Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 41
Filter
1.
J Appl Gerontol ; 39(2): 119-128, 2020 02.
Article in English | MEDLINE | ID: mdl-29504489

ABSTRACT

Few studies have been conducted on strategies to promote the implementation of complex interventions in nursing homes (NHs). This article presents a pilot study intended to assess the strategies that would enable the optimal implementation of a complex intervention approach in NHs based on the meanings of screams of older people living with Alzheimer's disease. An action research approach was used with 19 formal and family caregivers from five NHs. Focus groups and individual interviews were held to assess different implementation strategies. A number of challenges were identified, as were strategies to overcome them. These latter included interactive training, intervention design, and external support. This study shows the feasibility of implementing a complex intervention to optimize older people's well-being. The article shares strategies that may promote the implementation of these types of interventions in NHs.


Subject(s)
Caregivers/psychology , Delivery of Health Care , Health Services Research , Homes for the Aged , Nursing Homes , Aged , Aged, 80 and over , Alzheimer Disease/therapy , Female , Focus Groups , Humans , Inservice Training , Interviews as Topic , Male , Pilot Projects , Qualitative Research , Quebec
2.
Support Care Cancer ; 27(8): 2771-2781, 2019 Aug.
Article in English | MEDLINE | ID: mdl-30519734

ABSTRACT

PURPOSE: Although family caregivers (FCs) of older adults with cancer (OACs) provide invaluable assistance by fulfilling multiple tasks along the cancer trajectory, evidence suggests that their needs are poorly assessed, and there is a scarcity of supportive interventions that influence their well-being. Viewing these issues as opportunities for improvement, we conducted this qualitative study to understand FCs' needs and identify promising needs-focused interventions. METHODS: This descriptive interpretive qualitative study was conducted in Quebec, Canada, in a French Canadian Oncology Clinic. Participants were FCs who were spouses or adult children (n = 25) of OACs aged 70 years or older. Data were collected via focus groups and were analyzed using an ongoing analytic process following each interview. RESULTS: Three types of needs were of particular importance: information, relationships between FC and others, and care for oneself. The need for information was described in terms of the content, timeliness, and modalities in which information should be verbalized and delivered. The need for relationships specifically targeted health care providers (HCPs), family members, and OACs. The need to care for oneself was recognized as important throughout the cancer trajectory but also represented a challenge. Participants proposed innovative ideas for interventions, resources, and strategies for each type of need. CONCLUSIONS: According to our results, HCPs should systematically include FCs into OACs' care plan through the use of concrete actions such as the "family systems approach" suggested by Duhamel, and integrate a systematic FC's needs assessment.


Subject(s)
Adult Children , Caregivers , Child of Impaired Parents , Family , Focus Groups , Health Services Needs and Demand , Neoplasms , Adult , Adult Children/psychology , Adult Children/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Canada/epidemiology , Caregivers/psychology , Caregivers/statistics & numerical data , Child of Impaired Parents/psychology , Child of Impaired Parents/statistics & numerical data , Delivery of Health Care , Family/psychology , Female , Health Personnel , Health Services Needs and Demand/statistics & numerical data , Humans , Male , Middle Aged , Quebec/epidemiology
3.
Sante Ment Que ; 44(1): 31-46, 2019.
Article in French | MEDLINE | ID: mdl-32338677

