Analysis of communication and logistic processes in neonatal intensive care unit.

BACKGROUND: In neonatology, parents play a central role as guarantors of the new-born's autonomy. Notifying parents about their infant's status in neonatal critical care is an integral part of the care. However, conveying this information can be very difficult for physicians and the neonatal medical team. The objective of this work is to assess the dimensions and dynamic processes of critical care communications in neonatal intensive care in order to enhance the development of theoretical and applied knowledge of these discussions. METHODS: This qualitative, descriptive study was conducted on critical care new-borns less than 28 days-old who were hospitalized in a neonatal intensive care unit. Verbatim communications with the parents were recorded using a dictaphone. RESULTS: The verbatim information had five themes: (a) critical care, (b) establishing the doctor-patient relationship, (c) assistance in decision making, (d) Socio-affective and (e) socio-symbolic dimensions. Our recordings underscored both the necessity of communication skills and the obligation to communicate effectively. Analysis of the dynamics of the communication process, according to the categories of delivering difficult information, showed few significant differences. CONCLUSION: Physician training needs to include how to effectively communicate to parents to optimize their participation and cooperation in managing their care.

Les soignants de périnatalité face à la COVID-19 : stress, qualité de vie et préoccupations Perinatal caregivers coping with covid-19 : stress, quality of life and concerns.

AIMS: The first wave of the COVID-19 pandemic generated "risks" and uncertainties as well as organizational changes among French perinatal caregivers. Our study aimed to investigate the psychosocial impact of the first wave on this population. METHOD: Our participants (N=565) were invited to answer an online questionnaire that included questions on various indices of health and quality of life at work (e.g., ProQoL, perceived stress) and other questions on the impact of the pandemic on work organization. An open-ended question was designed to identify the participants' three most frequently perceived preoccupations with regard to the health situation. RESULTS: In addition to highlighting the multifactorial nature of participants' preoccupations, our results illustrated the effect of professional status and type of motherhood on the different indices of health and quality of life at work. When it was found that the pandemic had an impact on work organization and on teams, lower health and quality of work life scores were recorded. On the other hand, when positive impacts on organization were reported, mainly in terms of reduced work intensity, they were associated with higher health and quality of work life scores. CONCLUSION: We explain this last result as either one actual effect of the pandemic on work organization, or as a phenomenon of cognitive rationalization.

Assessment of illness representations in mental disorders: A mini review.

Health beliefs, and especially illness representations, have been widely used to understand clinical outcomes and psychosocial adjustment in people with physical diseases. However, this area of research has been under-explored in the field of mental health, and the few studies that have been conducted have used very different methods. Therefore, the aim of our study was to identify the tools and methods that have been used to evaluate illness representations in psychiatry. To this end, a mini review has been conducted and 58 articles were retained. This mini review highlights that the quantitative method is the most used, and that the scales mobilised are often adapted for the study, but not validated. Indeed, multiple modifications and adaptations have been made by the authors (e.g. deletion of subscales, addition of items), which lead to questions about the reliability of what is measured. In the future, it is essential to have a validated generic tool for mental disorders, which could be based on the Illness perceptions questionnaire for schizophrenia.

[Social representations of public health among healthcare workers within the French Armed Forces]. / Les représentations sociales de la santé publique chez les professionnels de santé dans les armées françaises.

BACKGROUND: Public health is a multidisciplinary activity whose fields of action are acquiring an increasingly broad. The Service de santé des armées (SSA) has always had a culture of public health problems thanks to doctors specialized in the treatment of major diseases. Often involved in public health activities, health professionals nevertheless have a fragmented vision. The objective was to describe the social representations of public health of military healthcare workers. METHOD: The responders were doctors, nurses, veterinarians and pharmacists practicing in different areas of SSA (caregivers, administrators, policy makers) and were interviewed by telephone. A question of spontaneous evocation on the representations of public health in the army was asked. The overall lexical analysis was performed according to the method of rank-frequency. Categorical analysis was conducted to better understand the whole lexical field use. RESULTS: There were 90 responders. The most salient terms were "prevention, epidemiological surveillance and vaccination". The categorical analysis showed that doctors used a lexical field primarily focused on diseases and risk behaviors, nurses on the specifics of military surveillance and policy makers about the cross-discipline. CONCLUSION: Public health in the army is mainly represented by epidemiological surveillance and prevention. Given the non-mentioned fields, a strengthening of communication on the current challenges of public health would probably improve adherence of healthcare professionals since public health takes on more and more importance in the development of the national health policy and management of health crises.

