Designing a resilience-based intervention program for children with cancer and their families: a study protocol.

Background: Advances in pediatric oncology have significantly increased survival rates, yet have introduced challenges in managing long-term treatment side effects. This study process introduces an interdisciplinary clinical intervention program rooted in the family resilience framework, aimed at improving well-being across the cancer trajectory for children and their families, especially those in Canadian communities far from specialized oncology centers with limited access to resources. Methods: Employing an intervention mapping approach, this program collaboratively involves patients, families, professionals, and researchers. It aims to identify vulnerability factors, establish a logic model of change, and devise comprehensive strategies that include professional interventions alongside self-management tools. These strategies, tailored to address biopsychosocial and spiritual challenges, are adapted to the unique contexts of communities distant from specialized cancer treatment centers. A mixed-methods approach will evaluate program effectiveness. Expected results: Anticipated outcomes include the empowerment of families with self-management tools and professional support, designed to mitigate biopsychosocial and spiritual complications. By addressing the specific needs and limitations of these communities, the program strives to improve the overall health and well-being of both undergoing treatment and survivorship phases. Discussion: By focusing on comprehensive care that includes both professional interventions and self-management, this initiative marks a significant shift toward a holistic, family-centered approach in pediatric oncology care for remote communities. It underlines the necessity of accessible interventions that confront immediate and long-term challenges, aiming to elevate the standard of care by emphasizing resilience, professional support, and family empowerment in underserved areas.

The Absence of Funeral Rites as a Risk Factor for the French Bereaved Population.

During the COVID-19 pandemic, stringent measures were imposed in numerous countries, including France. These measures significantly disrupted societal practices, particularly mourning and funeral rituals. This study, conducted between June and September 2021 as part of the COVIDEUIL-France research, involved 242 participants, predominantly female (84%) with an average age of 49.64 years. The research aimed to investigate the consequences of the absence of funeral rituals and the adoption of personalized, domestic, and digital alternatives. Using online surveys and psychological tools, including the Traumatic Grief Inventory Self Report Version (TGI-SR), General Health Questionnaire-28 (GHQ-28), and Post-traumatic Growth Inventory (PTGI), the study found a significant correlation between the lack of traditional practices and grief complications. Despite 21.81% of participants compensating with personal commemorations, digital commemorations were underutilized, raising questions about their effectiveness. The study provides crucial insights, emphasizing the need to address the psychological effects of disrupted mourning practices in France.

Predicting levels of prolonged grief disorder symptoms during the COVID-19 pandemic: An integrated approach of classical data exploration, predictive machine learning, and explainable AI.

BACKGROUND: Prior studies on Prolonged Grief Disorder (PGD) primarily employed classical approaches to link bereaved individuals' characteristics with PGD symptom levels. This study utilized machine learning to identify key factors influencing PGD symptoms during the COVID-19 pandemic. METHODS: We analyzed data from 479 participants through an online survey, employing classical data exploration, predictive machine learning, and SHapley Additive exPlanations (SHAP) to determine key factors influencing PGD symptoms measured with the Traumatic Grief Inventory - Self Report (TGI-SR) from 19 variables, comparing five predictive models. RESULTS: The classical approach identified eight variables associated with a possible PGD (TGI-SR score ≥ 59): unexpected causes of death, living alone, seeking professional support, taking anxiety and/or depression medications, using more grief services (telephone or online supports) and more confrontation-oriented coping strategies, and higher levels of depression and anxiety. Using machine learning techniques, the CatBoost algorithm provided the best predictive model of the TGI-SR score (r2 = 0.6479). The three variables influencing the most the level of PGD symptoms were anxiety, and levels of avoidance and confrontation coping strategies used. CONCLUSIONS: This pioneering approach within the field of grief research enabled us to leverage the extensive dataset collected during the pandemic, facilitating a deeper comprehension of the predominant factors influencing the grieving process for individuals who experienced loss during this period. LIMITATIONS: This study acknowledges self-selection bias, limited sample diversity, and suggests further research is needed to fully understand the predictors of PGD symptoms.

Factors Associated with Complicated Grief Following a Railway Tragedy.

On July 6, 2013, a train with 72 crude oil tank cars derailed in the heart of Lac-Mégantic, a small municipality of 6,000 inhabitants located in Québec (Canada). This tragedy killed 47 people. Technological disasters are rarely studied in bereavement research, and train derailments even less. The goal of this article is to increase our understanding of the bereavement consequences of technological disasters. Specifically, we aim to identify the factors that lead to the experience complicated grief and distinguish from the protective factors. A representative population-based survey was conducted among 268 bereaved people, three and a half years after the train accident. Of these, 71 people (26.5%) experienced complicated grief. People with complicated grief (CG) differ significantly from those without CG in terms of psychological health, perception of physical health, alcohol use and medication, as well as social and professional relationships. Hierarchical logistic regression analysis identified four predictive factors for CG: level of exposure to the disaster, having a negative perception of the event, as well as having a paid job and low-income increase the risk of CG. The importance of having health and social practitioners pay attention to these factors of CG are discussed along with future directions for research.

French-Canadian validation of the Traumatic Grief Inventory-Self Report (TGI-SR).

The Traumatic Grief Inventory Self-Report (TGI-SR), which aims to assess both Persistent Complex Bereavement Disorder and Prolonged Grief Disorder, has been validated in several languages. This study sought to validate the French-Canadian version. We conducted an online survey exploring the impact of the COVID-19 pandemic on grief. With data from 728 participants, the scale demonstrated high internal consistency, correlated significantly with three other scales known to measure similar concepts, and distinguished between groups known to be different. This study supports the use of the TGI-SR French-Canadian version by clinicians and researchers to assess complications of grief.

