Lise Fillion - Academia.edu (original) (raw)
Papers by Lise Fillion
BACKGROUND Little research has been done on pain assessment in critical care, especially in patie... more BACKGROUND Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally. • OBJECTIVES To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain indicators used for pain reassessment by nurses to verify the effectiveness of pain management in patients who are intubated. • METHODS Medical files from 2 specialized healthcare centers in Quebec City, Quebec, were reviewed. A data collection instrument based on Melzack's theory was developed from existing tools. Pain-related indicators were clustered into nonobservable/subjective (patients' self-reports of pain) and observable/ objective (physiological and behavioral) categories. • RESULTS A total of 183 pain episodes in 52 patients who received mechanical ventilation were analyzed. Observable indicators were recorded 97% of the time. Patients' self-reports of pain were recorded only 29% of the time, a practice contradictory to recommendations for pain assessment. Pharmacological interventions were used more often (89% of the time) than nonpharmacological interventions (<25%) for managing pain. Almost 40% of the time, pain was not reassessed after an intervention. For reassessments, observable indicators were recorded 66% of the time; patients self-reports were recorded only 8% of the time. • CONCLUSIONS Pain documentation in medical files is incomplete or inadequate. The lack of a pain assessment tool may contribute to this situation. Research is still needed in the development of tools to enhance pain assessment in critically ill intubated patients.
Journal of Pain and Symptom Management, 2009
A repeated measure design was used to evaluate additional psychometric qualities (sensitivity and... more A repeated measure design was used to evaluate additional psychometric qualities (sensitivity and specificity) of the Critical-Care Pain Observation Tool (CPOT), a previously validated tool, in intubated intensive care unit (ICU) adults after cardiac surgery recruited in a university cardiology health center in Canada. Patients were evaluated while conscious and intubated (n=99/105), and extubated (n=105). For each of these two
![Research paper thumbnail of [Loan of services developing palliative care skills based on the apprentice model]](https://attachments.academia-assets.com/46654733/thumbnails/1.jpg)
](Perspective infirmière : revue officielle de l'Ordre des infirmières et infirmiers du Québec
For over 25 years, the Maison Michel-Sarrazin, a private palliative care institution in the Quebe... more For over 25 years, the Maison Michel-Sarrazin, a private palliative care institution in the Quebec City region, has had an original agreement with other establishments in the healthcare network (hospitals, long-term residential centres and CLSCs), in the form of the loan of nursing services. Based on the findings of a study as part of a research program, this article describes the loan of nursing services and qualitatively assesses its effects on the development of nurses' palliative care skills. An evaluative descriptive approach based on two conceptual frameworks (Giddens; Patton) was used to compile the views of 79 players. The findings demonstrate the innovative nature of the loan of nursing services and its considerable influence on the development of nursing skills, thanks to training based on the apprenticeship model (learning through observation and imitation), and on nursing practice at the Maison Michel-Sarrazin. Nevertheless, the controversy surrounding training using...
Journal of palliative care, 2008
A significant challenge in virtually all caregiving studies is the measurement of burden, particu... more A significant challenge in virtually all caregiving studies is the measurement of burden, particularly within the specific context of palliative care. Existing tools in the caregiving field are not specifically designed for palliative care. A new tool, which specifically assesses family caregivers' (FC) burden within the palliative care context, was systematically developed and validated. This paper describes the steps taken to develop this tool and to examine its psychometric properties. The Caregiver's Burden Scale in End-of-Life Care (CBS-EOLC) is a 16-item self-report questionnaire. Internal consistency reliability: Cronbach's alpha = 0.95. Construct validity: Most inter-item associations were consistent with the conceptual framework that emerged from qualitative data analyses. Convergent validity: Interscale correlations: a) Zarit's Burden Interview (BI) = 0.72 (p < 0.01); b) POMS (fatigue) = 0.69 (p < 0.01); d) POMS (vigour) = -0.27 (p < 0.05). Social ...
