Diante do impacto da distribuição do tempo de trabalho da profissional enfermeira na determinação de parâmetros adequados para a operacionalização do processo de dimensionar pessoal de enfermagem, este estudo teve por objetivo identificar e analisar a distribuição do tempo de trabalho das enfermeiras em uma unidade de internação médico-cirúrgica. Trata-se de uma pesquisa de campo, prospectiva, de abordagem quantitativa, do tipo exploratório-descritiva, realizada em um Hospital geral, privado, de grande porte da cidade de São Paulo. Para a consecução dos objetivos da pesquisa considerou-se, como população estatística, as atividades de enfermagem realizadas pelas enfermeiras durante os turnos de trabalho. O tamanho da amostra e o período amostral foram estabelecidos a partir da determinação de critérios relacionados à probabilidade mínima de ocorrência das atividades realizadas pelas enfermeiras, bem como do número de enfermeiras por turno e do intervalo estipulado para a realização das observações das atividades executadas pelas enfermeiras. A identificação das atividades de enfermagem realizadas pelas enfermeiras ocorreu mediante solicitação de que cada enfermeira relacionasse, por escrito, as atividades executadas no cotidiano de trabalho da Unidade, que foram, posteriormente, categorizadas de acordo com um sistema padronizado de linguagem (NIC) e classificadas em intervenções de cuidado direto, intervenções de cuidado indireto, atividades associadas e de tempo pessoal. Os dados foram coletados no período de 15 a 19 de outubro de 2007, por quatro observadoras de campo, contratadas e treinadas especificamente, para a realização deste procedimento. Obteve-se 1032 amostras das atividades realizadas pelas enfermeiras, verificando-se que as intervenções e atividades de enfermagem que mais utilizaram o tempo de trabalho das enfermeiras foram Documentação (18,4%), Tempo Pessoal (17,8%), Supervisão (11,4%), Atividades Associadas (9,7%), Delegação (9,3%), Passagem do Plantão (4,8%), Apoio ao Médico (3,9%) e Cuidados na Admissão (3,1%). Observou-se que 50% do tempo das enfermeiras foram dedicados às intervenções de cuidado indireto, 22% às intervenções de cuidado direto de enfermagem, 18% às atividades de tempo pessoal e 10% às atividades associadas. Estes dados corroboram a indicação de pesquisadores que apontam a necessidade de serem considerados o tempo pessoal dos trabalhadores de enfermagem e a realização das atividades associadas nos métodos de dimensionamento de pessoal preconizados pelos órgãos oficiais. Com este estudo evidenciam-se perspectivas para a realização de novas investigações no sentido de contribuir para o aperfeiçoamento dos parâmetros relacionados à temática dimensionamento de pessoal de enfermagem em instituições hospitalares / The aim of this study was to identify and to analyze the work time distribution of nurses in a medical-surgical unit, considering the impact of the work time distribution of nurses to determine the adequate parameters for the process to measure nursery personnel .This is a prospective, quantitative, exploratory-descriptive type field research, conducted in a large, private, general hospital in the city of São Paulo. The activities performed by nursery personnel during work shifts were considered as statistical population to reach our objectives. Sample size and period were established after determining the criteria related to the minimum occurrence possibility of activities performed by the nurses, as well as the number of nursery personnel per shift and the specific interval to perform activities by the nurses. The identification of the nursing activities occurred by asking each nurse to write a report mentioning their daily activities at the Unit, which were later categorized in accordance with the standard language system (NIC) and classified as direct care and indirect care interventions, associated activities and personal time. Data were collected during the period from the 15th to the 19th of October, 2007, by four field observers, specifically hired and trained for this procedure. 1032 samples were obtained from the nurses\' activities. The nursing activities and interventions that most used work time of the nurses were: Documents (18,4%), Personal Time (17,8%), Supervision (11,4%), Associated Activities (9,7%), Assignment (9,3%), Shift Change (4,8%), Doctor\'s Support (3,9%) and Admission Care (3,1%). It was observed that 50% of the nurses\' time was dedicated to indirect care interventions, 22% to direct care nursing interventions, 18% to personal time activities and 10% to related activities. These data corroborated with the researcher\'s indication that showed the need to consider personal time of the nurse\'s work and the performance of associated activities within the methods of personnel measurement recommended by official institutions. New investigations are needed to contribute to the improvement of the parameters related to the nursing personnel measurement in hospital institutions

