For a better understanding of the relationship between caregivers and young adults living with a concomitant substance-related mental health and substance use disorder: an integrative review / Mieux comprendre la relation entre les intervenants et les jeunes adultes vivant avec un trouble concomitant de santé mentale et lié à l'usage de substances : une revue intégrative des écrits

Introduction: The importance of a quality relationship between young adults living with dual diagnosis and their health care providers is well documented. Context: Although this complex phenomenon was mostly studied from an individual perspective, the results indicated the systemic nature of this relationship. Objective: This study aims to better understand the relationship between young adults living with dual diagnosis and their health care providers, with a systemic perspective. Method: Six data bases were consulted; manual research in gray literature and references screening enhanced the process. Results: Of a total of 532 studies and reports identified, 44 were included in the review. Thematic data analysis was carried out, and two themes were identified: the health care system as a constraining environment; and the relationship at the heart of care. Discussion: This study confirms the joint role played by the young adult in question and their health care provider in developing and maintaining the relationship, by acknowledging the importance of the care, of mutual confidence, and of a hierarchic relationship. Conclusion: This integrative review provides a basis for future nursing interventions that foreground the relationship and take a systemic approach.

Introduction: Plusieurs écrits soulignent l'importance de la qualité de la relation entre de jeunes adultes présentant un trouble concomitant de santé mentale et lié aux substances, et leurs intervenants. Contexte: Ce phénomène complexe a toutefois été étudié surtout dans une perspective individuelle, alors que plusieurs résultats soutiennent le caractère systémique de cette relation. Objectif: Mieux comprendre, selon une perspective systémique, le phénomène de la relation entre ces jeunes adultes et leurs intervenants. Méthode: Une revue intégrative, encadrée par une approche systémique, a été effectuée à partir de six bases de données, d'une recherche manuelle de la littérature grise et d'une vérification des références. Résultats: 532 écrits ont été recensés, et 44 d'entre eux ont servi pour l'analyse thématique qui a fait ressortir deux thèmes : l'environnement contraignant du système de santé et la relation au cœur des soins. Discussion: Cette étude corrobore le rôle conjoint joué par le jeune et l'intervenant dans le développement et le maintien de leur relation, en reconnaissant l'importance des soins, de la confiance réciproque et de la relation hiérarchique. Conclusion: Les résultats peuvent constituer l'assise pour le développement d'interventions infirmières mettant à l'avant-plan la relation selon une perspective systémique.

For a better understanding of the relationship between caregivers and young adults living with a concomitant substance-related mental health and substance use disorder: An integrative review / Mieux comprendre la relation entre les intervenants et les jeunes adultes vivant avec un trouble concomitant de santé mentale et lié à l'usage de substances : une revue intégrative des écrits

INTRODUCTION: The importance of a quality relationship between young adults living with dual diagnosis and their health care providers is well documented. CONTEXT: Although this complex phenomenon was mostly studied from an individual perspective, the results indicated the systemic nature of this relationship. OBJECTIVE: This study aims to better understand the relationship between young adults living with dual diagnosis and their health care providers, with a systemic perspective. METHOD: Six data bases were consulted; manual research in gray literature and references screening enhanced the process. RESULTS: Of a total of 532 studies and reports identified, 44 were included in the review. Thematic data analysis was carried out, and two themes were identified: the health care system as a constraining environment; and the relationship at the heart of care. DISCUSSION: This study confirms the joint role played by the young adult in question and their health care provider in developing and maintaining the relationship, by acknowledging the importance of the care, of mutual confidence, and of a hierarchic relationship. CONCLUSION: This integrative review provides a basis for future nursing interventions that foreground the relationship and take a systemic approach.

Introduction: Plusieurs écrits soulignent l'importance de la qualité de la relation entre de jeunes adultes présentant un trouble concomitant de santé mentale et lié aux substances, et leurs intervenants. Contexte : ce phénomène complexe a toutefois été étudié surtout dans une perspective individuelle, alors que plusieurs résultats soutiennent le caractère systémique de cette relation. Objectif: Mieux comprendre, selon une perspective systémique, le phénomène de la relation entre ces jeunes adultes et leurs intervenants. Méthode: Une revue intégrative, encadrée par une approche systémique, a été effectuée à partir de six bases de données, d'une recherche manuelle de la littérature grise et d'une vérification des références. Résultats: 532 écrits ont été recensés, et 44 d'entre eux ont servi pour l'analyse thématique qui a fait ressortir deux thèmes : l'environnement contraignant du système de santé et la relation au cœur des soins. Discussion: Cette étude corrobore le rôle conjoint joué par le jeune et l'intervenant dans le développement et le maintien de leur relation, en reconnaissant l'importance des soins, de la confiance réciproque et de la relation hiérarchique. Conclusion: Les résultats peuvent constituer l'assise pour le développement d'interventions infirmières mettant à l'avant-plan la relation selon une perspective systémique.

Crisis plans in mental health: A scoping review.

Crisis situations are frequent among people with mental health disorders. Several interventions have been developed to act in prevention, including crisis plans recognized as particularly effective in reducing coercive measures. In the literature, several models of crisis plans are proposed with similar aims and contents. Based on the methodology proposed by the Joanna Briggs Institute, a scoping review was conducted to map the state of knowledge on crisis plans in adult mental health settings. The literature search conducted on six databases (CINAHL, PubMed, Medline, EMBASE, PsychINFO and Cochrane) yielded 2435 articles. Of these, 122 full-text articles were assessed for eligibility, and 78 met the inclusion criteria. Studies were critically appraised using the Joanna Briggs Institute appraisal tools, and data were extracted by two independent reviewers. Content analysis identified a typology of crisis plans: (1) the legal crisis plan and (2) the formal crisis plan. Five modalities were identified for its completion: the sections, the moment, the completion steps, the people involved and the training of key actors. Most identified outcomes are consistent with the main purpose of the intervention, which is crisis prevention. However, the most identified outcomes focused on the service user's recovery and indicated that crisis plans could provide an opportunity to operationalize recovery in mental healthcare, thus suggesting an evolution in the aim of the intervention. Future research should further focus on the modalities of crisis plans to guide the implementation in clinical practice.