International journal of palliative nursing, 2007
This article aims to present the beneficial effects associated with the local implementation of a... more This article aims to present the beneficial effects associated with the local implementation of an integrated network in palliative care, as perceived by diverse constituency groups. A case study was conducted in the province of Quebec, Canada, using individual (n=16) and group (n=16) interviews, with a total of 106 participants (i.e. managers and formal and informal caregivers). From a content analysis, two categories of beneficial effects emerged: those associated with professional practice and those with patient services. The most important effects of this organisational initiative were found to be the recognition of the palliative care domain necessitating specialized competencies, an improved interdisciplinary collaboration, and more efficient circulation of information between care settings, as well as improved accessibility, continuity and quality of care and services to patients at the end of life.
OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and o... more OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and outcomes of patients and families dealing with head and neck cancers. One specific research is presented as an illustration.
Canadian Oncology Nursing Journal, 2013
recently designed a conceptual framework for professional cancer navigators describing key functi... more recently designed a conceptual framework for professional cancer navigators describing key functions of professional cancer navigation.
Current Psychology, 2002
To study the relationship between cancer and emotional adjustment, investigation of situation-spe... more To study the relationship between cancer and emotional adjustment, investigation of situation-specific coping behaviors with respect to narrowly defined Stressors has recently been promoted. The development and validation of shorter instruments, designed to facilitate completion by clinical populations, has also been recommended. The current study examined the coping skills used by French-Canadian women undergoing radiation therapy for breast cancer. A
Pain, Jan 31, 2008
The purpose of this study was to verify the usefulness of an adaptation of the stress process mod... more The purpose of this study was to verify the usefulness of an adaptation of the stress process model in organizing the psychological variables associated with the development of low-back-pain related disability. French-speaking Canadian workers on compensated sick leave (N=439) due to recent occupational low back pain (LBP) were evaluated during the sub-acute stage of LBP (between 30 and 83 days after injury). They were assessed for the following factors: life events, injury-specific cognitive appraisal, emotional distress, avoidance coping, and functional disability. Confirmatory factor analyses were used to test and modify the measurement model. An important modification in the measurement model was the association of catastrophizing with the emotional distress factor. During the sub-acute stage, path analyses revealed a satisfactory fit of the following model (the following coefficients are standardized): (a) life events (.30) and cognitive appraisal (.42) explained emotional dist...
Palliative and Supportive Care, 2014
Objective: We developed a specific cognitive -existential intervention to improve existential dis... more Objective: We developed a specific cognitive -existential intervention to improve existential distress in nonmetastatic cancer patients. The present study reports the feasibility of implementing and evaluating this intervention, which involved 12 weekly sessions in both individual and group formats, and explores the efficacy of the intervention on existential and global quality of life (QoL) measures.
Qualitative Research in …, 2012
... Lise Fillion b & Marie Achille c pages 151-172. ... The meaning and value of death. Journ... more ... Lise Fillion b & Marie Achille c pages 151-172. ... The meaning and value of death. Journal of Palliative Medicine , 5(2): 279–288. View all references; Callahan 20007. Callahan, D. 2000. Death and the research imperative. New England Journal of Medicine , 342(9): 654–656. ...
Supportive Care in Cancer, 2011
Purpose This study aims to describe emotional distress and quality of life (QoL) of patients at d... more Purpose This study aims to describe emotional distress and quality of life (QoL) of patients at different phases of their lung cancer and the association with their family physician (FP) involvement.
Stress Medicine, 1994
According to the psychoneuroimmunology literature, stressful experiences and psychological stress... more According to the psychoneuroimmunology literature, stressful experiences and psychological stress can alter various immunological parameters. The lymphocyte proliferation response of T cells is known to be variable but no data can be found on the reliability of blastogenesis retesting. To address this problem, 10 healthy volunteer men were tested on four occasions in longitudinal repeated measures design. Immunological parameters were measured from blood samples testing date. Using a doubly multivariate repeated measures design, significant time and concentration effects were observed for both parameters: concanavalin A induced blastogenesis (ConA) and phytohemagglutinin induced response (PHA). An interaction effect between time and mitogen dose was observed. Satisfactory reliability for ConA could not be achieved even in controlling for mitogen dose. Better results were obtained for PHA, but only at dilution 1: 100. These data highlight the need for caution in interpreting fluctuations associated with lymphocyte proliferation responses in psychoneuroimmunology.
