Search

An electronic tool, the Competency Assessment Tool (CAT), was developed in order to guide interdisciplinary teams through clinical competency assessment.Objectives: To support the implementation and perpetuation of the CAT, the objectives were: 1) document health and social service professionals' needs in order to support the use of the CAT; 2) identify the facilitating factors and those hindering the implementation of the CAT in a healthcare establishment; 3) identify strategies favoring the use of the CAT.Participants: Health and social service professionals and doctors were recruited.Methods: A qualitative study was realized by conducting focus groups with health and social service professionals and individual interviews with doctors.Results: The results allowed us to bring to light the CAT's advantages, the issues associated with its implementation (facilitators and obstacles) and the needs to support its use. A number of avenues of intervention were identified and could be put in place to encourage the use of the CAT.Conclusion: This study will support the implementation of the CAT and ultimately, this will allow for the assurance that the decisions taken on the need for protection of vulnerable individuals will be just, rigorous and the fruit of a concerted ethical reflection. [ABSTRACT FROM AUTHOR]

The decision on patients' competency to manage their affairs and take care of themselves requires a rigorous evaluation process and consistency among practice settings. Research indicates there is a lack of resources to guide healthcare and social service professionals in the interprofessional decision-making process that such an evaluation requires. A web-based tool, the Competency Assessment Tool (CAT), was designed to assist professionals in that process. The authors conducted a usability study with a beta version of the CAT. The objectives of this study were to: (1) explore what is needed to support its use in community-based and specialized settings; and (2) identify barriers to and facilitators of implementation. A major concern was the perceived onerous nature of the tool. Participants indicated a need for different versions of the tool, depending on the complexity of the evaluation. They want to be directed to areas in the tool based on their field of expertise and want adjustments to functionalities related to collaborative work. This study highlights the importance of the awareness of User Experience (UX) considerations at the outset of the design process, to limit the impact of required modifications and facilitate implementation in the workplace. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francophone de Recherche en Ergotherapie is the property of Communaute Pour l Avancement de la Recherche Appliquee Francophone en Ergotherapie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo explore the effects of the Personalized Citizen Assistance for Social Participation (APIC), an intervention adapted here for visual impairment, involving weekly stimulation sessions over six to twelve months, provided by trained and supervised attendants, on seven outcomes (social participation, leisure, independence, mobility, quality of life, health-related quality of life, and empowerment) in older adults with visual impairment, and to document its facilitators and barriers.A mixed-method design, which included a pre-experimental and an exploratory qualitative clinical research component, was used on 8 older adults (7 women) with visual impairment aged 70–86, and 8 attendants (5 women) aged 20–74. Before the intervention, directly after, and four months later, older adults completed questionnaires on the 7 outcomes. During the intervention, attendants completed diaries and participated in monthly meetings. Semi-structured interviews were administered to all participants after the intervention.Social participation, leisure, mobility, quality of life and empowerment had increased immediately after the APIC. These improvements were still generally observed four months later. Participants reported that the APIC improved older adults’ capabilities, social participation, and social environment.The APIC is a promising intervention which helps older adults with visual impairment to deal with social restrictions.In older adults, visual impairment has important consequences on active and healthy aging.Personalized citizen assistance for social participation (APIC) is an intervention that aims to foster the social participation.This study shows that APIC adapted to visual impairment influences social participation, leisure, mobility, quality of life and empowerment of older adults with visual impairment.Participants also reported improvements in their capabilities, social participation, and social environment.In older adults, visual impairment has important consequences on active and healthy aging.Personalized citizen assistance for social participation (APIC) is an intervention that aims to foster the social participation.This study shows that APIC adapted to visual impairment influences social participation, leisure, mobility, quality of life and empowerment of older adults with visual impairment.Participants also reported improvements in their capabilities, social participation, and social environment. [ABSTRACT FROM AUTHOR]

Background: The importance of supporting caregivers is recognized in home care for older persons, and facilitating their help-seeking process is a way to meet that need. The use of electronic health (eHealth) is a potentially promising solution to facilitate caregivers' help-seeking process. Objective: The aim of this research was to develop, in partnership with community organizations, health and social service professionals and caregivers, an eHealth tool promoting the earlier identification of needs of older persons and an optimal use of available resources. Methods: To design the tool, 8 co-design sessions (CoDs) were conducted and 3 advisory committees were created (in 11 regions) in Quebec between May 2017 and May 2018. A variety of methods were used, including the sorting method, the use of personas, eHealth tool analysis, brainstorming, sketching, prototyping, and pretesting. Results: A total of 74 co-designers (women n=64 and men n=10) were recruited to participate in the CoDs or the advisory committees. This number allowed for the identification of needs to which the tool must respond and for the identification of its requirements (functionalities and content), as well as for the development of the information architecture. Throughout the study, adjustments were made to the planning of CoD, notably because certain steps required more sessions than expected. Among others, this was true for the identification of functionalities. Conclusions: This study led to the development of an eHealth tool for caregivers of functionally dependent older persons to help them identify their needs and the resources available to meet them. International Registered Report Identifier (IRRID): RR2-10.2196/11634 [ABSTRACT FROM AUTHOR]