Problématique. Basée sur les constats effectués lors d’un essai clinique randomisé qui visait à évaluer les effets du lait maternel de fin d’expression sur la croissance et le développement de nouveau-nés prématurés et qui s’est soldé par un recrutement infructueux, une intervention de soutien à la lactation chez les mères de nouveau-nés prématurés a été développée. La mère d’un nouveau-né prématuré est en effet trois fois plus à risque qu’une autre de présenter une production lactée insuffisante. Il est donc crucial de soutenir ces mères dans l’établissement et le maintien d’une production lactée adéquate. Le but de cette étude pilote est d’estimer les effets d’une intervention de soutien à la lactation sur l’expression de lait maternel et la production lactée de mères ayant donné naissance prématurément ainsi que d’évaluer les aspects d’acceptabilité et de faisabilité de l’intervention, de l’étude et de ses procédures. Hypothèse de recherche. Les mères de nouveau-nés prématurés qui reçoivent une intervention de soutien à la lactation expriment leur lait significativement plus longtemps et plus fréquemment et produisent significativement un plus grand volume de lait à plus grande concentration lipidique sur une base quotidienne que celles qui reçoivent les soins usuels. Méthode. Devis : Projet-pilote de type essai clinique randomisé. Échantillon: Quarante mères de nouveau-nés prématurés de <30 semaines de gestation admis à une unité de soins intensifs néonatals. Procédures: Les mères du groupe témoin reçoivent les soins usuels alors que celles du groupe expérimental reçoivent une intervention de soutien à la lactation. Cette dernière comporte quatre volets: une séance d’enseignement portant sur l’établissement et le maintien d’une production lactée suffisante, un suivi téléphonique, une ligne d’aide téléphonique et le prêt d’un tire-lait électrique double pompage. Dans les deux groupes, les mères sont amenées à tenir un journal de bord de leurs séances d’expression et du volume de lait maternel exprimé. Résultats. L’étude et ses procédures de même que l’intervention de soutien sont acceptables et faisables. Les résultats observés en lien avec l’hypothèse de recherche sont orientés dans la même direction que cette dernière à l’exception de la concentration lipidique du lait maternel. Recommandations. Une étude à plus grande échelle doit être réalisée afin d’évaluer les effets de l’intervention de soutien à la lactation sur la production lactée de mères de nouveau-nés prématurés. Quant à la clinique, des actions concertées doivent être menées afin de créer un contexte propice et des conditions favorables à l’expression de lait maternel chez les mères de nouveau-nés prématurés. / Problem statement. Based on observations from an unsuccessful randomized clinical trial that aimed to evaluate the effects of hindmilk on the short-term growth and development of preterm infants, a lactation support intervention for mothers of preterm infants has been developed. Mothers who give birth prematurely are three times more likely to have an insufficient milk output compared to those who give birth at term. It is therefore crucial to support these mothers in order to facilitate the establishment and maintenance of their milk supply. The aim of this pilot study is to estimate the effects of a lactation support intervention on the expression of breast milk and milk output of mothers who gave birth prematurely and assess the acceptability and feasibility of the intervention, study and its procedures. Research hypothesis. A lactation support intervention in mothers who deliver prematurely enables them to express their milk significantly longer and more frequently, and produce a greater milk output with a higher lipid concentration compared to mothers who deliver prematurely and receive usual care. Method. Design: A pilot study of a randomized clinical trial. Sample: Forty mothers of preterm infants born at <30 weeks of gestation and admitted to a neonatal intensive care unit. Procedures: The mothers in the control group receive usual care while those in the experimental group receive a lactation support intervention. The intervention has four components: an education session on the establishment and maintenance of an adequate milk supply, a telephone follow-up, a telephone helpline and the loan of a double electric breast pump. In both the intervention and control groups, mothers kept a logbook of the frequency, duration and volume of their breast milk expressions. Results. Both the study design and the intervention are feasible and acceptable to mothers of preterm infants. With the exception of milk lipid concentration, the results are oriented in the same direction as the research hypothesis. Recommendations. A larger scale study should be conducted to evaluate the effects of the lactation support intervention on the frequency, duration, and volume of breast milk expression among mothers of premature infants. As for the clinical practice, concerted interprofessional actions must be undertaken to create the environment and conditions conducive to breast milk expression in these mothers.