ABSTRACT

The use of Information and Communication Technologies (ICT) for help-seeking is becoming more and more common for adolescents at risk of suicide. Objectives The aim of this current study was to better understand the help-seeking process of adolescents at risk for suicide. Methods A grounded theory methodology was used to describe the experience of adolescents at risk of suicide and gain a deeper understanding of their ICT help-seeking process. Data was collected through semi-structured interviews, an ICT help-seeking questionnaire and live observations of ICT help-seeking strategies by the adolescents of this study. Theoretical saturation was reached with a total of 15 adolescents, aged 13 to 17, at risk of suicide. Results The grounded theory that emerged gravitated towards the fact that adolescents chose to virtually deal with emotional drowning. A specific context allowed this central category to emerge and included the adolescents' state, their personal triggers, their social environment as well as their desire to use ICT. The ICT strategies used by the adolescents to deal with their emotional drowning were to distract themselves, to get informed, to reveal themselves or to help others. Adolescents in this study used different ways to distract themselves with ICT. This included reading texts, watching online videos, listening to music and playing games. They also increased their literacy by informing themselves on suicide and mental health problems. However, many adolescents also searched for ways to help them commit suicide. Although most of the results were suicide prevention related, the keywords used by the adolescents remain preoccupying. Revealing their thoughts and their feelings about their emotional state seemed to be easier through ICT. They sometimes chose to reveal themselves anonymously but most of the time, they revealed themselves to use ICT to friends they already had in real life. Also, helping friends through ICT seemed to be very rewarding and helpful to the adolescents of our study even when they were in a state of emotional drowning. These different strategies to virtually deal with their emotional drowning hindered many different consequences which were to grow emotionally, to get help, to get temporary relief, to stay indifferent, to worsen their suicidal thoughts or to attempt suicide. Conclusion Although some negative consequences of ICT emerge from this study, a great deal of the consequences was positive and helpful for these adolescents. Overall, this study shows that ICT offer great opportunities for adolescent suicide prevention. Implications for practice, training and research are further discussed.


Subject(s)
Emotions , Grounded Theory , Help-Seeking Behavior , Internet , Suicidal Ideation , Adolescent , Communication , Female , Humans , Information Technology , Male , Risk , Self Report , Suicide/psychology , Suicide Prevention
4.
Nurs Inq ; 25(4): e12249, 2018 10.
Article in English | MEDLINE | ID: mdl-29888496

ABSTRACT

Qualitative research should strive for knowledge translation toward the goal of closing the gap between knowledge and practice. However, it is often a challenge in nursing to identify knowledge translation strategies able to illustrate the usefulness of qualitative results in any given context. This article defines storytelling and uses pragmatism to examine storytelling as a strategy to promote the knowledge translation of qualitative results. Pragmatism posits that usefulness is defined by the people affected by the problem and that usefulness is promoted by modalities, like storytelling, that increase sensitivity to an experience. Indeed, stories have the power to give meaning to human behaviors and to trigger emotions, and in doing so bring many advantages. For example, by contextualizing research results and appealing to both the reason and the emotions of audiences, storytelling can help us grasp the usefulness of these research results. Various strategies exist to create stories that will produce an emotional experience capable of influencing readers' or listeners' actions. To illustrate the potential of storytelling as a knowledge translation strategy in health care, we will use our story of discovering this strategy during a qualitative study in a nursing home as an example.


Subject(s)
Narration , Qualitative Research , Translational Research, Biomedical/methods , Humans , Research Personnel/standards , Translational Research, Biomedical/standards , Translational Research, Biomedical/trends
6.
J Adv Nurs ; 74(2): 239-250, 2018 Feb.
Article in English | MEDLINE | ID: mdl-28815750

ABSTRACT

AIM: To identify the theories used to explain learning in simulation and to examine how these theories guided the assessment of learning outcomes related to core competencies in undergraduate nursing students. BACKGROUND: Nurse educators face the challenge of making explicit the outcomes of competency-based education, especially when competencies are conceptualized as holistic and context dependent. DESIGN: Theoretical review. DATA SOURCES: Research papers (N = 182) published between 1999-2015 describing simulation in nursing education. REVIEW METHODS: Two members of the research team extracted data from the papers, including theories used to explain how simulation could engender learning and tools used to assess simulation outcomes. Contingency tables were created to examine the associations between theories, outcomes and tools. RESULTS: Some papers (N = 79) did not provide an explicit theory. The 103 remaining papers identified one or more learning or teaching theories; the most frequent were the National League for Nursing/Jeffries Simulation Framework, Kolb's theory of experiential learning and Bandura's social cognitive theory and concept of self-efficacy. Students' perceptions of simulation, knowledge and self-confidence were the most frequently assessed, mainly via scales designed for the study where they were used. Core competencies were mostly assessed with an observational approach. CONCLUSION: This review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context-dependent constructs.


