Nursing Interventions Designed to Improve Healthcare in General Healthcare Settings for Adults Living with Mental Illness: A Scoping Review.

People living with mental illness have difficulty obtaining quality physical care services. Nurses find it hard to fully assume their role and adopt a person-centered approach when they care for people with both physical and mental health problems. A scoping review was carried out to document the breadth and depth of literature on nurse interventions designed to improve nursing care in general healthcare settings for adults living with mental illness. Two researchers independently screened titles, abstracts and full documents to obtain publications, and the relevant data was extracted from individual studies. Of the 384 studies identified, 16 documents were included in the study. Few interventions have been the subject of scientific publications and they are scattered in their objectives and very heterogeneous in their content. Interventions are often included in a large program that may be difficult to apply in various care settings. There are many different nursing roles and activities in care-management and in support of behavioral changes although their main measured outcomes differ. This study highlights a tendency for interventions to relegate people with mental health problems to specialized services, which reinforces the dichotomization of services and does not favor a holistic and person-centered approach. There is an urgent need to develop and evaluate nursing interventions in general healthcare settings for adults living with mental illness. The development of relevant continuing education and training must take into account both the point of view of the people living with mental illness and that of nurses.

The Prenatal Primary Nursing Care Experience of Pregnant Women in Contexts of Vulnerability: A Systematic Review With Thematic Synthesis.

The contexts of vulnerability are diversified and cover a wide range of situations where pregnant women are likely to experience threats or disparities. Nurses should consider the particular circumstances of women in contexts of vulnerability. We used a qualitative thematic synthesis to describe the experience of these women regarding their prenatal primary nursing care. We identified that the women's experience is shaped by the prenatal care. The fulfillment of their needs and expectations will guide their decision regarding the utilization of their prenatal care. We propose a theoretical model to guide nurses, promoting person-centered delivery of prenatal care.

Coconstruction d'une intervention infirmière centrée sur la personne pour soutenir l'autogestion des individus vivant avec le diabète de type 2.

Introduction : People living with type 2 diabetes are brought to make demanding behavioral changes that can lead to self-management difficulties.Background : The guidelines recommend that healthcare professionals follow a person-centered approach (PCA) when caring. However, this approach seems difficult to adopt in practice.Objective : Coconstruct an intervention inspired by the concept map (CM) to promote the adoption of PCA by nurses during self-management support encounters.Method : This study is based on a model for developing evidence-based nursing interventions. Five experts (2 patients, 2 nurses, 1 educational specialist) collaborated in the coconstruction of the intervention.Results : The Person-Centered Approach Diabetes Self-Management Support (PCA-DSMS) intervention has been developed in accordance with the foundations of a PCA and the CM. It includes four steps : 1) Introduce the intervention ; 2) Develop the Needs Map ; 3) Intervene according to priority needs ; 4) Conclude and plan a follow-up.Discussion : More studies are needed to explore whether the intervention is acceptable and feasible as well as its ability to lead nurses to adopt PCA.Conclusion : The PCA-DSMS could bring nurses to adopt a PCA.

Factors associated with frequent use of emergency-department services in a geriatric population: a systematic review.

BACKGROUND: Frequent geriatric users of emergency departments (EDs) constitute a small group of individuals accounting for a disproportionately high number of ED visits. In addition to overcrowding, this situation might result in a less appropriate response to health needs and negative health impacts. Geriatric patients turn to EDs for a variety of reasons. A better understanding of the variables associated with frequent ED use will help implement interventions best suited for their needs. OBJECTIVE: This review aimed at identifying variables associated with frequent ED use by older adults. METHODS: For this systematic review, we searched Medline, CINAHL, Healthstar, and PsyINFO (before June 2018). Articles written in English or French meeting these criteria were included: targeting a population aged 65 years or older, reporting on frequent ED use, using an observational study design and multivariate regression analysis. The search was supplemented by manually examining the reference lists of relevant studies. Independent reviewers identified articles for inclusion, extracted data, and assessed quality with the JBI Critical Appraisal Checklist for Studies Reporting Prevalence. A narrative synthesis was done to combine the study results. A sensitivity analysis was performed to evaluate the effect of removing the studies not meeting the quality criteria. RESULTS: Out of 5096 references, 8 met our inclusion criteria. A high number of past hospital and ED admissions, living in a rural area adjacent to an urban center, low income, a high number of prescribed drugs, and a history of heart disease were associated with frequent ED use among older adults. In addition, having a principal-care physician and living in a remote rural area were associated with fewer ED visits. Some variables recognized in the literature as influencing ED use among older adults received scant consideration, such as comorbidity, dementia, and considerations related to primary-care and community settings. CONCLUSION: Further studies should bridge the gap in understanding and give a more global portrait by adding important personal variables such as dementia, organizational variables such as use of community and primary care, and contextual variables such as social and economic frailty.

[Difficulties related to self-care among people living with type 2 diabetes: a narrative literature review based on Audulv Asplund and Norbergh's model.]

Introduction : self-care activities require a lot of adaptation from people living with type 2 diabetes.Context : existing interventions to support self-care are often determined by a conventional vision focused on managing the disease.Objective : this article aims to present the difficulties of people living with type 2 diabetes in relation with the Audulv, Asplund and Norbergh self-care integration model.Method : a narrative review of the literature on self-care in adults with type 2 diabetes was conducted on the CINAHL, MEDLINE, PsycINFO, PASCAL and FRANÇIS databases.Results : 29 articles were selected. The main difficulties related to self-care are identified according to the four phases of the self-care integration model and the four factors related to the person's life context.Discussion : nurses could pull out some benefits from using the Audulv model by understanding the difficulties that the patients are living with and using this method, they could intervene with a better understanding towards the patients.Conclusion : further studies are needed to elaborate strategies to support people according to each of the identified difficulties.