Diante do impacto da distribuição do tempo de trabalho da profissional enfermeira na determinação de parâmetros adequados para a operacionalização do processo de dimensionar pessoal de enfermagem, este estudo teve por objetivo identificar e analisar a distribuição do tempo de trabalho das enfermeiras em uma unidade de internação médico-cirúrgica. Trata-se de uma pesquisa de campo, prospectiva, de abordagem quantitativa, do tipo exploratório-descritiva, realizada em um Hospital geral, privado, de grande porte da cidade de São Paulo. Para a consecução dos objetivos da pesquisa considerou-se, como população estatística, as atividades de enfermagem realizadas pelas enfermeiras durante os turnos de trabalho. O tamanho da amostra e o período amostral foram estabelecidos a partir da determinação de critérios relacionados à probabilidade mínima de ocorrência das atividades realizadas pelas enfermeiras, bem como do número de enfermeiras por turno e do intervalo estipulado para a realização das observações das atividades executadas pelas enfermeiras. A identificação das atividades de enfermagem realizadas pelas enfermeiras ocorreu mediante solicitação de que cada enfermeira relacionasse, por escrito, as atividades executadas no cotidiano de trabalho da Unidade, que foram, posteriormente, categorizadas de acordo com um sistema padronizado de linguagem (NIC) e classificadas em intervenções de cuidado direto, intervenções de cuidado indireto, atividades associadas e de tempo pessoal. Os dados foram coletados no período de 15 a 19 de outubro de 2007, por quatro observadoras de campo, contratadas e treinadas especificamente, para a realização deste procedimento. Obteve-se 1032 amostras das atividades realizadas pelas enfermeiras, verificando-se que as intervenções e atividades de enfermagem que mais utilizaram o tempo de trabalho das enfermeiras foram Documentação (18,4%), Tempo Pessoal (17,8%), Supervisão (11,4%), Atividades Associadas (9,7%), Delegação (9,3%), Passagem do Plantão (4,8%), Apoio ao Médico (3,9%) e Cuidados na Admissão (3,1%). Observou-se que 50% do tempo das enfermeiras foram dedicados às intervenções de cuidado indireto, 22% às intervenções de cuidado direto de enfermagem, 18% às atividades de tempo pessoal e 10% às atividades associadas. Estes dados corroboram a indicação de pesquisadores que apontam a necessidade de serem considerados o tempo pessoal dos trabalhadores de enfermagem e a realização das atividades associadas nos métodos de dimensionamento de pessoal preconizados pelos órgãos oficiais. Com este estudo evidenciam-se perspectivas para a realização de novas investigações no sentido de contribuir para o aperfeiçoamento dos parâmetros relacionados à temática dimensionamento de pessoal de enfermagem em instituições hospitalares / The aim of this study was to identify and to analyze the work time distribution of nurses in a medical-surgical unit, considering the impact of the work time distribution of nurses to determine the adequate parameters for the process to measure nursery personnel .This is a prospective, quantitative, exploratory-descriptive type field research, conducted in a large, private, general hospital in the city of São Paulo. The activities performed by nursery personnel during work shifts were considered as statistical population to reach our objectives. Sample size and period were established after determining the criteria related to the minimum occurrence possibility of activities performed by the nurses, as well as the number of nursery personnel per shift and the specific interval to perform activities by the nurses. The identification of the nursing activities occurred by asking each nurse to write a report mentioning their daily activities at the Unit, which were later categorized in accordance with the standard language system (NIC) and classified as direct care and indirect care interventions, associated activities and personal time. Data were collected during the period from the 15th to the 19th of October, 2007, by four field observers, specifically hired and trained for this procedure. 