Evaluating facilitators' challenges administering a program building on existing strengths in families facing difficulties.

The primary objective of this study was to understand the challenges faced by 12 facilitators (9 women and 3 men) of the Strengthening Families Program (SFP) implemented in the Adélard-Dugré and Jean-Nicolet neighbourhoods of Trois-Rivières, Quebec. This objective was operationalized as the following question: How did facilitators manage to buy in to, and align themselves with, program principles while avoiding an expert stance and remaining focused on participating families' strengths? This question has not been investigated before in connection with the SFP program. This study was conducted between 2011 and 2014, and relied on semi-annual group interviews. The results indicate that facilitators' first step was to acknowledge their expectations. Once they had accomplished this, they were able to let go and distance themselves from an expert stance. This allowed them to recognize the benefits flowing from application of the program's principles, and understand how they could repurpose their expertise for intervention with program participants. Facilitators also came to realize that they had developed strong relationships with the families and better understood the latter's realities. Finally, this article explores the implications of the results, both for practice (in terms of program compliance) and research (in terms of program evaluation).

A systematic review of older adults' request for or attitude toward euthanasia or assisted-suicide.

OBJECTIVES: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, religious, or existential) associated with attitudes toward, wishes and requests for, as well as death by EUT/PAS among individuals aged 60 years and over. METHOD: The search for quantitative studies in PsycINFO and MEDLINE databases was conducted three times from February 2016 until April 2018. Articles of probable relevance (n = 327) were assessed for eligibility. Studies that only presented descriptive data (n = 306) were excluded. RESULTS: This review identified 21 studies with predictive analyses, but in only 4 did older adults face actual end-of-life decisions. Most studies (17) investigated attitudes toward EUT/PAS (9 through hypothetical scenarios). Younger age, lower religiosity, higher education, and higher socio-economic status were the most consistent predictors of endorsement of EUT/PAS. Findings were heterogeneous with regard to physical health, psychological, and social factors. Findings were difficult to compare across studies because of the variety of sample characteristics and outcomes measures. CONCLUSION: Future studies should adopt common and explicit definitions of EUT/PAS, as well as research designs (e.g. mixed longitudinal) that allow for better consideration of personal, social, and cultural factors, and their interplay, on EUT/PAS decisions.