[Meleis theory: a tool for better understanding city-hospital transitions]. / La théorie de Meleis : un outil pour mieux comprendre les transitions ville-hôpital.

Meleis' theory: a tool for better understanding the hospital/town transitions. The purpose of this article is to provide a critique of the transition theory conceptualized by Afaf Meleis. A clinical vignette is used to highlight the strengths and limitations of the theory in the care of elderly people returning home after hospitalization for heart failure. The discussion is based on Peggy Chinn and Maeona Kramer's method of critical analysis.

Transition from driving to driving-cessation: experience of older persons and caregivers: a descriptive qualitative design.

BACKGROUND: For some older persons, driving is essential to maintain their daily activities and engagement with society. Unfortunately, some will have to stop driving, as they age. Driving-cessation is an important transition for older persons and caregivers, well known to cause significant challenges and consequences. This study aimed to describe the experience of older persons and caregivers in the transition from driving to ceasing to drive. METHODS: Within a descriptive qualitative design, semi-structured interviews were undertaken with older persons (n = 8) and caregivers (n = 6) from the city of Québec (Quebec, Canada), from November 2020 to March 2021. Using an inductive approach, the qualitative data was analyzed with the content analysis method. RESULTS: Some older persons had never thought they might someday lose their driver's license. The process of legislative assessment was unknown by almost all older persons and caregivers. The process was therefore very stressful for the research participants. Driving-cessation is a difficult transition that is associated with loss of independence, freedom, spontaneity, and autonomy. Qualitative analysis of data showed different factors that positively or negatively influence the experience of ceasing to drive, such as the older person's ownership of the decision, the presence of a network of friends and family, and self-criticism. There was significant impact related to driving-cessation for caregivers, such as assuming the entire burden of travel, psychologically supporting older persons in their grief, and navigating the driver's licensing system. CONCLUSIONS: These study results could help organizations and healthcare professionals to better accompany and support older drivers and caregivers in the transition from driving to driving-cessation. TRIAL REGISTRATION: None.

Road safety of older drivers and the nursing profession: A scoping review.

BACKGROUND: Population ageing will lead to an increase in the number of older drivers. The ageing process can affect older adults' driving ability. Nurses can play a major role in identifying potentially at-risk drivers and providing guidance about driving safety and cessation, but their role remains somewhat unknown. OBJECTIVE: This scoping review aims to present the scientific literature in relation to the nursing profession in the field of road safety. DESIGN: CINAHL and PubMed databases were used to identify quantitative, qualitative, mixed methods or clinical practice guideline articles that referred to the role of nurses in older people's road safety and were published in English or French languages between January 1990 and August 2020. Ten (10) articles met the inclusion criteria and were analysed. RESULTS: Analysis of included articles revealed one main theme: Nurses' and NPs' roles in the mobility continuum. Results showed that nurses and nurse practitioners (NPs) often see older drivers in their clinical practice and that they have the competencies to screen and assess their fitness to drive. They are well positioned to discuss age-related changes, fitness to drive and a driving retirement plan with their older patients, but they are not confident when addressing this issue. Few older adults have discussed their driving abilities with healthcare professionals, but they would be willing to discuss this if the subject were brought up. CONCLUSIONS: This scoping review highlighted the paucity of research addressing the role of the nurse in road safety. More research is needed to adequately document this role.

Fondamentaux des soins : un cadre et un processus pratique pour répondre aux besoins physiques, psychosociaux et relationnels des personnes soignées.

Since 2008, an international group has been helping to promote a better response to the fundamental needs of individuals receiving care. This group provides a framework on the fundamentals of care that focuses on the relationship between the nurse, the individual being cared for, and his or her relatives, as well as on the response to the patient’s physical, psychosocial, and relational needs. A practice process supports the concrete application of this framework. The purpose of this discursive article is to present the French translation of the Fundamentals of Care Framework and its Practice Process. To begin with, the translation process will be briefly explained. Next, the Fundamentals of Care Framework and the stages in its Practice Process will be presented. To help the reader better understand the proposal, a clinical illustration will be used to present the situation of Mr. Perron, who is living with Alzheimer’s disease, and his spouse, who is his family caregiver. Finally, the article discusses the usefulness of the Fundamentals of Care Framework and its Practice Process in terms of the four main areas of the discipline of nursing : practice, management, training, and research. This article paves the way for the development of knowledge on the fundamentals of care in the French-speaking world.

Finding the fundamental needs behind resistance to care: Using the Fundamentals of Care Practice Process.

A person living with Alzheimer's disease (PA) can experience difficulty during bodily care and therefore may show resistance to care behaviours (RTCBs). Nurses must take a clinical approach to planning care that meets the person's needs. Therefore, it is necessary to identify training strategies for bedside nurses and nursing students. AIMS AND OBJECTIVES: To describe and discuss how the FOC practice process (FOC-PP) can help nurses understand PAs who show RTCBs during bodily care. BACKGROUND: Resistance to care behaviour phenomenon and the importance of bodily care as fundamental care are described. The FOC-PP enables nurses to apply the FOC framework in their practice. DESIGN: This discursive paper is based on the literature of the FOC framework and PP. METHOD: A clinical scenario that develops through the five stages of the FOC-PP. RESULTS: The scenario centres on Mrs. Emily Morgan, 81, who lives in a nursing home and is not receiving the bodily care that she needs. Camille, a nursing student, and her supervisor Florence collaborate with Mrs. Morgan's family to improve the quality of her care. Three particular aspects of nursing practice based on the FOC-PP are described: the critical thinking process, relational process and pedagogical process. CONCLUSION: The FOC-PP promotes holistic care centred on the person and his or her needs and encourages the nurse to use his or her skills and knowledge. All these dimensions are fundamental for high-quality nursing care. RELEVANCE TO CLINICAL PRACTICE: Mrs. Morgan's scenario enables us to perceive that the FOC-PP is very useful for nursing students and bedside nurses. However, given the amount of specific and diverse knowledge required by the FOC-PP, it is necessary to identify avenues for teaching them. Using clinical scenarios could facilitate the integration of the FOC-PP, with taking into account the specific characteristics of individual clients.

Design factors influencing performance of constrained acetabular liners: finite element characterization.

Constrained acetabular liners are utilized to deal with the infrequent but devastating problem of recurrent dislocation. While an encouraging treatment of last resort, the clinical performance of contemporary constrained liners has been somewhat mixed. There are multiple factors contributing to this variability, one of which is the limited understanding of the intrinsic mechanical characteristics of these specialty devices. To address this issue, a three-dimensional, materially nonlinear, multi-surface contact finite element model of a representative constrained liner was created. The model was physically validated, and then used for parametric testing to explore the effects of individual design features. The model was exercised for both intra-operative assembly and lever-out dislocation. It was found that the coefficient of friction between the femoral head and the liner substantially affected both the force required to seat the femoral head into the liner during assembly, and the peak moment resisting dislocation (226% increase in assembly force for friction coefficients of 0.2 versus 0.0; 49% reduction in dislocation moment for friction coefficients of 0.013 versus 0.135). As expected, the cup opening radius also had a dominant effect on both maneuvers: decreasing the opening radius from 13.9 to 13.6 mm increased assembly force by 506 N and increased the dislocation moment by over 3.5 N-m, whereas the influence of other design parameters was much more modest.