Facilitators and barriers in implementing clinical nursing assessment in mental health care for older people: A multimethod approach.

With the aging of the population and the growing prevalence of dementia, specialized and collaborative nursing care is paramount in this area. To ensure better quality care, it is necessary to use effective and context-specific processes to implement evidence-based practices and more specifically clinical nursing assessment. This study aimed to identify and describe factors that may influence the implementation of clinical nursing assessment in mental health care for older people. The Consolidated Framework for Implementation Research was employed to guide evaluation in the pre-implementation phase in the specific context of mental health care for older people. Using a multimethod approach, interviews, focus groups, and a quantitative survey were conducted with a non-probability convenience sample. A total of 39 hospital nurses (registered nurses and head nurses) were interviewed. Analysis yielded five main factors, notably three barriers and two facilitators. Barriers include a lack of general nursing culture, deficiencies in leadership, and difficulties in communication and collaboration. Facilitators comprise team cohesion and the perceived benefits of the study.

Fondamentaux des soins : un cadre et un processus pratique pour répondre aux besoins physiques, psychosociaux et relationnels des personnes soignées.

Since 2008, an international group has been helping to promote a better response to the fundamental needs of individuals receiving care. This group provides a framework on the fundamentals of care that focuses on the relationship between the nurse, the individual being cared for, and his or her relatives, as well as on the response to the patient’s physical, psychosocial, and relational needs. A practice process supports the concrete application of this framework. The purpose of this discursive article is to present the French translation of the Fundamentals of Care Framework and its Practice Process. To begin with, the translation process will be briefly explained. Next, the Fundamentals of Care Framework and the stages in its Practice Process will be presented. To help the reader better understand the proposal, a clinical illustration will be used to present the situation of Mr. Perron, who is living with Alzheimer’s disease, and his spouse, who is his family caregiver. Finally, the article discusses the usefulness of the Fundamentals of Care Framework and its Practice Process in terms of the four main areas of the discipline of nursing : practice, management, training, and research. This article paves the way for the development of knowledge on the fundamentals of care in the French-speaking world.

Does physical exercise improve ADL capacities in people over 65 years with moderate or severe dementia hospitalized in an acute psychiatric setting? A multisite randomized clinical trial.

BACKGROUND: Several studies on the effect of physical exercise on activities of daily living (ADL) for people with dementia exist; yet, data concerning the specific context of acute psychiatric hospitals remain scant. This study measured the effect of a physical exercise program on ADL scores in patients with moderate to severe dementia hospitalized in an acute psychiatric ward. METHODS: A multicenter clinical trial was conducted in five Swiss and Belgian psychiatric hospitals. Participants were randomly allocated to either an experimental group (EG) or a control group (CG). Members of the EG received 20 physical exercise sessions (strengthening, balance, and walking) over a four-week period while members of the CG participated in social interaction sessions of equivalent duration and frequency, but without physical exercise. The effect of exercise on ADL was measured by comparing scores of the Barthel Index and the Functional Independence Measure in the EG and CG before and after the intervention, and two weeks later. RESULTS: Hundred and sixty patients completed the program. Characteristics of participants of both groups were similar at the inception of the study. The mean ADL score of EG decreased slightly over time, whereas that of the CG significantly decreased compared to initial scores. Overall differences between groups were not significant; however, significant differences were found for mobility-related items. CONCLUSIONS: ADL scores in elderly with moderate to severe dementia deteriorate during acute psychiatric hospitalization. An exercise program delays the loss of mobility but does not have a significant impact on overall ADL scores.