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Introduction: Around 16% of world's population lives with visible and invisible disabilities. People with disabilities' participation may be limited because of the environmental obstacles. Moreover, historic heritage places were built before the development of accessibility standards and the rights of people living with disabilities and the majority were not designed to be accessible. Access to historic heritage places is important for carrying out the activities in place but also to create and reinforce identity. The aim of this study was to explore the experiences of people with visible and invisible disabilities when visiting heritage sites considering accessibility issues. Methods: This study is a qualitative interpretive description. Participants were adults with visible (e.g., motor disability) or invisible (e.g., autism) disabilities. For data collection, go along interviews (also referred to in the literature as "walking interview" in two different locations in the Historic District of Old Quebec in Quebec City were conducted. Thematic analysis was done. Results: Twenty-one participants completed two go along interviews: one in the Séminaire de Québec (Seminary of Quebec City) and the other in Petit-Champlain and Place Royale areas of Quebec City. Three themes emerged: (1) Obstacles and impact on participation; (2) Disabling accessibility; and (3) Heritage meaning. Discussion: The barriers identified by participants are diverse and differ according to the person and the type of disability. However, social and leisure activities were particularly limited, despite the strategies developed by some participants. Participants in the study demonstrated an interest in accessing to heritage places, therefore it seems essential to consider the needs of people with disabilities when developing accessibility solutions, and to seek a balance between preserving heritage and promoting inclusive and equitable access for all.
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Current strategies for teaching evacuation methods in private seniors' residences (PSR) and long-term care (LTCH) homes may pose risks to people with disabilities (PWD) and seniors' physical and psychological health. This study aimed to address the following questions: (1) Which are the current fire evacuation learning strategies used with PWD or seniors? (2) What are the barriers and facilitators for PWD and seniors' during fire evacuation and learning strategies in PSR and LTCH? (3) What is the existing equipment that could be used with PWD seniors?. A scoping review of grey and scientific literature was done in six databases and Google scholar. Additional information was found on Québec government websites. This review identified 13 scientific papers and 22 documents. Twenty barriers (personal = 9, environmental = 11), and 14 facilitators (personal = 4, environmental = 10) were extracted. The current fire evacuation learning strategies currently used can be grouped into three categories: drills; training; promotion of a fire safety plan. Six types of evacuation equipment were found; however, their use has been scarcely documented. Safety for seniors during fire evacuation is still an important issue to be improved. Increasing awareness and creating new practices and tools that consider the strengths and difficulties of seniors seems to be a promising avenue for improving evacuation.
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Introduction. In long-term care (LTC), person-centred approaches are encouraged. One such approach, relationship-based care (RBC), aims among other things to reduce residents' agitated behaviours. RBC has been used in numerous Quebec LTC facilities over the past decade but it has never been studied. Objective. Explore correlations between use of RBC by trained caregivers and the frequency of agitated and positive behaviours of residents with cognitive impairments. Methods. Two independent raters observed fourteen caregiver/resident dyads in two LTC facilities during assistance with hygiene and dressing. Checklists were used to quantify caregivers' RBC use and residents' agitated and positive behaviours. Results. Scores for RBC use were high, suggesting good application of the approach by caregivers. Correlation analyses showed that offering residents realistic choices and talking to them during care were associated with both positive and agitated behaviours (P from 0.03 to 0.003). However, many other components of RBC were not associated with residents' behaviours during care. Conclusions. There were only a few quantitative links between the RBC checklist items and the frequency of agitated or positive behaviours. Other studies with a more rigorous research design are needed to better understand the impact of relationship-based care on residents' behaviours.
RESUMEN
The person-centered approach is increasingly recommended in long-term care facilities to increase quality of care. In Quebec, Canada,. caregivers were specifically trained in "relationship-based care. "This study analyzed caregivers' assessment of this approach's usefulness and their capacity, after training, to apply it to care practices. Questionnaires with open-ended questions were administered to caregivers (n= 392) one month after training. Caregivers' answers were categorized using a qualitative approach. Respondents perceive some features of this approach are beyond their reach or in opposition to their beliefs. They reported feeling pressure related to time constraints, their peers and the families of residents. These results indicate that training itself is insufficient to transform practice. Institutions wishing to implement such an approach must also act upon the beliefs of individuals, as well as upon work situations.
