Nursing practices on sexual health for people with neurological disorders: A narrative review.

AIMS: To identify and describe nursing practices on the sexual health of people with neurological disorders. DESIGN: Narrative review. METHODS: Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used. DATA SOURCES: PubMed, Embase, ScienceDirect and CINAHL. RESULTS: In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles. CONCLUSION: Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized. IMPACT: Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients. REPORTING METHOD: PRISMA. No patient or public contribution.

The deployment of advanced practice nurses in the French health system: From clinics to professional networks.

AIM: The aim of this study is to contribute to an understanding of the role deployment of advanced practice nurses (APNs) in French healthcare settings. INTRODUCTION: The introduction of APNs was formalised in France by the decrees issued on 18 July 2018, which described the areas, activities and training of APNs. BACKGROUND: A qualitative study on the role implementation of APNs was conducted between July 2021 and May 2022 following a call for projects launched by the Île-de-France Regional Health Agency to evaluate the deployment of APNs in the area. METHODS: Data were collected through field observations and semi-structured interviews in order to explore both the APNs deployment processes in nine healthcare structures and the roles played by APN networks and associations with regard to the deployment of APN activities in their working environments. RESULTS: The projects proved to be evolutionary, and their development was marked by various forms of APN isolation and multiple obstacles that were specific to their professional practice settings. Some APNs relied on a variety of forms of mutual assistance and advocacy deployed throughout APN networks and associations. DISCUSSION: The deployment of APNs' role was impacted by diverse configurations of professional power relations and the nature of the obstacles that were structural for APNs in primary care. Their experience of isolation derived from the novelty of their role, the challenge they posed to the cohesion of the nursing profession and a lack of supportive policies for their deployment. Their participation in APN networks and associations enabled them to access advocacy and manage the uncertainties and unknowns related to the deployment of their activities. CONCLUSION: The results suggest that the formalisation of schemes for mutual assistance among APNs and advocacy should be integrated into the guidelines for the implementation of their role. IMPLICATIONS FOR NURSING POLICY: APN policy should strengthen a bottom-up approach, relying in particular on the development of different forms of collaboration and communication between APN networks and associations on the one hand and the public authorities on the other.

For a better understanding of the profile of nurses working in France who hold or are working toward a Ph.D: A quantitative descriptive study / Mieux connaître le profil des infirmières titulaires d'un doctorat en sciences ou doctorantes exerçant en France : une étude descriptive quantitative

Introduction: In 2009, the French Association de recherche en soins infirmiers (Nursing Research Association) counted fifty-four nurses holding a doctorate or working toward one. Recent developments in this area include the creation of section 92, for nursing sciences, in the National Council of Universities, making it possible for nurses in France to become professors with teaching and research responsibilities. Objectives: To update and complete the 2009 data by identifying the grades, fields of activity, and disciplines of nurses holding a doctorate or studying for one. Method: A quantitative descriptive study was carried out using an online questionnaire between December 1, 2021 and March 22, 2022. Results: the study involved 147 nurses working in France: seventy-five with a doctorate and 72 doctoral students. The majority of the respondents were women, held a supervisory position, and were working in the field of education. Among the doctorates obtained, education sciences accounted for the largest share. However, this disciple was less well represented among the doctoral candidates. Discussion: This study shows a change in the characteristics of nurses who are also doctoral candidates and in the disciplines in which they have obtained or are currently obtaining a doctorate, and an increase in the value of the degree, particularly in research, but little access to academic posts.

Introduction: En 2009, l'Association de recherche en soins infirmiers avait recensé 54 infirmières titulaires d'un doctorat et doctorantes. Parmi les intérêts récents de s'engager dans des cursus académiques figure la création, en 2019, de la section 92 « sciences infirmières ¼ au Conseil national des universités, rendant possible en France l'accès au corps d'enseignants-chercheurs à des infirmières. Objectifs: Actualiser et compléter les données de 2009 en identifiant les grades, les domaines d'activité, les disciplines des infirmières titulaires d'un doctorat ou doctorantes. Méthode: Une étude quantitative descriptive a été réalisée par un questionnaire en ligne, entre le 01/12/2021 et le 22/03/2022. Résultats: 147 participants, exerçant en France, ont été inclus, dont 75 infirmières titulaires d'un doctorat et 72 doctorantes. La majorité des répondants étaient des femmes, avaient un grade d'encadrement et exerçaient une activité professionnelle dans le domaine de la formation. Le plus grand nombre de doctorats a été obtenu en sciences de l'éducation ; cette discipline est moins représentée chez les doctorantes. Discussion: Cette étude montre une évolution des caractéristiques des infirmières doctorantes et des disciplines des doctorats obtenus ou en cours, une valorisation du diplôme notamment en recherche mais un faible accès aux fonctions académiques.