1032 samples were obtained from the nurses\' activities. The nursing activities and interventions that most used work time of the nurses were: Documents (18,4%), Personal Time (17,8%), Supervision (11,4%), Associated Activities (9,7%), Assignment (9,3%), Shift Change (4,8%), Doctor\'s Support (3,9%) and Admission Care (3,1%). It was observed that 50% of the nurses\' time was dedicated to indirect care interventions, 22% to direct care nursing interventions, 18% to personal time activities and 10% to related activities. These data corroborated with the researcher\'s indication that showed the need to consider personal time of the nurse\'s work and the performance of associated activities within the methods of personnel measurement recommended by official institutions. New investigations are needed to contribute to the improvement of the parameters related to the nursing personnel measurement in hospital institutions

La phase aiguë de la pandémie de COVID-19 a imposé une réduction des contacts face à face lors des soins traditionnels post-partum. La situation pandémique a alors mis en évidence l’utilisation de la vidéoconférence comme forme de soutien novatrice et complémentaire aux pratiques déjà implantées pour soutenir les femmes allaitantes. Considérant le manque de connaissances quant aux effets de la vidéoconférence sur l’expérience d’allaitement, le but de cette revue rapide était de synthétiser les données probantes sur les effets du soutien à l’allaitement par vidéoconférence lors de la période post-partum à domicile sur l’expérience d’allaitement de mères de nouveau-né à terme. Employant la méthode en sept recommandations d'examen rapide de Cochrane (2021), six études comportant des interventions de vidéoconférence ont été incluses et une seule d’entre elles présente des résultats statistiquement significatifs sur l’intensité des allaitements. Les effets sur l’exclusivité et la durée de l’allaitement lors du soutien par vidéoconférence se sont avérés équivalents aux soins usuels actuellement offerts lors du retour à domicile. Bien que les effets soient comparables au soutien face à face, les taux d’allaitement demeurent inférieurs aux cibles mondiales visées. À la lumière des trois constats découlant de la revue rapide, de futures études pourraient permettre d’explorer les effets d’un soutien proactif par vidéoconférence, et ce, basé sur un cadre théorique. En somme, les résultats obtenus ont permis la formulation de recommandations pour la recherche, la formation et la pratique à dessein de favoriser l’expérience positive d’allaitement et ainsi l’exclusivité, la durée et l’intensité de l’allaitement. / The outbreak of the coronavirus pandemic has imposed a reduction in face-to-face contact during traditional postpartum care. The pandemic situation then highlighted the use of videoconferencing as an innovative form of support and complementary to the practices already established to support breastfeeding women. Considering the lack of knowledge about the effects of videoconferencing on the breastfeeding experience, the aim of the rapid review was to synthesize the evidence on the effects of breastfeeding support by videoconference during the postpartum period to home on the breastfeeding experience of mothers with term newborns. Using the Cochrane (2021) seven-recommendation rapid review method, six studies with videoconferencing interventions were included and only one of these showed statistically significant results on breastfeeding intensity. The effects on the exclusivity and duration of breastfeeding during videoconference support have been shown to be equivalent to the standard care currently offered upon return home. Although the effects are comparable to face-to-face support, breastfeeding rates remain below target global targets. Considering the three findings resulting from the rapid review, future studies could explore the effects of proactive support by videoconference based on a theoretical framework. In sum, the results obtained allowed the formulation of recommendations for research, training, and practice to purposely increase the positive breastfeeding experience and thus the exclusivity, duration, and intensity of breastfeeding.

