La négligence en matière de soins médicaux : travailler auprès des enfants, des adolescents et des familles

Les soins de santé sont un droit fondamental pour tous les enfants. Lorsque les besoins de santé de l'enfant ne sont pas respectés, quelle qu'en soit la raison, les professionnels de la santé doivent réfléchir aux obstacles en cause et aux processus nécessaires pour trouver des solutions. Des obstacles sociaux, économiques ou autres peuvent empêcher les parents d'accéder aux soins pour leur enfant. Il arrive que les avis, les priorités ou les valeurs des professionnels de la santé de l'enfant divergent de ceux des parents, ce qui compromet les soins à l'enfant. Dans certains cas, l'abstention des personnes qui s'occupent de l'enfant à assurer les soins nécessaires peut être considérée comme de la négligence en matière de soins médicaux. Des habiletés et des connaissances particulières peuvent aider les professionnels de la santé à éviter de telles situations et à collaborer avec efficacité avec la famille lorsque ces situations se produisent. Le présent document de principes offre une approche que peuvent utiliser les professionnels de la santé pour promouvoir l'intérêt supérieur, le bien-être et la sécurité des enfants ou des adolescents vulnérables à la négligence en matière de soins médicaux.

The correlation between cognitive function and dysphagia in stroke patients

BACKGROUND

Dysphagia and cognitive decline are frequently found in stroke patients. Dysphagia can reduce the patients' quality of life and increase hospital stays and the risk of death.

AIM

To investigate the correlation between cognitive function and dysphagia in stroke patients.

METHODS

A total of 37 stroke patients with oropharyngeal dysphagia participated in this cross-sectional study. Mini-Mental State Examination (MMSE) was used to assess their cognitive levels. In addition, the swallowing function of patients was assessed using the Mann Assessment Swallowing Ability (MASA).

RESULTS

Most of patients (62.2%) were male, and the mean ± standard deviation of patients' age was 62± 8. The results showed that 35.1% of patients had impaired cognitive function, and 56.8 % had severe dysphagia. Moreover, there was a fair positive correlation between MMSE and MASA with a correlation coefficient equal to 0.373 (P = 0.023), indicating that the severity of dysphagia increases with increasing cognitive decline.

CONCLUSION

Our findings suggest that cognitive function may have a role in the severity of dysphagia in stroke patients.

[Consequences of parental burnout on the parent and the children]

Parental burnout is a serious disorder not only because of its prevalence, but also and especially because of the nature and extent of its repercussions. It is therefore necessary to review the state of the art in terms of its consequences, based on the scientific literature to date. This is necessary in order to describe precisely the psychological, behavioural and physiological consequences for the parent concerned, as well as the already documented consequences for the children.

[The orphan child and his family confronted with the violence of deathThe orphan child and his family facing the violent consequences of death]

The death of a parent is a form of extreme violence which has an effect on the child and on the adults around him/her, often leaving them powerless. There are risks of avoidance, of silence about the event and the figure of the deceased, to which can be added a lack of identification of the child's difficulties and the absence of responses adapted to his or her needs, at each stage of development. A better knowledge of their needs could reduce the risk of being negligent, or even ill-treating them, and allow them to grow up, better assured in their filiation and their personal identity.

A Master Mariner's Left Testicle and the Law of Surgical Consent in Mid-20th Century Canada

Canadian medical and legal historians have given little attention to the history of medical malpractice law. This article examines one aspect of this subject, the litigation that arose over issues of consent in advanced surgeries, by offering a contextualized case study of Marshall v. Curry (1933). In Marshall, a master mariner from Nova Scotia sued for $10,000 in damages for negligence and assault after a surgeon removed his left testicle without his approval during a hernia operation. Marshall lost at trial, but the Nova Scotia Supreme Court decision became precedent for the principle that doctors could undertake more aggressive procedures without consent only if the patient's life or health were in immediate danger. This study considers why these cases became more common by the early twentieth century, teases out the changing law of consent, and suggests what the case tells us about judicial attitudes towards patients and doctors.

Normalization of Neglect: A Grounded Theory of RNs' Experiences as Family Caregivers of Hospitalized Seniors

Often older people, while maintaining a level of independence, rely on family members to provide care and assistance. Caregivers who are also registered nurses (RNs) may provide a different perspective around the experience when their older relative is admitted to acute care. The aim of our research was to investigate and develop theory regarding nursing care provision as described by RNs, who were family caregivers to older adults, when that older adult was admitted to acute care. Over a six-month period in 2011, RNs meeting this criterion (n = 12) were interviewed individually. We identified two central categories: "Culture of Neglect" and "Vigil by the Bedside". The core category "Normalization of Neglect" was identified as the theory, grounded in the data the participants provided which described a culture of neglect that had normalized poor nursing care. These findings highlight the issue of neglect and abuse, and further investigation is warranted.

Best-Practice Guideline on the Prevention of Abuse and Neglect of Older Adults

A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000-April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed.

[Infant development in a family with multiple problems]

Supporting families with multiple problems involves the close cooperation of various disciplines. The babies from these families must be considered as individuals potentially at high risk of developmental problems, who need to be surrounded and protected. Observation enables professionals to get to know these babies and rapidly spot any signs of suffering. Child health nurses have an essential preventive and nursing role.