Subject(s)
Clinical Competence/standards , Competency-Based Education/standards , Education, Nursing, Baccalaureate/standards , Educational Measurement/standards , Guidelines as Topic , Simulation Training/standards , Students, Nursing/statistics & numerical data , Adult , Female , Humans , Male , Young Adult
7.
Can J Nurs Res ; 50(2): 49-56, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29169244

ABSTRACT

Background To provide effective pain management, nurses must have sufficient knowledge and adequate beliefs about pain management. In Quebec, however, nurses seem to be generally uninvolved in pain management, and there is little significant evidence shedding light on nurses' pain management knowledge and beliefs in postoperative settings. To perform such studies, a valid questionnaire in French to assess nurses' knowledge and beliefs is required. Some valid questionnaires are available in English, but none are available in French. Purpose This article describes the process of translation, adaptation, and preliminary validation of the Toronto Pain Management Index into French. Results For temporal stability of the Toronto Pain Management Index, French-Canadian version, the result of intraclass correlation coefficient for the total score of this questionnaire is 0.59 (CI: 0.44-0.72). Conclusion Following this process, the French version of this questionnaire has suitable face and content validity and can be used to evaluate nurses' knowledge and beliefs about pain management in postoperative settings.


Subject(s)
Nursing Staff , Pain Management/methods , Translating , Adult , Female , Humans , Male , Ontario , Pain, Postoperative/nursing , Surveys and Questionnaires , Young Adult
8.
Psychiatr Psychol Law ; 25(1): 124-130, 2018.
Article in English | MEDLINE | ID: mdl-31984011

ABSTRACT

Involuntary hospitalisation has been legal in France since 1838. The first reform took place in 1990. However, critics postulated that this first reform did not adequately respect the rights of patients. Consequently, further reforms were introduced in 1990. In 2011 further reforms rendered involuntary hospitalisation consistent with European requirements, introducing systematic control by the Juge des Libertés et de la Détention (Judge of Freedoms and Detention) for each patient hospitalised without consent. The purpose of this article is to provide a qualitative description of the evolution of the legal concerns surrounding involuntary hospitalisation in France.

10.
Nephrol Nurs J ; 43(6): 463-493, 2016.
Article in English | MEDLINE | ID: mdl-30550076

ABSTRACT

Patients with advanced chronic kidney disease (CKD) face many choices regarding future dialysis modalities. Decision-making is difficult for patients. The objective of this study was to describe the decision-making needs from the perspectives of patients with advanced CKD, professionals, and others involved in the decision. Guided by a shared decision-making model, this qualitative study was conducted using interviews with key informants (17 patients, two peer helpers, and eight health professionals) and a focus group (five nurses). The results revealed evolving decisional needs in five-stage through the decision making journey: 1) Progress toward acceptance of dialysis, 2) Receive information, 3) Take some time for personal reflection, 4) Seek opinion and support of other, and 5) Re-evaluate one's choice. As we anticipate decisional needs, we will be able to develop decision support interventions that are stage-matched.


Subject(s)
Decision Making , Nursing Process , Renal Dialysis , Renal Insufficiency, Chronic/therapy , Adult , Aged , Aged, 80 and over , Female , Focus Groups , Humans , Interviews as Topic , Male , Middle Aged , Needs Assessment , Nephrology Nursing , Renal Insufficiency, Chronic/nursing , Young Adult
11.
BMC Res Notes ; 8: 571, 2015 Oct 15.
Article in English | MEDLINE | ID: mdl-26471509