Au Québec, près de 25 000 personnes, principalement des aînés, sont touchées par la maladie de Parkinson (MP), la majorité étant soignée par leur conjoint. Au stade modéré, la MP altère la santé et la qualité de vie de ces couples. Ce stade est propice à la mise en place d’interventions dyadiques, car les couples expérimentent des pertes croissantes, nécessitant plusieurs ajustements. Néanmoins, aucune étude n’avait encore examiné leurs besoins d’intervention lors de cette transition et peu d’interventions pour les soutenir ont fait l’objet d’études évaluatives. Avec comme cadre de référence la théorie de l’expérience de transition de Meleis et al. (2000) et l’approche systémique de Wright et Leahey (2009), cette étude visait à développer, mettre à l’essai et évaluer une intervention auprès de couples âgés vivant avec la MP au stade modéré. À cette fin, un devis qualitatif et une approche participative ont été privilégiés. L’élaboration et l’évaluation de l’intervention s’appuient sur le cadre méthodologique d’Intervention Mapping de Bartholomew et al. (2006) et sur les écrits de Miles et Huberman (2003). L’étude s’est déroulée dans une clinique ambulatoire spécialisée dans la MP. Dix couples et quatre intervenants ont collaboré à la conceptualisation de l’intervention. Trois nouveaux couples en ont fait l’expérimentation et l’évaluation. L’intervention dyadique compte sept rencontres de 90 minutes, aux deux semaines. Les principaux thèmes, les méthodes et les stratégies d’intervention sont basés sur les besoins et les objectifs des dyades ainsi que sur des théories et des écrits empiriques. L’intervention est orientée vers les préoccupations des dyades, la promotion de la santé, la résolution de problèmes, l’accès aux ressources, la communication et l’ajustement des rôles. Les résultats de l’étude ont montré la faisabilité, l’acceptabilité et l’utilité de l’intervention. Les principales améliorations notées par les dyades sont l’adoption de comportements de santé, la recherche de solutions ajustées aux situations rencontrées et profitables aux deux partenaires, la capacité de faire appel à des services et l’accroissement des sentiments de maîtrise, de soutien mutuel, de plaisir et d’espoir. Cette étude fournit des pistes aux infirmières, engagées dans différents champs de pratique, pour développer et évaluer des interventions dyadiques écologiquement et théoriquement fondées. / In Quebec, nearly 25 000 people are affected by Parkinson’s disease (PD). They are, for the most part, elders cared for by their spouse. At the moderate stage, PD alters the couples health and quality of life. This stage of the illness offers opportunities for dyadic interventions, as these couples experiment growing losses requiring numerous adjustments. Nevertheless, no study had yet explored their intervention needs during this transition and few interventions to support them have been the object of evaluative studies. Based on transition theory by Meleis and colleagues (2000) and on family systems approach by Wright and Leahey (2009), the purpose of this study was to develop, implement and evaluate a dyadic intervention oriented towards elderly couples living with PD at the moderate stage. To achieve this goal, a qualitative design and a participative approach were privileged. The Intervention Mapping framework by Bartholomew and colleagues (2006) and the analytic methods developed by Miles and Huberman (2003) were used to conceptualize and evaluate the intervention. The study took place in an ambulatory clinic specialized in PD. Ten couples and four health professionals collaborated to the intervention development. Three new couples tested and evaluated the intervention. The dyadic intervention consists of seven sessions of 90 minutes, held every second week. The themes of the sessions and the intervention methods and strategies are based on the couples needs and goals, as well as on specific theories and empirical findings. The intervention is oriented towards dyads concerns, health promotion, problem solving, access to resources, communication, and role adjustments. The study results showed the feasibility, the acceptability and the utility of the intervention. The main benefits observed by the dyads are the adoption of health behaviors, the finding of solutions adapted to various situations and favorable to both partners, the skills to get help and services, and the increased feelings of mastery, mutual support, pleasure and hope. This study can illuminate nurses involved in different domains of practice and interested in developing and evaluating dyadic interventions that are ecologically and theoretically based.

Le taux de mortalité chez les patients à risque d’arythmies cardiaques menaçantes à la vie a été considérablement réduit grâce au défibrillateur cardiaque implantable (DCI). Toutefois, des préoccupations uniques face au DCI, y compris les chocs que l’appareil peut déclencher, sont susceptibles de provoquer des symptômes d'anxiété et une limitation perçue des activités chez les porteurs de DCI. Ces réactions émotives et modifications de comportement peuvent affecter l’acceptation du patient envers le DCI. Cette étude pilote randomisée avec groupe contrôle (n=15 /groupe) visait à examiner la faisabilité et l'acceptabilité d'une intervention infirmière individualisée de même que ses effets préliminaires sur l’anxiété, le fonctionnement dans les activités de la vie quotidienne et l’acceptation du DCI auprès de nouveaux porteurs de DCI. L'intervention infirmière, basée sur la théorie du Human Caring et teintée d’une approche cognitive comportementale, ciblait les préoccupations individuelles face au DCI. À partir des