Spine, 2010
Study Design. Twelve-month cohort study. Objective. The aim of the study was to examine the abili... more Study Design. Twelve-month cohort study. Objective. The aim of the study was to examine the ability of an adaptation of the stress process model to predict different outcomes among low back pain (LBP) sufferers.
Seminars in Oncology Nursing, 2009
OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and o... more OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and outcomes of patients and families dealing with head and neck cancers. One specific research is presented as an illustration.
Psycho-Oncology, 2009
Objective: Palliative care (PC) nurses experience several recurrent organizational, professional,... more Objective: Palliative care (PC) nurses experience several recurrent organizational, professional, and individual challenges. To address existential and emotional demands, the meaning-centered intervention was recently developed. The intervention applied didactic and process-oriented strategies, including guided reflections, experiential exercises, and education based on themes of Viktor Frankl's logotherapy. The objective of this study was to test its efficiency to improve job satisfaction and quality of life in PC nurses from three regional districts in Quebec Province, Canada.
Palliative & Supportive Care, 2006
This article introduces a new meaning-centered psycho-educational group intervention, called Enha... more This article introduces a new meaning-centered psycho-educational group intervention, called Enhancing meaning in palliative care nursing, designed to support nurses providing palliative care. This intervention aims at increasing job satisfaction and quality of life, as well as preventing burnout in this particular population. THEORETICAL FRAMEWORKS: Its format and content are founded on the meaning-centered psychotherapy approach developed for terminally ill cancer patients (Breitbart, 2001; Greenstein &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Breitbart, 2000). Frankl&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s existential therapeutic approach, called logotherapy, serves as the underlying theoretical framework to this intervention. Following the presentation of the context and the development of the intervention, its content is described. A brief description of the ongoing randomized controlled trial testing the intervention is then provided. Finally, the way in which this intervention could contribute to nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; quality of life and suggestions for future developments are briefly discussed.
Palliative and Supportive Care, 2014
Objective: Implementation of routine Screening for Distress constitutes a major change in cancer ... more Objective: Implementation of routine Screening for Distress constitutes a major change in cancer care, with the aim of achieving person-centered care.
Oncology Nursing Forum, 2012
Purpose/Objectives: To elaborate, refine, and validate the professional navigation framework in a... more Purpose/Objectives: To elaborate, refine, and validate the professional navigation framework in a Canadian context.
Oncology Nursing Forum, 2004
Purpose/Objectives: To verify the predictive capacity of the stressprocess theory to explain pers... more Purpose/Objectives: To verify the predictive capacity of the stressprocess theory to explain persistent fatigue following completion of breast cancer treatments; to verify the relationship between interleukin-1b and fatigue.
BACKGROUND Little research has been done on pain assessment in critical care, especially in patie... more BACKGROUND Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally. • OBJECTIVES To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain indicators used for pain reassessment by nurses to verify the effectiveness of pain management in patients who are intubated. • METHODS Medical files from 2 specialized healthcare centers in Quebec City, Quebec, were reviewed. A data collection instrument based on Melzack's theory was developed from existing tools. Pain-related indicators were clustered into nonobservable/subjective (patients' self-reports of pain) and observable/ objective (physiological and behavioral) categories. • RESULTS A total of 183 pain episodes in 52 patients who received mechanical ventilation were analyzed. Observable indicators were recorded 97% of the time. Patients' self-reports of pain were recorded only 29% of the time, a practice contradictory to recommendations for pain assessment. Pharmacological interventions were used more often (89% of the time) than nonpharmacological interventions (<25%) for managing pain. Almost 40% of the time, pain was not reassessed after an intervention. For reassessments, observable indicators were recorded 66% of the time; patients self-reports were recorded only 8% of the time. • CONCLUSIONS Pain documentation in medical files is incomplete or inadequate. The lack of a pain assessment tool may contribute to this situation. Research is still needed in the development of tools to enhance pain assessment in critically ill intubated patients.