ABSTRACT

BACKGROUND: Seven chronic disease prevention and management programs were implemented across Quebec with funding support from a provincial-private industry funding initiative. Given the complexity of implementing integrated primary care chronic disease management programs, a knowledge transfer meeting was held to share experiences across programs and synthesize common challenges and success factors for implementation. METHODS: The knowledge translation meeting was held in February 2014 in Montreal, Canada. Seventy-five participants consisting of 15 clinicians, 14 researchers, 31 knowledge users, and 15 representatives from the funding agencies were broken up into groups of 10 or 11 and conducted a strengths, weaknesses, opportunities, and threats analysis on either the implementation or the evaluation of these chronic disease management programs. Results were reported back to the larger group during a plenary and recorded. Audiotapes were transcribed and summarized using pragmatic thematic analysis. RESULTS AND DISCUSSION: Strengths to leverage for the implementation of the seven programs include: (1) synergy between clinical and research teams; (2) stakeholders working together; (3) motivation of clinicians; and (4) the fact that the programs are evidence-based. Weaknesses to address include: (1) insufficient resources; (2) organizational change within the clinical sites; (3) lack of referrals from primary care physicians; and (4) lack of access to programs. Strengths to leverage for the evaluation of these programs include: (1) engagement of stakeholders and (2) sharing of knowledge between clinical sites. Weaknesses to address include: (1) lack of referrals; (2) difficulties with data collection; and (3) difficulties in identifying indicators and control groups. Opportunities for both themes include: (1) fostering new and existing partnerships and stakeholder relations; (2) seizing funding opportunities; (3) knowledge transfer; (4) supporting the transformation of professional roles; (5) expand the use of health information technology; and (6) conduct cost evaluations. Fifteen recommendations related to mobilisation of primary care physicians, support for the transformation of professional roles, and strategies aimed at facilitating the implementation and evaluation of chronic disease management programs were formulated based on the discussions at this knowledge translation event. CONCLUSION: The results from this knowledge translation day will help inform the sustainability of these seven chronic disease management programs in Quebec and the implementation and evaluation of similar programs elsewhere.


Subject(s)
Chronic Disease/prevention & control , Delivery of Health Care/organization & administration , Disease Management , Health Services Research/organization & administration , Program Development/economics , Translational Research, Biomedical/organization & administration , Data Collection , Health Knowledge, Attitudes, Practice , Healthcare Financing , Humans , Primary Health Care , Public-Private Sector Partnerships/organization & administration , Quebec
13.
Sante Publique ; 27(1 Suppl): S111-8, 2015.
Article in French | MEDLINE | ID: mdl-26168624

ABSTRACT

The burden of chronic disease requires a new organization of medical care and services. Enhancing collaboration among front-line care givers facilitates access to care and optimizes follow-up. As a result, a new organizational structure has been gradually deployed in Quebec since 2003. Family Medicine Groups (FMGs) use a new type of standing order, prescribing details of care. Among 52 FMGs surveyed, an exemplarygroup was identified that most successfully instituted more and higher-impact standing orders. This single case study explored the impact of standing orders used for diabetes follow-up on professional practices, physician-nurse-patient interactions and patient self-management. The data collected and analyzed were derived from more than 200 documents, 15 hours of observation in the clinic, and individual interviews of ten patients, three nurses and eight doctors. Standing ordersformalizing thejointfollow-up ofdiabetic patients both increased professional collaboration and improved patient-professional interactions. As professionals and patients achieved a better consensus, patient self-management was improved. Ultimately, for professionals, standing orders facilitate a better match between the use of their time and skills, and their aspirationsfor practice. Patients are reassured and empowered by ready access to care and their progress in self-management skills. Concrete measures, such as standing orders, modify care delivery by reinforcing professional collaboration, and facilitate patient self-care, in accordance with the Chronic Care Model (CCM).


Subject(s)
Continuity of Patient Care/organization & administration , Diabetes Mellitus/therapy , Practice Patterns, Physicians'/organization & administration , Primary Health Care/organization & administration , Case Management/organization & administration , Case Management/standards , Cooperative Behavior , Drug Prescriptions/standards , Humans , Monitoring, Physiologic/nursing , Monitoring, Physiologic/standards , Nurse-Patient Relations , Physician-Nurse Relations , Physician-Patient Relations , Practice Patterns, Physicians'/standards , Self Care
15.
Pain Manag Nurs ; 16(3): 354-66, 2015 Jun.
Article in English | MEDLINE | ID: mdl-26025795

ABSTRACT

Although many intensive care unit patients experience significant pain, very few studies explored massage to maximize their pain relief. This study aimed to evaluate the preliminary effects of hand massage on pain after cardiac surgery in the adult intensive care unit. A pilot randomized controlled trial was used for this study. The study was conducted in a Canadian medical-surgical intensive care unit. Forty adults who were admitted to the intensive care unit after undergoing elective cardiac surgery in the previous 24 hours participated in the study. They were randomly assigned to the experimental (n = 21) or control (n = 19) group. The experimental group received a 15-minute hand massage, and the control group received a 15-minute hand-holding without massage. In both groups the intervention was followed by a 30-minute rest period. The interventions were offered on 2-3 occasions within 24 hours after surgery. Pain, muscle tension, and vital signs were assessed. Pain intensity and behavioral scores were decreased for the experimental group. Although hand massage decreased muscle tension, fluctuations in vital signs were not significant. This study supports potential benefits of hand massage for intensive care unit postoperative pain management. Although larger randomized controlled trials are necessary, this low-cost nonpharmacologic intervention can be safely administered.