Communication, information, and the parent-caregiver relationship in neonatal intensive care units: A review of the literature.

This literature review focuses on the neonatal context. It provides an update of knowledge on the psychosocial consequences and communication needs expressed by parents. It highlights the obstacles to communication and proposes lines of thought for the development of new training systems to improve the communication practices of caregivers. OBJECTIVE: This review aims to assess and categorize the specific needs and expectations of families in terms of communication within the neonatal intensive care unit (NICU). METHODS: A bibliographic search was carried out on the Web of Sciences, PubMed and PsycArticles databases with the following keywords: "neonat* AND new* AND communication AND parent*". RESULTS: In total, 16 papers were selected showing that information and communication are particular needs for parents in NICUs. They are confronted with a stressful situation and have to deal with the fear and anticipation of the situation in a context of uncertainty. Parents are satisfied with the caregiver-parent relationship when the type of communication is adapted to the context and to their changing needs. Conversely, they feel excluded when they cannot be involved as they would like to be in the care or in the decision-making process. CONCLUSION: The development of new communication training methods and tools such as simulation would allow healthcare workers to acquire new communication skills focused on the needs of families.

Ten steps towards a safe and feasible total laparoscopic hysterectomy.

OBJECTIVE: To contribute to the training of specialists by describing in a systematic and detailed way the ten steps to perform a safe and feasible Total Laparoscopic Hysterectomy (HTL). METHOD: The detailed description of the steps of the HTL intends that this procedure can be safely and effectively reproduced. RESULTS: By clearly knowing the steps of HTL, it is possible to favor minimally invasive routes so that patients benefit from its multiple proven benefits. CONCLUSIONS: The benefits of minimally invasive routes for performing a hysterectomy have already been demonstrated in the literature. It is particularly important that specialists are familiar with these techniques and that groups standardize the procedure so that more patients can safely undergo and benefit from the laparoscopic approach.

OBJETIVO: Contribuir a la formación de los especialistas describiendo de manera sistemática y pormenorizada los diez pasos para realizar una histerectomía total por laparoscopia (HTL) segura y reproducible. MÉTODO: La descripción detallada de los pasos de la HTL pretende que este procedimiento pueda ser reproducido de manera segura y efectiva. RESULTADOS: Al conocer claramente los pasos de la HTL es posible favorecer las rutas de mínima invasión para que las pacientes se beneficien de sus múltiples beneficios demostrados. CONCLUSIONES: Los beneficios de las rutas mínimamente invasivas para la realización de una histerectomía ya han sido demostrados en la literatura. En muy importante que los especialistas estén familiarizados con estas técnicas y que los grupos estandaricen el procedimiento para que más pacientes puedan ser intervenidas de manera segura y se beneficien de la vía laparoscópica.

Understanding breastfeeding behavior: rates and shifts in patterns in Québec.

The study objective was to measure breastfeeding rates and patterns in the Montérégie region of Québec. A survey of 632 mothers of 6-month-old infants was performed, of which 80% initiated breastfeeding, and 68% exclusively breastfed at birth. Breastfeeding rates progressively decreased with time: 63%, 56%, 51%, 44%, 39%, and 32% of mothers breastfed at 1, 2, 3, 4, 5, and 6 months, respectively. Among mothers breastfeeding at a given period, 62%, 57%, 48%, 35%, and 10% of women exclusively breastfed since birth for 1, 2, 3, 4, and 5 months, respectively. Exclusive breastfeeding for 6 months among the 200 women still breastfeeding was practically nonexistent. Introduction of nonhuman milk or solids was primarily responsible for the shift in patterns from exclusive to complementary feeding without passing through predominant breastfeeding. These findings confirm the need to prioritize effective hospital-based and community-based interventions to increase breastfeeding duration and exclusivity in the region.