Journal of Pain and Symptom Management, 2009
A repeated measure design was used to evaluate additional psychometric qualities (sensitivity and... more A repeated measure design was used to evaluate additional psychometric qualities (sensitivity and specificity) of the Critical-Care Pain Observation Tool (CPOT), a previously validated tool, in intubated intensive care unit (ICU) adults after cardiac surgery recruited in a university cardiology health center in Canada. Patients were evaluated while conscious and intubated (n=99/105), and extubated (n=105). For each of these two
Perspective infirmière : revue officielle de l'Ordre des infirmières et infirmiers du Québec
For over 25 years, the Maison Michel-Sarrazin, a private palliative care institution in the Quebe... more For over 25 years, the Maison Michel-Sarrazin, a private palliative care institution in the Quebec City region, has had an original agreement with other establishments in the healthcare network (hospitals, long-term residential centres and CLSCs), in the form of the loan of nursing services. Based on the findings of a study as part of a research program, this article describes the loan of nursing services and qualitatively assesses its effects on the development of nurses' palliative care skills. An evaluative descriptive approach based on two conceptual frameworks (Giddens; Patton) was used to compile the views of 79 players. The findings demonstrate the innovative nature of the loan of nursing services and its considerable influence on the development of nursing skills, thanks to training based on the apprenticeship model (learning through observation and imitation), and on nursing practice at the Maison Michel-Sarrazin. Nevertheless, the controversy surrounding training using...
Journal of palliative care, 2008
A significant challenge in virtually all caregiving studies is the measurement of burden, particu... more A significant challenge in virtually all caregiving studies is the measurement of burden, particularly within the specific context of palliative care. Existing tools in the caregiving field are not specifically designed for palliative care. A new tool, which specifically assesses family caregivers' (FC) burden within the palliative care context, was systematically developed and validated. This paper describes the steps taken to develop this tool and to examine its psychometric properties. The Caregiver's Burden Scale in End-of-Life Care (CBS-EOLC) is a 16-item self-report questionnaire. Internal consistency reliability: Cronbach's alpha = 0.95. Construct validity: Most inter-item associations were consistent with the conceptual framework that emerged from qualitative data analyses. Convergent validity: Interscale correlations: a) Zarit's Burden Interview (BI) = 0.72 (p < 0.01); b) POMS (fatigue) = 0.69 (p < 0.01); d) POMS (vigour) = -0.27 (p < 0.05). Social ...
International journal of palliative nursing, 2007
This article aims to present the beneficial effects associated with the local implementation of a... more This article aims to present the beneficial effects associated with the local implementation of an integrated network in palliative care, as perceived by diverse constituency groups. A case study was conducted in the province of Quebec, Canada, using individual (n=16) and group (n=16) interviews, with a total of 106 participants (i.e. managers and formal and informal caregivers). From a content analysis, two categories of beneficial effects emerged: those associated with professional practice and those with patient services. The most important effects of this organisational initiative were found to be the recognition of the palliative care domain necessitating specialized competencies, an improved interdisciplinary collaboration, and more efficient circulation of information between care settings, as well as improved accessibility, continuity and quality of care and services to patients at the end of life.
OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and o... more OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and outcomes of patients and families dealing with head and neck cancers. One specific research is presented as an illustration.
Canadian Oncology Nursing Journal, 2013
recently designed a conceptual framework for professional cancer navigators describing key functi... more recently designed a conceptual framework for professional cancer navigators describing key functions of professional cancer navigation.
Current Psychology, 2002
To study the relationship between cancer and emotional adjustment, investigation of situation-spe... more To study the relationship between cancer and emotional adjustment, investigation of situation-specific coping behaviors with respect to narrowly defined Stressors has recently been promoted. The development and validation of shorter instruments, designed to facilitate completion by clinical populations, has also been recommended. The current study examined the coping skills used by French-Canadian women undergoing radiation therapy for breast cancer. A
Pain, Jan 31, 2008
The purpose of this study was to verify the usefulness of an adaptation of the stress process mod... more The purpose of this study was to verify the usefulness of an adaptation of the stress process model in organizing the psychological variables associated with the development of low-back-pain related disability. French-speaking Canadian workers on compensated sick leave (N=439) due to recent occupational low back pain (LBP) were evaluated during the sub-acute stage of LBP (between 30 and 83 days after injury). They were assessed for the following factors: life events, injury-specific cognitive appraisal, emotional distress, avoidance coping, and functional disability. Confirmatory factor analyses were used to test and modify the measurement model. An important modification in the measurement model was the association of catastrophizing with the emotional distress factor. During the sub-acute stage, path analyses revealed a satisfactory fit of the following model (the following coefficients are standardized): (a) life events (.30) and cognitive appraisal (.42) explained emotional dist...