Background: It is often only when the initial signs of exhaustion appear that caregivers first may engage in help-seeking behavior, but it is difficult for them to know which is the most appropriate formal service in their situation. Electronic health (eHealth) can support caregivers in keeping the older person they are caring for at home, but few eHealth tools designed for supporting the process of help-seeking by caregivers of functionally impaired older persons have been developed using a co-design approach. Objective: This paper aims to describe the protocol of a project that tries to assist caregivers to target their needs and those of the older person they support early in their help-seeking process, and guide them effectively to the formal service most appropriate for their situation. This project aims to answer the following questions: (1) What type of tool can better support caregivers to identify their needs and those of the older person they are caring for and then refer them to an appropriate formal service? and (2) What information should be found in such a tool? Methods: This study presents a description of the process of an ongoing multicenter research project based on a co-design approach, which includes 3 phases (1) identification of caregivers' needs in terms of tools to support their help-seeking behavior, (2) development of a tool, and (3) evaluation of its usability. Results: The project began in January 2016 with the ethics application for the 3 phases of the project. For phase 1, recruitment began in December 2016 and ended in September 2017. Phase 2 began in the spring of 2017 and ended in June 2018. All the co-design sessions have been completed. Phase 3 of the project will begin in September 2018. Conclusions: Although there are some challenges associated with this type of methodology, the methodology still remains relevant, as it involves future users in the development of a tool, which increases the chances that the tool will meet the users' needs. International Registered Report Identifier (IRRID): DERR1-10.2196/11634 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]

Contexte : Il est reconnu dans les écrits scientifiques que le raisonnement clinique est une compétence importante à acquérir chez les étudiants en sciences de la santé. Toutefois, son enseignement est complexe et c'est souvent lors des stages que les étudiants ont l'occasion d'intégrer cette compétence. Des auteurs soutiennent l'utilisation des technologies de l'information pour favoriser l'apprentissage de cette compétence chez les étudiants en sciences de la santé, car elles permettent de placer l'étudiant face à un plus grand nombre de situations cliniques simulées, mais réalistes Objectifs : Dans le cadre de l'implantation d'un nouveau continuum bac-maîtrise en ergothérapie, un outil pédagogique informatisé, nommé IDÉO, a été conçu pour soutenir l'apprentissage et l'évaluation du raisonnement clinique chez les étudiants Méthode : Cet outil permet aux étudiants de résoudre des cas cliniques authentiques de façon virtuelle Pour bonifier son apport, IDÉO est utilisé conjointement avec différentes modalités pédagogiques (cours magistraux, laboratoires, travail en petits groupes) Par ailleurs, cet outil a été conçu afin que les étudiants puissent s'autoévaluer tout au long de leur progression Ils peuvent alors porter un jugement critique sur leur raisonnement clinique. Enfin, puisqu'il s'agit d'un outil interactif, les enseignants ont accès aux réponses des étudiants, ce qui leur permet de cibler les difficultés de chacun et de leur donner de la rétroaction formative ou sommative, selon le cas Lors de cette communication, cette application pédagogique sera présentée. Nous discuterons plus précisément de son utilité pédagogique et évaluative et les modalités d'utilisation seront aussi abordées. Les avantages et limites de cette méthode pédagogique à la lumière des quatre années d'expérimentation seront aussi abordés Résultats : Depuis son implantation en 2009, cette méthode pédagogique est reconnue, tant par les enseignants que par les cliniciens et les étudiants comme un outil-clé pour permettre l'acquisition du raisonnement clinique par les étudiants. En effet, il a été possible d'observer, lors des évaluations sommatives, que les étudiants exposent leur raisonnement clinique de façon plus rigoureuse et pertinente que les années antérieures. [ABSTRACT FROM AUTHOR]