[End-of-life support experiences at home during the Covid-19 pandemic: Issues and challenges]. / Expériences d'accompagnement en fin de vie à domicile durant la pandémie de COVID-19 : enjeux et défis.

Objective The aim of this text is to describe the challenges and issues associated with family caregivers during the experience of caring for a person at the end of life at home, in the context of a pandemic. This support situation, already normally demanding, turned out to be more difficult and complicated than usual due to the many challenges and issues associated, in particular, with the health restrictions imposed at the time. Here, we present an analysis of comments gathered from family caregivers during the pandemic. Method Testimonials from caregivers were drawn from a research study entitled COVIDEUIL. The qualitative component of this study included many rich comments drawn from the voices of PPA and collected by questionnaire. For the present article, the focus was on qualitative data relating to the end-of-life situation at home of a loved one. This theme was documented by analyzing the responses of 71 caregivers. These people described, sometimes in detail, the particular circumstances surrounding their loved one's final days and death. Results PPAs report various issues in end-of-life care at home during the pandemic. Some results are similar to studies already carried out, including fatigue and the benefits of outside help, while others are perhaps more amplified, including the lack of support from caregivers, isolation, and the absence of continuity in services, due to the pandemic context. Testimonies show that home care requires physical and mental availability on the part of PPAs; the burden is imposing. In some cases, financial resources have been invested to pay for home care services. Moreover, formal and informal help remains an important element in maintaining home care until the end, otherwise it is compromised and institutional care becomes necessary. Conclusion For PPAs who were able to provide end-of-life care at home for their loved one at the end of life, various challenges were reported. In short, if end-of-life care at home is to be a safe and satisfying experience, PPAs must receive adequate support, and care must be tailored to the needs of the person being cared for. Support at the end of life at home is part of a long process of assistance and care provided by PPAs. The formal assistance offered should follow the evolution of the dyad's journey-PPA and cared-for person. End-of-life care at home is likely to increase as the population ages. As such, care and services must be orchestrated and adapted from the moment the diagnosis is announced. The Observatoire québécois de la proche aidance will certainly be able to assess the impact of the national policy on PPAs and measure the effects on their health, well-being and quality of life (art. 40) (ministère de la Santé et des Services sociaux, 2021a).

Psychological, Physical and Behavioral Health of Adults, 3 Years After Exposure to a Train Derailment.

In July 2013, a train derailment profoundly disrupted the tranquility of the population of Lac-Mégantic for months and even years. In 2016, we conducted a representative population-based survey among 387 people from Lac-Mégantic and 413 from other municipalities with the aim to document psychological and physical health of adults exposed to the disaster. This article examines differences between 3 groups of respondents: those who were highly, moderately or not exposed to the train accident. Khi Square analyses, odds ratios and logistic regressions were used to examine differences between the 3 groups of respondents (high, moderate and no exposure). Results show that the level of exposure to this technological disaster is strongly associated with psychological suffering, post-traumatic growth, physical heath, drinking patterns, and use of prescribed and non-prescribed drugs. We can explain these results by the nature and cause of the event as well as its consequences.

[Development of the concept of positive spirituality in health]. / Élaboration du concept de spiritualité positive en santé.

Positive spirituality has three central attributes: connectedness, meaning of life, and identity. Six factors are likely to contribute to its emergence and it can allow the development of ten positive consequences.

[Influence of spirituality on health status in times of pandemic]. / Influence de la spiritualité sur l'état de santé en temps de pandémie.

Spirituality is a health protection factor recognised in the scientific literature. However, few studies have evaluated its impact on French-speaking populations, in secularised societies and even fewer in the context of a pandemic. It is therefore interesting to highlight significant relationships between spiritual quality of life and health.

Sociographie des ritualités funéraires en temps de pandémie: des rites empêchés aux rites appropriés.

COVID-19 has led to unprecedented health and social measures in several countries, including major restrictions on funeral rituals. These restrictions concerned pre-mortem, peri-mortem and post-mortem rites. Based on a longitudinal study of 955 French-speaking Canadians bereaved of a loved one during the pandemic, this article describes the reality of these impediments. Through an analysis of the quantitative and qualitative data collected, it is possible to identify the gap between desired and realized funeral rituals during the first year of the COVID-19 pandemic. The results show important hindrances to the various desired rituals, yet some ritual and symbolic creativity by the bereaved.

La Covid-19 a entraîné dans plusieurs pays des mesures sociosanitaires inédites, notamment des restrictions majeures aux rituels funéraires. Ces empêchements ont concerné tant les rites pré-mortem, péri-mortem que post-mortem. À partir d'une étude longitudinale débutée en mars 2021 auprès de 955 personnes francophones canadiennes endeuillées d'un proche pendant la pandémie, cet article propose de décrire la réalité vécue de ces empêchements. Par une analyse des données quantitatives et qualitatives recueillies, il est possible d'identifier l'écart entre les rituels funéraires souhaités et réalisés pendant la première année de la pandémie de Covid-19. Les résultats montrent d'importantes privations des différents rites souhaités, mais également une certaine créativité rituelle et symbolique de la part des personnes endeuillées.

Predictive Factors of Spiritual Quality of Life during the COVID-19 Pandemic: A Multivariate Analysis.

COVID-19 has led to the implementation of various social and sanitary measures, impacting populations' quality of life. Aims: Documenting the spiritual quality of life (SQoL) of university employees and students in Quebec, Canada. A survey of 2,202 employees and students was conducted using health measurement tools, including the short version of the WHOQoL-SRPB. We ran a multiple linear regression to determine which variables promote the SQoL. SQoL was very low (2.92/5). Positive mental health, religion, and age are the main predictors of the SQoL. Some dimensions of spirituality contribute more than others to the respondents' quality of life and health during the COVID-19 pandemic.