Les personnes incarcérées présentent plus de problèmes de santé mentale que la population générale. L’environnement carcéral en soi peut provoquer des troubles mentaux et un haut niveau de stress mais, pour beaucoup de détenus, les troubles mentaux étaient préexistants à l’incarcération. Actuellement, les soins dispensés dans les prisons sont au centre d’enjeux sociopolitiques importants, ils représentent une opportunité d’améliorer la santé mentale des personnes incarcérées. Le but de cette étude est de constater la santé mentale des personnes incarcérées ainsi que leur perception du stress et d’explorer les relations entre leur santé mentale, leur perception du stress et leurs caractéristiques sociodémographiques. Cette étude descriptive exploratoire a inclus 40 personnes incarcérées en détention avant jugement dans une prison préventive de Suisse selon une méthode d’échantillonnage non probabiliste par convenance. Les trois instruments utilisés afin de collecter les données sont l’échelle HoNOS-Secure-F, l’échelle du stress perçu et un questionnaire sociodémographique. Les résultats montrent que les domaines obtenant les scores les plus élevés au niveau de la santé mentale concernent les problèmes sociaux et les troubles du comportement. Les détenus présentant la plus mauvaise santé mentale sont incarcérés pour des délits relatifs aux mœurs. Les détenus souffrant d’antécédents psychiatriques présentent plus de problèmes sociaux durant leur détention. Les détenus souffrant de troubles liés à la consommation de substances ainsi que de troubles cognitifs ont la fréquence la plus élevée d’incarcérations. Dans cette étude, la santé mentale est associée de manière statistiquement significative avec le stress perçu. Les résultats de cette étude, discutés d’après le modèle conceptuel pour la promotion de la santé mentale et la prévention des troubles mentaux permettent de constater que les personnes incarcérées présentent un cumul de facteurs de risque pour la santé mentale, alors que les facteurs protecteurs de la santé mentale sont peu présents en milieu carcéral.

The purpose of this study was to identify the self-report physical activity (PA) tool best suited for assessment of PA in community-dwelling older adults with multiple chronic conditions (MCC). PA can positively influence physical and psychological health in this population. Although self-report PA tools exist, little is known about the psychometric properties and feasibility of using these tools in older adults with MCC. A systematic literature review from 2000 to 2018 was conducted of studies reporting on the psychometric properties and feasibility of 18 self-report PA tools for community-dwelling older adults (≥ 65 years) to determine the suitability of these tools for use in older adults with MCC. Based on an assessment of the available evidence for the psychometric properties and feasibility of 18 different self-report PA tools, the Physical Activity Assessment Scale for the Elderly (PASE) is recommended as the best-suited self-report PA tool for older adults with MCC.

The prevention and management of dementia in Canada is at a crossroads. Despite the low diagnosis rates, the number of persons living with dementia continues to increase. Yet, Canada’s health care policies have resulted in more people living with dementia living at home, and with most of their care being provided by family, friends, and significant others. This Policy Note provides an overview of a joint submission from the Canadian Gerontological Nursing Association (CGNA) and the Registered Nurses’ Association of Ontario (RNAO) to the Standing Senate Committee on Social Affairs, Science, and Technology. This article outlines the background and recommendations in five key areas of dementia care in Canada: health system resources, education and training of health providers, housing, care partners, and the integration of health and social supports. Based on these five key areas, a number of health and social policy interventions are discussed.

Hospitalized older adults are at high risk of falling. The HELPER system is a ceiling-mounted fall detection system that sends an alert to a smartphone when a fall is detected. This article describes the performance of the HELPER system, which was pilot tested in a geriatric mental health hospital. The system’s accuracy in detecting falls was measured against the hospital records documenting falls. Following the pilot test, nurses were interviewed regarding their perceptions of this technology. In this study, the HELPER system missed one documented fall but detected four falls that were not documented. Although sensitivity (.80) of the system was high, numerous false alarms brought down positive predictive value (.01). Interviews with nurses provided valuable insights based on the operation of the technology in a real environment; these and other lessons learned will be particularly valuable to engineers developing this and other health and social care technologies.