préoccupations identifiées, l’infirmière intervenait en mettant l'accent sur les croyances contraignantes du patient, qui pouvaient mener à de l’anxiété et des comportements d'évitement. Après randomisation, les patients du groupe intervention (GI) ont participé à un premier entretien en face-à-face avant le congé hospitalier. Subséquemment, deux entretiens se sont faits par téléphone, à environ 7 et 14 jours suite au congé hospitalier. Les résultats soutiennent la faisabilité et l’acceptabilité du devis de l’étude et de l’intervention évaluée. De plus, ils soulignent le potentiel de l’intervention à diminuer les sentiments anxieux chez les participants du GI. Les résultats de cette étude pilote offrent des pistes de recherches futures et permettront de guider la pratique clinique. / Patients with an implantable cardiac defibrillator (ICD) decrease their risk of mortality related to life threatening arrhythmias. However, multiple concerns about this device exist, including ICD shocks, which may result in increased anxiety and a perceived limitation in performing everyday activities. These emotional reactions and behavioral changes may have a negative impact on the acceptance of the device. The purpose of this randomized pilot study with a group control (n=15 / group), was to verify the feasibility and acceptability of an individualized nursing intervention aiming to decrease anxiety, improve performance in everyday activities and device acceptance in patients with newly implanted ICDs. Based on Human Caring theory and a cognitive behavioral approach, this intervention addressed each patient’s unique concerns. From the identified concerns, the nurse intervened focussing on the patient’s dysfunctional beliefs that can lead to anxiety and avoidance behavior. After randomization, the first encounter for the experimental group (EG) was face-to-face before hospital discharge. Subsequently, two encounters were made via telephone, 7 and 14 days after discharge. The results support the feasibility and acceptability of the study design and the intervention evaluated. In addition, they emphasize the potential of the intervention to reduce symptoms of anxiety among the participants of the EG. The results of this pilot study may provide directions for future research and help guide clinical practice.

No description available.

Le taux de mortalité chez les patients à risque d’arythmies cardiaques menaçantes à la vie a été considérablement réduit grâce au défibrillateur cardiaque implantable (DCI). Toutefois, des préoccupations uniques face au DCI, y compris les chocs que l’appareil peut déclencher, sont susceptibles de provoquer des symptômes d'anxiété et une limitation perçue des activités chez les porteurs de DCI. Ces réactions émotives et modifications de comportement peuvent affecter l’acceptation du patient envers le DCI. Cette étude pilote randomisée avec groupe contrôle (n=15 /groupe) visait à examiner la faisabilité et l'acceptabilité d'une intervention infirmière individualisée de même que ses effets préliminaires sur l’anxiété, le fonctionnement dans les activités de la vie quotidienne et l’acceptation du DCI auprès de nouveaux porteurs de DCI. L'intervention infirmière, basée sur la théorie du Human Caring et teintée d’une approche cognitive comportementale, ciblait les préoccupations individuelles face au DCI. À partir des préoccupations identifiées, l’infirmière intervenait en mettant l'accent sur les croyances contraignantes du patient, qui pouvaient mener à de l’anxiété et des comportements d'évitement. Après randomisation, les patients du groupe intervention (GI) ont participé à un premier entretien en face-à-face avant le congé hospitalier. Subséquemment, deux entretiens se sont faits par téléphone, à environ 7 et 14 jours suite au congé hospitalier. Les résultats soutiennent la faisabilité et l’acceptabilité du devis de l’étude et de l’intervention évaluée. De plus, ils soulignent le potentiel de l’intervention à diminuer les sentiments anxieux chez les participants du GI. Les résultats de cette étude pilote offrent des pistes de recherches futures et permettront de guider la pratique clinique. / Patients with an implantable cardiac defibrillator (ICD) decrease their risk of mortality related to life threatening arrhythmias. However, multiple concerns about this device exist, including ICD shocks, which may result in increased anxiety and a perceived limitation in performing everyday activities. These emotional reactions and behavioral changes may have a negative impact on the acceptance of the device. The purpose of this randomized pilot study with a group control (n=15 / group), was to verify the feasibility and acceptability of an individualized nursing intervention aiming to decrease anxiety, improve performance in everyday activities and device acceptance in patients with newly implanted ICDs. Based on Human Caring theory and a cognitive behavioral approach, this intervention addressed each patient’s unique concerns. From the identified concerns, the nurse intervened focussing on the patient’s dysfunctional beliefs that can lead to anxiety and avoidance behavior. After randomization, the first encounter for the experimental group (EG) was face-to-face before hospital discharge. Subsequently, two encounters were made via telephone, 7 and 14 days after discharge. The results support the feasibility and acceptability of the study design and the intervention evaluated. In addition, they emphasize the potential of the intervention to reduce symptoms of anxiety among the participants of the EG. The results of this pilot study may provide directions for future research and help guide clinical practice.