For a better understanding of the profile of nurses working in France who hold or are working toward a Ph.D: A quantitative descriptive study / Mieux connaître le profil des infirmières titulaires d'un doctorat en sciences ou doctorantes exerçant en France : une étude descriptive quantitative

INTRODUCTION: In 2009, the French Association de recherche en soins infirmiers (Nursing Research Association) counted fifty-four nurses holding a doctorate or working toward one. Recent developments in this area include the creation of section 92, for nursing sciences, in the National Council of Universities, making it possible for nurses in France to become professors with teaching and research responsibilities. OBJECTIVES: To update and complete the 2009 data by identifying the grades, fields of activity, and disciplines of nurses holding a doctorate or studying for one. METHOD: A quantitative descriptive study was carried out using an online questionnaire between December 1, 2021 and March 22, 2022. RESULTS: the study involved 147 nurses working in France: seventy-five with a doctorate and 72 doctoral students. The majority of the respondents were women, held a supervisory position, and were working in the field of education. Among the doctorates obtained, education sciences accounted for the largest share. However, this disciple was less well represented among the doctoral candidates. DISCUSSION: This study shows a change in the characteristics of nurses who are also doctoral candidates and in the disciplines in which they have obtained or are currently obtaining a doctorate, and an increase in the value of the degree, particularly in research, but little access to academic posts.

Introduction: En 2009, l'Association de recherche en soins infirmiers avait recensé 54 infirmières titulaires d'un doctorat et doctorantes. Parmi les intérêts récents de s'engager dans des cursus académiques figure la création, en 2019, de la section 92 « sciences infirmières ¼ au Conseil national des universités, rendant possible en France l'accès au corps d'enseignants-chercheurs à des infirmières. Objectifs: Actualiser et compléter les données de 2009 en identifiant les grades, les domaines d'activité, les disciplines des infirmières titulaires d'un doctorat ou doctorantes. Méthode: Une étude quantitative descriptive a été réalisée par un questionnaire en ligne, entre le 01/12/2021 et le 22/03/2022. Résultats: 147 participants, exerçant en France, ont été inclus, dont 75 infirmières titulaires d'un doctorat et 72 doctorantes. La majorité des répondants étaient des femmes, avaient un grade d'encadrement et exerçaient une activité professionnelle dans le domaine de la formation. Le plus grand nombre de doctorats a été obtenu en sciences de l'éducation ; cette discipline est moins représentée chez les doctorantes. Discussion: Cette étude montre une évolution des caractéristiques des infirmières doctorantes et des disciplines des doctorats obtenus ou en cours, une valorisation du diplôme notamment en recherche mais un faible accès aux fonctions académiques.

Préfigurer l'exercice de la pratique infirmière avancée : une coconstruction à l'œuvre en milieu de soins.

INTRODUCTION: Advanced nursing practice is the subject of a growing number of studies. To date, however, few of them have analyzed the local processes used to implement the functions of advanced practice nurses (APNs). The research presented in this article concerns a pilot project on the precursors of APNs (pre-APNs) in the French healthcare system. PURPOSE OF THE RESEARCH: This article analyzes the major obstacles to and levers for the development of pre-APNs’ functions in the light of their active role in the implementation process. RESULTS: The obstacles include confusion of the function of pre-APN with other nursing functions on the part of their colleagues and superiors, partial assimilation to the medical profession, restriction of the practice of pre-APN under the control of physicians in highly ambivalent interprofessional relationships. Physicians also played a leveraging role in interprofessional mentoring to promote the introduction of pre-APN. They adopted strategies for negotiating their competencies, providing information and raising awareness about their function while asserting a professional identity based on their competence as nurses expert in nursing care in their field of practice (the elderly, mental health and psychiatry, support for chronic or cancer patients, primary care). CONCLUSION: The development of advanced nursing practice can only partially derive from formal structures and regulatory frameworks. The various initiatives to publicize, build and install these functions are illustrative of a process of co-construction in practice settings.