Subject(s)
Massage/methods , Pain, Postoperative/prevention & control , Thoracic Surgical Procedures/adverse effects , Aged , Aged, 80 and over , Critical Care/methods , Female , Hand , Humans , Intensive Care Units , Male , Middle Aged , Muscle Tonus/physiology , Pain Management/nursing , Pain Measurement , Pain, Postoperative/nursing , Pilot Projects , Postoperative Care/methods , Postoperative Care/nursing , Thoracic Surgical Procedures/nursing , Vital Signs
16.
J Emerg Nurs ; 41(4): 323-8, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25583425

ABSTRACT

INTRODUCTION: A large number of patients who are in pain upon arriving at the emergency department are still in pain when they are discharged. It is suggested that nurses' personal traits and their level of empathy can explain in part this issue in pain management. The purpose of this study was to better understand the shortfalls in pain management provided by emergency nurses by considering nurses' characteristics. METHODS: A cross-sectional descriptive correlational design was used for this pilot study. French validated self-administrated questionnaires (sociodemographic characteristics, empathy, psychological distress, and well-being) were presented to 40 emergency nurses. Thirty emergency nurses completed all questionnaires during work hours. Descriptive statistics, group comparisons, and correlation analyses were used for the data analysis. RESULTS: Emergency nurses appear to have low levels of empathy. High levels of psychological distress and low levels of well-being were also observed in our sample. Among these variables, only empathy and well-being appear to be related, because we found higher empathy scores in nurses with higher well-being. DISCUSSION: The poor mental health we found among emergency nurses is alarming. A clear need exists for supportive interventions for nurses. Finally, well-being was the only variable related to empathy. To our knowledge, this is the first study to report this relationship in nurses.


Subject(s)
Emergency Nursing , Empathy , Mental Health/statistics & numerical data , Nursing Staff, Hospital/psychology , Pain Management/psychology , Adaptation, Psychological , Adult , Canada , Cross-Sectional Studies , Emergency Service, Hospital , Female , Humans , Male , Pilot Projects , Socioeconomic Factors , Stress, Psychological/psychology , Surveys and Questionnaires , Young Adult
17.
Heart Lung ; 43(5): 437-44, 2014.
Article in English | MEDLINE | ID: mdl-25064487

ABSTRACT

OBJECTIVE: The purpose was to evaluate the acceptability and feasibility of hand massage therapy in the intensive care unit (ICU). BACKGROUND: Clinical guidelines suggest the use of non-pharmacological interventions for pain management in ICU adults. The results presented are secondary to a pilot RCT evaluating the preliminary effectiveness of hand massage on pain after cardiac surgery. METHODS: A qualitative descriptive design was used. Acceptability was evaluated using individual interviews with participants in both groups i.e., experimental and control (n = 40). Feasibility was examined using field notes and video recordings. RESULTS: While participants receiving the massage perceived it as appropriate, the control group suggested different dosages of the treatment and body areas targeted. Results also suggest that barriers (e.g. noise, numerous clinical activities) need to be overcome. CONCLUSIONS: Increasing staff acceptance, reducing the rest period, involving families, and repeating the treatment are avenues to consider. Building evidence for non-pharmacological pain management in the critical care setting is necessary.