Les difficultés cognitives consécutives aux troubles neurocognitifs majeurs (TNCM) engendrent des enjeux dans la réalisation d'activités de la vie quotidienne. Ce projet visait à identifier auprès des proches aidants et des intervenants des situations nécessitant des méthodes optimisant l'apprentissage pour faciliter l'engagement de personnes vivant avec un TNCM dans leurs activités de la vie quotidienne. Des entrevues individuelles semi-dirigées, d'une durée de 60 à 90 minutes, ont été menées auprès de proches aidants et d'intervenants. Les résultats montrent que les activités quotidiennes et domestiques sont notamment affectées par les difficultés à repérer ou à utiliser les objets, à garder en tête la tâche en cours, à mettre en séquences des étapes, à ne pas se laisser distraire par autre chose et à constater ses difficultés pour s'y adapter. Les proches aidants souhaitent du soutien dans l'application des méthodes optimisant l'apprentissage pour contribuer au maintien de l'autonomie des personnes vivant avec un TNCM.

This study documented the provision of services and issues experienced by community organizations supporting older adults and caregivers in the province of Quebec during the coronavirus disease (COVID-19) pandemic, as well as promising strategies to adapt the provision of services in this context. A cross-sectional electronic survey using open- and closed-ended questions was conducted in July 2020. Almost three-quarters of the 307 respondents (71.4%) reported having maintained services at least partially throughout the lockdown, and the majority (85.3%) adapted their services. Among key challenges, participants reported difficulties identifying and supporting older adults at greater risk of vulnerability (54.8%), managing health risks for service users (60.2%), and recruiting volunteers (59.5%). Promising strategies included strategies to reach out to older adults and understand their needs (e.g., systematic phone calls) in addition to direct interventions supporting them (e.g., activities promoting social ties); implementing prevention and protection measures; accessing and using technologies; human resources management (e.g., recruiting new volunteers); finding financial support for their organization; developing intersectoral partnerships (e.g., multisectoral crisis cell); and promoting a positive view of older adults. The integration of multiple perspectives from different stakeholders may help identify strategies potentially transferable to other crises in order to meet older adults' needs.

Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.

Introduction: Many occupational therapists contribute to the assessment of competence to take care of oneself and manage one’s affairs, but few guidelines exist regarding this practice with adults who have experienced a traumatic brain injury (TBI)., Purpose: This study explored the ability of the Instrumental Activities of Daily Living Profile (IADL Profile) to capture competence following a TBI., Method: Task performance on the IADL Profile of a 46-year-old man (ML) who was found to be incompetent following a severe TBI was compared to eight control subjects (mean age 49.3 ± 4.2 years). The IADL Profile scores, observable behaviours, and verbalizations were compared using descriptive statistics (M, SD) and qualitative analyses., Results: The independence level of ML was lower than that of the control subjects on seven of the eight tasks of the IADL Profile (p < .05), especially for preparing a hot meal and creating a budget. ML demonstrated difficulties that impacted his performance on many tasks, and he had difficulty critiquing his results., Implications: The IADL Profile could be used as part of a functional assessment to document competence., (© CAOT 2016.)

Western societies currently face the aging of their populations. New challenges are experienced by health professionals who are involved in competency assessment that may necessitate a public guardianship. This assessment is complex and its consequences are significant. The Competency Assessment Tool (CAT) can be used to provide a rigorous, objective and ethical evaluation by an interdisciplinary team. The purpose of this study was to validate the CAT. To do this, a Delphi study was conducted among 33 experts from five professions (social worker, occupational therapist, physician, neuropsychologist and nurse), working in seven administrative regions of Quebec. An expert consensus on the content of the CAT was obtained in the first round of consultation. Thus, this study has validated an assessment and decision-making process (CAT) designed for health and social professionals. This decision model can guide the competency assessment of the ability of persons with cognitive impairment to take care of themselves and to manage their finances. Further studies will be necessary to support use of the CAT in practice.

The accelerated aging of the Canadian population is a recognized fact and leads to an increasing number of seniors with cognitive impairments (Curateur public du Québec, 2010a). This has a definite impact on health professionals who have to assess their competency to live independently and manage their finances. This decision, which has important consequences for the person, must be based on an objective and rigorous assessment. The purpose of this paper is to analyse the available tools, both in the scientific literature and in clinical settings, to better document the various components to assess seniors' competency to live independently and manage their finances. The goal is to help practitioners who work with older people with cognitive impairments to accurately assess their ability to manage themselves and their property. A review of the relevant literature and training available, as well as three group consultations, showed that there is no consensus about the tools used to assess the capacity to take care of oneself and one's property. Additional studies are thus needed to fill the gap in knowledge about specific tools used to assess competency.