Au Québec, près de 25 000 personnes, principalement des aînés, sont touchées par la maladie de Parkinson (MP), la majorité étant soignée par leur conjoint. Au stade modéré, la MP altère la santé et la qualité de vie de ces couples. Ce stade est propice à la mise en place d’interventions dyadiques, car les couples expérimentent des pertes croissantes, nécessitant plusieurs ajustements. Néanmoins, aucune étude n’avait encore examiné leurs besoins d’intervention lors de cette transition et peu d’interventions pour les soutenir ont fait l’objet d’études évaluatives. Avec comme cadre de référence la théorie de l’expérience de transition de Meleis et al. (2000) et l’approche systémique de Wright et Leahey (2009), cette étude visait à développer, mettre à l’essai et évaluer une intervention auprès de couples âgés vivant avec la MP au stade modéré. À cette fin, un devis qualitatif et une approche participative ont été privilégiés. L’élaboration et l’évaluation de l’intervention s’appuient sur le cadre méthodologique d’Intervention Mapping de Bartholomew et al. (2006) et sur les écrits de Miles et Huberman (2003). L’étude s’est déroulée dans une clinique ambulatoire spécialisée dans la MP. Dix couples et quatre intervenants ont collaboré à la conceptualisation de l’intervention. Trois nouveaux couples en ont fait l’expérimentation et l’évaluation. L’intervention dyadique compte sept rencontres de 90 minutes, aux deux semaines. Les principaux thèmes, les méthodes et les stratégies d’intervention sont basés sur les besoins et les objectifs des dyades ainsi que sur des théories et des écrits empiriques. L’intervention est orientée vers les préoccupations des dyades, la promotion de la santé, la résolution de problèmes, l’accès aux ressources, la communication et l’ajustement des rôles. Les résultats de l’étude ont montré la faisabilité, l’acceptabilité et l’utilité de l’intervention. Les principales améliorations notées par les dyades sont l’adoption de comportements de santé, la recherche de solutions ajustées aux situations rencontrées et profitables aux deux partenaires, la capacité de faire appel à des services et l’accroissement des sentiments de maîtrise, de soutien mutuel, de plaisir et d’espoir. Cette étude fournit des pistes aux infirmières, engagées dans différents champs de pratique, pour développer et évaluer des interventions dyadiques écologiquement et théoriquement fondées. / In Quebec, nearly 25 000 people are affected by Parkinson’s disease (PD). They are, for the most part, elders cared for by their spouse. At the moderate stage, PD alters the couples health and quality of life. This stage of the illness offers opportunities for dyadic interventions, as these couples experiment growing losses requiring numerous adjustments. Nevertheless, no study had yet explored their intervention needs during this transition and few interventions to support them have been the object of evaluative studies. Based on transition theory by Meleis and colleagues (2000) and on family systems approach by Wright and Leahey (2009), the purpose of this study was to develop, implement and evaluate a dyadic intervention oriented towards elderly couples living with PD at the moderate stage. To achieve this goal, a qualitative design and a participative approach were privileged. The Intervention Mapping framework by Bartholomew and colleagues (2006) and the analytic methods developed by Miles and Huberman (2003) were used to conceptualize and evaluate the intervention. The study took place in an ambulatory clinic specialized in PD. Ten couples and four health professionals collaborated to the intervention development. Three new couples tested and evaluated the intervention. The dyadic intervention consists of seven sessions of 90 minutes, held every second week. The themes of the sessions and the intervention methods and strategies are based on the couples needs and goals, as well as on specific theories and empirical findings. The intervention is oriented towards dyads concerns, health promotion, problem solving, access to resources, communication, and role adjustments. The study results showed the feasibility, the acceptability and the utility of the intervention. The main benefits observed by the dyads are the adoption of health behaviors, the finding of solutions adapted to various situations and favorable to both partners, the skills to get help and services, and the increased feelings of mastery, mutual support, pleasure and hope. This study can illuminate nurses involved in different domains of practice and interested in developing and evaluating dyadic interventions that are ecologically and theoretically based.

No description available.