La clinique infirmière : manière singulière de penser et d'agir dans le champ de la santé.

Clinical practice, generally identified as a medical activity, is also a feature of other professions. Anecdotal evidence generally shows that nurses, but also the people they work with and the recipients of care, do not identify their "bedside" activity as "clinical practice." However, from the initial training stage onward, teaching and learning center on providing people with care. Professional practices focus essentially on clinical activity with the acquisition and mobilization of knowledge produced by various disciplines, including nursing.Clinical practice can be approached in various ways depending on the field of study and/or the objectives pursued. To better understand nursing clinical practice, considered as a whole, we focus in particular on its purpose, language, phases, and the substance of each stage.Clarification of nursing clinical practice is of value both epistemologically and in relation to social utility : this latter by making it possible to standardize the modalities of exposure to nursing care situations, making visible the activities of care conception and practice by nurses.This article aims to lay the foundations for reflecting on a vast and complex field. Clarifying nursing clinical practice and considering it in its entirety constitutes a change of perspective. It allows us to see it as a whole and in its constituent parts, to situate each element according to its purpose and function, to carry out critical analyses, and to contribute to the development of knowledge. Understanding of nursing clinical practice and its related issues, notably in terms of structure and language, has begun to emerge, but also poses a challenge for nursing.

Le savoir expérientiel : exploration épistémologique d'une expression répandue dans le domaine de la santé.

Among the different forms of knowledge, experiential knowledge is widely used in certain activities in the field of health. Most often connected to patients, it is also discussed in relation to health professionals, but less frequently. This article offers some points of reference and clarifies what underlies experiential knowledge. These points of reference are based on definitions of experience and knowledge, as well as work on the type of knowledge created by experience. An exploration of the contexts in which “experiential knowledge” has emerged and the focus of the disciplines that discuss it finds few epistemological connections between knowledge and experience. In the humanities and social sciences, experiential knowledge is most often connected to patients or adults in educational situations. With regard to nursing knowledge, the analysis of Carper and Lechasseur’s work on the nature of nursing knowledge reveals how the characteristics of experience are integrated into their typologies, particularly when it comes to artistic and personal knowledge. The explicit absence of experience in these typologies is then questioned with regard to the scientific imperatives that nursing science, at this particular period in its construction, is determined to promote.

La construction d'une problématique de recherche : de l'histoire d'une femme atteinte de sclérose en plaques à une recherche en sciences infirmières dans le domaine de la santé sexuelle.

The problematic, an essential step in the scientific research process, includes different components that must be articulated in the same temporality, hence its complexity. There is no consensus on definitions and a relatively short description of construction modalities in the literature. The problematization process is an intellectual, reflexive, questioning, documentation, and choice process aimed at moving from an idea or subject to a specific research question to be answered. The construction of the problem makes it possible in particular to specify the theoretical, methodological, and analytical orientation of the research. This step is an essential step which positions research in a continuum of disciplinary knowledge, and in this case, in the history of nursing knowledge. The objective of this article is to show, using a concrete example, how the analysis of clinical observations allows the development of a nursing research problem that integrates a project and then a research program. The clinical situation concerns the sexual health of women with multiple sclerosis. Beyond personal experience and the narrative of a singular, reinterpreted approach, it is a twofold movement to illustrate concretely, based on a situation and empirical observations, abstract elements and to transform them with the support of theoretical knowledge into communicable and transferable information useful in the construction of the research problem. The presentation of the invisible history of the construction of this problem can have an impact on teaching but also reflects the conceptual framework drawn from nursing sciences and mobilizable in this context of care. Through this example, it is therefore necessary to illustrate, through a retrospective analysis, the construction of nursing knowledge both on research methods and on theoretical models useful for care.

[The discipline of nursing : Knowledge, teaching, and care] / Les sciences infirmières : savoir, enseignement et soin.