For the past 10 years, in long-term care systems, we have witnessed the accelerated deployment of casemix management systems. A casemix is formed by clusters, defined by individual characteristics that explain similar resource use. However, certain questions regarding the development of these systems must be raised. Moreover, none of these systems was developed in the context of an integrated care organization that can track the progress of a dependent elderly person through every kind of care arrangement available—from own home, through intermediate facility, to long-term care institution. This article emphasizes the necessity of being well informed about the features of existing systems, in order to choose or develop the system that best answers the goals of a particular health care system. Finally, it underlines important elements that should be considered in each step of the development of a casemix system in this context.

D’ici à 2038, le nombre d’heures de soins non rémunérées aux aînés offert par les membres de la famille devraient tripler. Les membres des familles sont souvent suppliés d’aider dans le processus parce que vivre avec la démence peut inhiber la capacité pour prendre une décision. Cette étude ethnographique a soumis les relations au sein de soins de la démence à domicile à un examen critique par le biais des entrevues face-à-face et les observations des participants des clients, des aidants naturels et des prestataires de soins à domicile. Les résultats ont révélé comment les décisions sont imposées dans le contexte du système de soins à domicile formels, et ont mis en évidence trois thèmes: (1) L’accommodation de la compétence/incompétence, comme définie cliniquement; (2) La prise de décisions inopportunes; et (3) Le renforcement de l’exclusion des déments dans la prise de décision. Ces thèmes illuminent la façon dont les valeurs culturelles (la compétence), les croyances (l’immuabilité du système) et les pratiques (le réglage des décisions) dans le système de soins à domicile sont finalement déterministes dans la prise de décisions pour les déments et leurs aidants. Afin d’optimiser la santé des déments qui se font soignés à domicile, il faut accorder d’attention supplémentaire aux pratiques collaboratives et inclusives des membres des familles.

Using the 2002 Aging and Social Support Survey (GSS16), multinomial logit regression, and cohort-component projection techniques, this study explored how social support networks, health, and economic characteristics have shaped the residential choices of older Canadians, and predicts how they are likely to do so in the future. It focused on the distribution of 55-to-75-year-olds across three private-dwelling types: general community living, age-restricted housing, and age-restricted housing with nursing care. The analysis shows that social support characteristics are the strongest predictors of dwelling type, meaning that individuals appear to choose their dwellings largely on the basis of their social needs and wants, rather than on their economic or health characteristics. The analysis also indicates an increased age-specific demand for all dwelling types in the future, but with a reduction of over 2 million older Canadians living in dwellings in the general community between 2002 and 2022.

Although the experiences of formal and informal caregiving have been discussed and debated in the literature, more is assumed than is actually known (McDaniel & Gee, 1993). This qualitative study explored both informal and formal caregivers' perceptions of their own caregiving and the views of each other's caregiving. Information was collected through the use of in-depth interviews with 23 family caregivers and 15 nurses providing home care to older persons. Analysis of interview transcripts and field notes reveals that both informal and formal caregivers engage in all facets of caring work – physical, intellectual and emotional care – but that they carry out this work in varying degrees, and for different reasons. The reasons given for these differences, namely the nurses' professional knowledge and higher status designation, are key elements that define the boundaries between professional and family caregiving. However, it is apparent that, over time, this demarcation diminishes as family caregivers' knowledge and skill match those of health professionals. Study findings point to implications for future theory development and research.

The objective of this study was to explore the way in which relationships develop between family members and staff working in long-term care facilities. In-depth, qualitative interviews were conducted with 17 registered nurses. Data were analysed inductively using the constant comparative method. Findings showed that RNs perceive their relationships with families to develop in four stages: the “initial greeting,” sizing up,” “making a tentative decision,” and “reaching a final decision”. Several contextual factors were associated with the way in which relationships developed, including structural factors, family recognition of staff efforts, open communication, and professional identity. Findings suggest that relationships can best be understood from an interpretive perspective and that an analysis of family-staff relationships should consider the influence of social power.