Subject(s)
Cardiac Surgical Procedures , Intensive Care Units , Massage/methods , Pain, Postoperative/therapy , Aged , Feasibility Studies , Female , Hand , Humans , Male , Middle Aged , Pilot Projects , Single-Blind Method
18.
Nurs Crit Care ; 19(6): 272-80, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24811955

ABSTRACT

BACKGROUND: Performing routine pain assessments with all intensive care unit (ICU) patients is strongly recommended in clinical practice guidelines. As many ICU patients are unable to self-report, the Critical-Care Pain Observation Tool (CPOT) is one of the two behavioural pain scales suggested for clinical use. Still, no study has described the evaluations of its use in ICU daily practice. OBJECTIVE: To describe the nurses' evaluation of the feasibility, clinical relevance and satisfaction with the CPOT use 12 months after its implementation in the ICU. METHOD: A descriptive design was used. It was conducted in the medical-surgical ICU of a university affiliated setting at Greenfield Park (Québec, Canada). A self-administered evaluation questionnaire including four sections (i.e. feasibility, clinical relevance, satisfaction and socio-demographic information) was completed by ICU nurses who were all trained to use the CPOT. The questionnaires were completed anonymously. RESULTS: A total of 38 ICU nurses returned their completed questionnaire (63% participation rate). Regarding its feasibility, the majority rated the CPOT as quick to use, simple to understand and easy to complete (92-100%). According to clinical relevance, close to 70% of ICU nurses acknowledged that the CPOT had influenced their practice, but lower results (<50%) were found for effective communication of pain assessment findings with the physicians and other health professionals. More than 80% of ICU nurses were satisfied with its daily use. CONCLUSION: The CPOT use was deemed feasible and relevant in daily practice as per the nurses' evaluations but did not allow an effective communication with other ICU care team members. RELEVANCE TO CLINICAL PRACTICE: Training should be offered to all members of the ICU care team, and other implementation strategies should be explored as well to ensure optimal uptake of a pain assessment approach which impacts on their decision-making process for pain management.


Subject(s)
Intensive Care Units , Nursing Assessment , Pain Measurement/instrumentation , Pain Measurement/nursing , Adult , Feasibility Studies , Female , Humans , Male , Observation , Surveys and Questionnaires
20.
Nurs Crit Care ; 18(6): 307-18, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24165072

ABSTRACT

BACKGROUND: Pain is a major stressor for critically ill patients. To maximize pain relief, non-pharmacological interventions are an interesting avenue to explore. AIMS AND OBJECTIVES: The study aim was to describe the perspectives of patients/family members and nurses about the usefulness, relevance and feasibility of non-pharmacological interventions for pain management in the intensive care unit (ICU). DESIGN: A qualitative descriptive design was used. METHODS: Patients/family members (n = 6) with a previous experience of ICU hospitalization and ICU nurses (n = 32) were recruited. Using a semi-structured discussion guide, participants were asked to share their perspective about non-pharmacological interventions that they found useful, relevant and feasible for pain management in the ICU. Interventions were clustered into five categories: a) cognitive-behavioural, b) physical, c) emotional support, d) helping with activities of daily living and, e) creating a comfortable environment. RESULTS: A total of eight focus groups (FGs) with patients/family members (two FGs) and ICU nurses (six FGs) were conducted. Overall, 33 non-pharmacological interventions were discussed. The top four non-pharmacological interventions found to be useful, relevant and feasible in at least half of the FGs were music therapy and distraction (cognitive-behavioural category), simple massage (physical category) and family presence facilitation (emotional support category). Interestingly, patients/family members and nurses showed different interests towards some interventions. For instance, patients discussed more about active listening/reality orientation, while nurses talked mostly about teaching/positioning. CONCLUSIONS: Four non-pharmacological interventions reached consensus in patients and nurses' FGs to be useful, relevant and feasible for pain management in the ICU. Other interventions seemed to be influenced by personal experience or professional role of the participants. RELEVANCE TO CLINICAL PRACTICE: While more evidence is required to conclude to their effectiveness, ICU nurses can use non-pharmacological interventions complementary to pharmacological treatment of pain as they are low cost and safe.


Subject(s)
Critical Care/methods , Intensive Care Units , Nursing Staff/psychology , Pain Management/psychology , Patients/psychology , Adult , Attitude of Health Personnel , Cluster Analysis , Cognitive Behavioral Therapy/methods , Family/psychology , Feasibility Studies , Female , Focus Groups , Humans , Interviews as Topic , Male , Middle Aged , Nurse's Role/psychology , Nursing Staff/education , Nursing Staff/standards , Organ Transplantation , Organizational Case Studies , Pain, Postoperative/nursing , Physical Therapy Modalities , Qualitative Research , Quebec , Social Support
SELECTION OF CITATIONS
SEARCH DETAIL