In recent years, professional skills and the nursing profession in France have undergone major transformations. These have included the recognition of advanced nursing practice and its implementation in 2018, and the creation by the National Council of Universities in 2019 of a “Nursing” section (n° 92), which has paved the way for the development of research and teaching in nursing in an academic environment in France.To support these transformations, the Association de recherche en soins infirmiers (Arsi) (Nursing Research Association) has for several years been organizing seminars and symposia. The seminar “The discipline of nursing : Knowledge, teaching, and care,” held on November 16, 2019 in Paris, was a continuation of those organized in 2014 and 2016.This seminar focused on the acquisition of nursing knowledge, in particular through the analysis of clinical situations using two middle-range theories : comfort and symptom management.The first part of this article describes the objectives and the working methodology of the seminar. The second part provides a recap of the theoretical foundations, while the third and final part presents the results of what the workshops participants produced.

Les sciences infirmières : savoir, enseignement et soin.

In recent years, professional skills and the nursing profession in France have undergone major transformations. These have included the recognition of advanced nursing practice and its implementation in 2018, and the creation by the National Council of Universities in 2019 of a "Nursing" section (n° 92), which has paved the way for the development of research and teaching in nursing in an academic environment in France.To support these transformations, the Association de recherche en soins infirmiers (Arsi) (Nursing Research Association) has for several years been organizing seminars and symposia. The seminar "The discipline of nursing : Knowledge, teaching, and care," held on November 16, 2019 in Paris, was a continuation of those organized in 2014 and 2016.This seminar focused on the acquisition of nursing knowledge, in particular through the analysis of clinical situations using two middle-range theories : comfort and symptom management.The first part of this article describes the objectives and the working methodology of the seminar. The second part provides a recap of the theoretical foundations, while the third and final part presents the results of what the workshops participants produced.

[Constructing a research problem: From the story of a female patient with multiple sclerosis to a nursing research project on sexual health]. / La construction d'une problématique de recherche : de l'histoire d'une femme atteinte de sclérose en plaques à une recherche en sciences infirmières dans le domaine de la santé sexuelle.

The research problem, an essential step in the scientific research process, comprises different components that should be combined within the same time frame, hence its complexity. There is no consensus regarding its definition, and the ways in which it can be constructed have received little attention in the literature. Forming a research problem is an intellectual and reflective process that involves questioning, documentation, and choices aimed at moving from an idea or subject to a specific research question. In particular, the construction of the research problem makes it possible to define the theoretical, methodological, and analytical orientation of the research. This is an essential step that positions research within a continuum of disciplinary knowledge, and in this case, within the history of nursing knowledge. The aim of this article is to show, using a concrete example from nursing practice, how analyzing clinical observations can enable the formation of a research problem for a single project and then a whole research program. The clinical situation described here concerns the sexual health of female patients suffering from multiple sclerosis. Alongside detailing personal experience and the individual approach taken, reinterpreted, this involves concretely illustrating abstract elements, in a twofold process, drawing upon a particular situation and empirical observations, and using theoretical knowledge to transform these elements into communicable and transferable information that can be used to construct a research problem. Bringing to light the invisible story behind the construction of a research problem can be beneficial for learning, but also reveals the conceptual framework drawn from the field of nursing, which can be applied to a care setting. The example presented in this paper illustrates how nursing knowledge can be created through the use of research methods and theoretical models, and how these can then be used in nursing.

[The contribution of advanced practice nurses in the care of the frail and agitated elderly in emergencies: State of the art and qualitative study]/The contribution of advanced practice nurses in the care of the frail and agitated elderly in emergencies: State of the art and qualitative study.] / Contribution de l'infirmière de pratique avancée dans la prise en soins de la personne âgée de 75 ans et plus, fragile et agitée aux urgences : état des connaissances et étude qualitative.

INTRODUCTION: Emergency services are faced with people over the age of 75 whose frailty leads to states of agitation. OBJECTIVE: To improve the quality of the care of this situation through the invention of an advanced practice nurse. METHOD: A phenomenological and monocentric study from interviews with professionals intervening in emergencies about the difficulties they encountered. A thematic tree was constructed once the interviews were transcribed and coded. RESULTS: Five themes emerged from nine interviews, including: definition of agitation, its causes, and contributing factors. The consequences, the risks for the elderly, and the impact on care. The significance of this phenomenon. The link between agitation and frailty. Difficulties and possible measures to improve care. DISCUSSION: The data collected correspond to the data featuring in the literature and allow advanced practice nurses to pinpoint their actions. CONCLUSION: Advanced practice nurses can contribute to improving the care of the agitated elderly through primary and secondary prevention.

