficients (ICC) and within-subject standard deviation (Sw) were calculated for each device. The ICCs were compared using Fisher r-to-z transformation and the Sw were compared using paired-sample t-tests. We found no difference between the reproducibility of the INVOS {ICC=0.92 [95% confidence interval (CI) 0.90 to 0.93]} and Equanox [ICC=0.90 (95% CI 0.88 to 0.93)] in terms of ICCs (p=0.06). However, the Equanox [Sw=1.96 (95% CI 1.91 to 2.02)] showed a better Sw than the INVOS [Sw=2.11 (95% CI 2.05 to 2.17)] (p=0.019). Also, when compared directly to stable condition, the readings produced by the two oximeters varied considerably [ICC 0.43 (95% CI 0.36 to 0.49)]. When taken individually, both tissue oximeters displayed good reproducibility, the Equanox being slightly better than the INVOS in terms of absolute reproducibility. However, when compared, the oximeters showed poor interdevices agreement. Reference values were also described.
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Affiliation(s)
- Alexis Cournoyer
- Université de Montréal, Faculty of Medicine, Department of Family Medicine and Emergency Medicine, 5400 Gouin Ouest, Montréal H4J 1C5, Canada
| | - André Denault
- Université de Montréal, Faculty of Medicine, Department of Anesthesia and Critical Care Division, 5000 Bélanger, Montréal H1T 1C8, Canada
| | - Sylvie Cossette
- Université de Montréal, Faculty of Nursing, 2375 Côte-Ste-Catherine, Montréal H3T 1A8, Canada
| | - Annik Fortier
- Montréal Health Innovations Coordinating Center, 4100 Molson #400, Montréal H1Y 3N1, Canada
| | - Raoul Daoust
- Université de Montréal, Faculty of Medicine, Department of Family Medicine and Emergency Medicine, 5400 Gouin Ouest, Montréal H4J 1C5, Canada
| | - Massimiliano Iseppon
- Université de Montréal, Faculty of Medicine, Department of Family Medicine and Emergency Medicine, 5400 Gouin Ouest, Montréal H4J 1C5, Canada
| | - Jean-Marc Chauny
- Université de Montréal, Faculty of Medicine, Department of Family Medicine and Emergency Medicine, 5400 Gouin Ouest, Montréal H4J 1C5, Canada
| | - Eric Notebaert
- Université de Montréal, Faculty of Medicine, Department of Family Medicine and Emergency Medicine, 5400 Gouin Ouest, Montréal H4J 1C5, Canada
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Fontaine G, Cossette S, Heppell S, Boyer L, Mailhot T, Simard MJ, Tanguay JF. Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study. J Med Internet Res 2016; 18:e224. [PMID: 27539960 PMCID: PMC5010651 DOI: 10.2196/jmir.6298] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers. OBJECTIVE The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses' perceived brief MI skills and self-reported clinical use of brief MI. METHODS We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients' motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session. RESULTS We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%-91%) completed both sessions in ≤20 days. At 30 days, 28 of the 31 participants (90%) had completed at least one session. The training was rated as highly acceptable, with the highest scores observed for information quality (mean 6.26, SD 0.60; scale 0-7), perceived ease of use (mean 6.16, SD 0.78; scale 0-7), and system quality (mean 6.15, SD 0.58; scale 0-7). Posttraining scores for self-reported clinical use of confidence interventions were higher than pretraining scores (mean 34.72, SD 6.29 vs mean 31.48, SD 6.75, respectively; P=.03; scale 10-50). Other results were nonsignificant. CONCLUSIONS Brief MI training using a Web-based e-learning platform including role-modeling videos is both feasible and acceptable according to cardiovascular care nurses. Further research is required to evaluate the e-learning platform in a randomized controlled trial. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 16510888; http://www.isrctn.com/ISRCTN16510888 (Archived by WebCite at http://www.webcitation.org/6jf7dr7bx).
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Cournoyer A, Iseppon M, Chauny JM, Denault A, Cossette S, Notebaert É. Near-infrared Spectroscopy Monitoring During Cardiac Arrest: A Systematic Review and Meta-analysis. Acad Emerg Med 2016; 23:851-62. [PMID: 27028004 DOI: 10.1111/acem.12980] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/05/2016] [Accepted: 03/28/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Tissue oximetry using near-infrared spectroscopy (NIRS) is a noninvasive monitor of cerebral oxygenation. This new technology has been used during cardiac arrest (CA) because of its ability to give measures in low-blood-flow situations. The aim of this study was to assess the evidence regarding the association between the types of NIRS measurements (mean, initial, and highest values) and resuscitation outcomes (return of spontaneous circulation [ROSC], survival to discharge, and good neurologic outcome) in patients undergoing cardiopulmonary resuscitation. METHODS This review was registered (Prospero CRD42015017380) and is reported as per the PRISMA guidelines. Medline, Embase, and CENTRAL were searched. All studies, except case reports and case series of fewer than five patients, reporting on adults that had NIRS monitoring during CA were eligible for inclusion. Two reviewers assessed the quality of the included articles and extracted the data. The outcome effect was standardized using standardized mean difference (SMD). RESULTS Twenty nonrandomized observational studies (15 articles and five conference abstracts) were included in this review, for a total of 2,436 patients. We found a stronger association between ROSC and mean NIRS values (SMD = 1.33; 95% confidence interval [CI] = 0.92 to 1.74) than between ROSC and initial NIRS measurements (SMD = 0.51; 95% CI = 0.23 to 0.78). There was too much heterogeneity among the highest NIRS measurements group to perform meta-analysis. Only two of the 75 patients who experienced ROSC had a mean NIRS saturation under 30%. Patients who survived to discharge and who had good neurologic outcome displayed superior combined initial and mean NIRS values than their counterparts (SMD = 1.63; 95% CI = 1.34 to 1.92; and SMD = 2.12; 95% CI = 1.14 to 3.10). CONCLUSIONS Patients with good resuscitation outcomes have significantly higher NIRS saturations during resuscitation than their counterparts. The types of NIRS measurements during resuscitation influenced the association between ROSC and NIRS saturation. Prolonged failure to obtain a NIRS saturation higher than 30% may be included in a multimodal approach to the decision of terminating resuscitation efforts (Class IIb, Level of Evidence C-Limited Data).
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Affiliation(s)
| | | | - Jean-Marc Chauny
- Université de Montréal; Montréal Québec
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec
| | - André Denault
- Université de Montréal; Montréal Québec
- Montreal Heart Institute; Montréal Québec
- Centre Hospitalier de l'Université de Montréal; Montréal Québec
| | - Sylvie Cossette
- Université de Montréal; Montréal Québec
- Montreal Heart Institute; Montréal Québec
| | - Éric Notebaert
- Université de Montréal; Montréal Québec
- Hôpital du Sacré-Cœur de Montréal; Montréal Québec
- Cité de la Santé de Laval; Montréal Québec Canada
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