[Social representations of contention in children: of the viewpoint of pediatric professionals]. / Représentations sociales de la contention en pédiatrie: regards de professionnels.

AIMS: This study is part of a current context raising questions on restraint practices in healthcare at the national and international level. It examines how social representations of restraint organize and shape the discourse of professionals within the context of healthcare and support for sick and/or disabled children. The main objective was to understand how these social representations were expressed in restraint practices. POPULATION AND METHODS: A qualitative method using semi-structured interviews was chosen to meet the goals set out. The research was conducted with 15 healthcare professionals in pediatrics, infant intensive care, and neurorespiratory rehabilitation at Raymond Poincaré Hospital. The data were processed using a content analysis of the thematic type. RESULTS: The results suggest that social representations particularly affect the experience of these professionals and the representations they may have concerning the experience of children, parents, and the role played by the latter in restraint situations. They also show that restraint is a multidimensional object that is difficult to understand, particularly because of the current context of questioning this practice within pediatric departments. CONCLUSION: Despite certain methodological limitations, this study has contributed to a reflective process around restraint practices within a psychosocial approach of understanding the subject and its issues.

[Study of the social representations of drugs and cannabis: motivation for prevention]. / L'étude des représentations sociales de la drogue et du cannabis: un enjeu pour la prévention.

Drugs and cannabis are two complex, multifaceted social objects. Two exploratory research projects were conducted from semi-directive interviews (n = 50) and questionnaires (n = 300) in order to investigate the social representations contained in these two objects according to both the social characteristics of individuals (gender, age) and their proximity to cannabis (consumption versus non-consumption). The study of their representations allows for emphasis to be placed upon the socio-cognitive reconstruction that individuals maneuver, reconstruction largely influenced by the social insertion of individuals but also by their method of cannabis consumption. Knowledge of these representations seems to be a tool for understanding the often complex realities linked to the world of drugs and allows for reflection upon more adapted prevention methods.

[Practice of trauma and emergency units in delivering care to youth who attempt suicide--experiences from Provence]. / Pratiques de prise en charge des jeunes suicidants en Provence-Alpes-Côte d'Azur.

Suicide attempts (SA) represent a significant public health problem and raise questions wih respect to the best, most appropriate methods for triage and the delivery of care. A prospective investigation to evaluate the quality of SA health care was carried out over a three month period within 18 hospitals having an emergency care unit. A total of 393 youth having attempted suicide were triaged and treated by these establishments during the period of the survey, with a large majority of them being girls (77%). Medicinal intoxication was the most often used method (85.1%). The criteria and regulations relating to the initial health care provided upon the patient's arrival were most followed, contrary to those concerning hospitalisation modalities and preparation for release following treatment. Factors explaining the implementation of these criteria were related to the type of emergency unit, the presence of a mental disorder and the duration of the patient's hospitalisation. These results show that several aspects of health care provided to young suicide attempters should be improved in Provence.

[Social representations of cancer and chemotherapy: some stakes to define the therapeutic situation]. / Représentations sociales du cancer et de la chimiothérapie: enjeux pour la définition de la situation thérapeutique.

This research studies social representations of cancer and chemotherapy with patients (N = 62) and of oncologists (N = 26) in a medical oncology unit. The collection of the data was made from free association tasks (concerning cancer and chemotherapy) and attitude questions concerning chemotherapy. Patients also had to produce representations "for" oncologists and conversely. Results indicate a variety of representations marked by the status of sample (patients versus oncologists). The stressful component of the disease is very present. Contrary to the patients, oncologists seize relatively well the representation, which the patients have of concerning cancer and chemotherapy. Patients' representations are connected with phenomena of belief that give evidence for some process of anticipation and expectation linked to the experience of illness and testify the emotional charge related to it. The study of the representations is particularly relevant to highlight the psychosocial stakes associated with the therapeutic situation.