[Understanding people with Steinert's disease to provide them with better care.] / Comprendre les personnes atteintes de la maladie de Steinert pour mieux les soigner.

INTRODUCTION: the lifestyles of individuals with myotonic dystrophy type 1 (DM1), also known as Steinert's disease, are poorly understood and yet they need to be considered when it comes to effective long-term care. The nursing care provided in referral centers is mindful of the clinical diversity of Steinert's disease when it comes to interdisciplinary care, but the disease is more complex from a relational point of view. The objective of this qualitative study was to understand the life experiences of individuals with Steinert's disease, by looking at the limitations of their bodies and the adaptation strategies they develop. METHOD: this social science and nursing science study examines this problem of care, adopting an ethno-sociological perspective. RESULTS: The study brought to light the changes that Steinert's disease imposes on a body. These changes contribute to individuals' construction of a body schema and social identity, which, despite allowing them to maintain a "normal" daily life for as long as possible, can also reach limits, requiring them to make radical life changes. The study's results are discussed using an analytical framework based on the four different ways of interpreting the body proposed by Nicolas Vonarx: the "material body," the "able body," the "feeling body," and the "knowing/judging body." To discuss the role the body plays for people living with Steinert's disease within a normative society, we propose that the concept of the "socializing body" be added to this framework.

[Nursing care perspectives and foresights] / Les soins infirmiers : perspectives et prospectives.

As a continuation of its work and of the seminar on nursing sciences education in 2014, the "Association de recherche en soins infirmiers" (Arsi) organized a seminar on the 3rd and-4th of June 2016 in Nantes entitled : "nursing : perspectives and foresights". More than fifty participants from the francophone area representing various sectors of practice : clinical, teaching, management and students gathered to debate and produce benchmarks to support the development of nursing sciences in France and to draw future directions for clinical practice and training. The successive sessions made it possible to reflect, to confront opinions, to make proposals and to identify the terms of the problematic of care and nursing knowledge today and the methodological elements relating to foresight. At the end of this very creative seminar, new avenues of reflection emerged shifting our usual look at the nurse profession. Orientations for training and practice have been defined with different stakes depending on the level of training and professional commitment. The strong links between professional, scientific and academic discipline have also been clarified, highlighting the importance to hold a high theoretical and scientific requirement, rigorous clinical practice, strong professional commitment and effective leadership.

[Socianalytical device: intervention instrument and data collection in qualitative research in nursing]. / Dispositif socianalytique: instrument d'intervention et de collecte de données en recherche qualitative en soins infirmiers.

The aims of this paper is to describe and to analyze the use of a socioanalytical device as a data collection too as well as a space of professional practice and work relations analysis, with nurses from a School Hospital of the Minas Gerais Federal University, Brazil. The qualitative approach was chosen to develop an intervention research with Institutional Analysis as theoretical and methodological framework. In the first stage of data collection, an exploratory research was carried out through a questionnaire and, in the second phase, a socianalytical device was built in 5 meetings that took place during two months. For the nurses, the analysis device has enabled personal and professional growth; to review positions; to exchange experience and to reflect on their own problems through the experience of other colleagues. We conclude that the socioanalytical device was a space for discussion, for analysis of professional practice and was the methodological strategy for data collection in this research. It has allowed the creation and recreation of forms of intervention, the production of knowledge and has improved quality of health work.

[The Association de recherche en soins infirmiers: a story of combination of circumstances, a strong axis and encounters]. / L'Association de recherche en soins infirmiers : une histoire de concours de circonstances, un axe fort et des rencontres.

Research in Nursing has grown significantly in France. The usefulness and necessity of scientific research, to provide quality care, and its role in the professionalization are now accepted. The Nursing Research Association (Arsi) is a key player contributing for over thirty years to the development and recognition of research as a means to develop and acquire knowledge, and to base care on Scientifics data. Established in 1983 Arsi is a combination of circumstances of history, a major focus, objectives and encounters with people who identified the interest of research in nursing and supported the associations initiatives. Its characteristic is to have been able to balance cares 'need, research, and to put itself in a prospective dimension. Today, the association is recognized nationally and internationally for the quality of its work and its contribution to the development of research and nursing sciences. This recognition is the result of a continous and demanding work of many volunteers committed to support the objectives of the association.