Palliative and Supportive Care, 2014
Objective: We developed a specific cognitive -existential intervention to improve existential dis... more Objective: We developed a specific cognitive -existential intervention to improve existential distress in nonmetastatic cancer patients. The present study reports the feasibility of implementing and evaluating this intervention, which involved 12 weekly sessions in both individual and group formats, and explores the efficacy of the intervention on existential and global quality of life (QoL) measures.
Qualitative Research in …, 2012
... Lise Fillion b & Marie Achille c pages 151-172. ... The meaning and value of death. Journ... more ... Lise Fillion b & Marie Achille c pages 151-172. ... The meaning and value of death. Journal of Palliative Medicine , 5(2): 279–288. View all references; Callahan 20007. Callahan, D. 2000. Death and the research imperative. New England Journal of Medicine , 342(9): 654–656. ...
Supportive Care in Cancer, 2011
Purpose This study aims to describe emotional distress and quality of life (QoL) of patients at d... more Purpose This study aims to describe emotional distress and quality of life (QoL) of patients at different phases of their lung cancer and the association with their family physician (FP) involvement.
Stress Medicine, 1994
According to the psychoneuroimmunology literature, stressful experiences and psychological stress... more According to the psychoneuroimmunology literature, stressful experiences and psychological stress can alter various immunological parameters. The lymphocyte proliferation response of T cells is known to be variable but no data can be found on the reliability of blastogenesis retesting. To address this problem, 10 healthy volunteer men were tested on four occasions in longitudinal repeated measures design. Immunological parameters were measured from blood samples testing date. Using a doubly multivariate repeated measures design, significant time and concentration effects were observed for both parameters: concanavalin A induced blastogenesis (ConA) and phytohemagglutinin induced response (PHA). An interaction effect between time and mitogen dose was observed. Satisfactory reliability for ConA could not be achieved even in controlling for mitogen dose. Better results were obtained for PHA, but only at dilution 1: 100. These data highlight the need for caution in interpreting fluctuations associated with lymphocyte proliferation responses in psychoneuroimmunology.
Spine, 2010
Study Design. Twelve-month cohort study. Objective. The aim of the study was to examine the abili... more Study Design. Twelve-month cohort study. Objective. The aim of the study was to examine the ability of an adaptation of the stress process model to predict different outcomes among low back pain (LBP) sufferers.
Seminars in Oncology Nursing, 2009
OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and o... more OBJECTIVES: To discuss professional cancer navigation roles, models, implementation process and outcomes of patients and families dealing with head and neck cancers. One specific research is presented as an illustration.
Psycho-Oncology, 2009
Objective: Palliative care (PC) nurses experience several recurrent organizational, professional,... more Objective: Palliative care (PC) nurses experience several recurrent organizational, professional, and individual challenges. To address existential and emotional demands, the meaning-centered intervention was recently developed. The intervention applied didactic and process-oriented strategies, including guided reflections, experiential exercises, and education based on themes of Viktor Frankl's logotherapy. The objective of this study was to test its efficiency to improve job satisfaction and quality of life in PC nurses from three regional districts in Quebec Province, Canada.
Palliative & Supportive Care, 2006
This article introduces a new meaning-centered psycho-educational group intervention, called Enha... more This article introduces a new meaning-centered psycho-educational group intervention, called Enhancing meaning in palliative care nursing, designed to support nurses providing palliative care. This intervention aims at increasing job satisfaction and quality of life, as well as preventing burnout in this particular population. THEORETICAL FRAMEWORKS: Its format and content are founded on the meaning-centered psychotherapy approach developed for terminally ill cancer patients (Breitbart, 2001; Greenstein &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Breitbart, 2000). Frankl&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s existential therapeutic approach, called logotherapy, serves as the underlying theoretical framework to this intervention. Following the presentation of the context and the development of the intervention, its content is described. A brief description of the ongoing randomized controlled trial testing the intervention is then provided. Finally, the way in which this intervention could contribute to nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; quality of life and suggestions for future developments are briefly discussed.
Palliative and Supportive Care, 2014
Objective: Implementation of routine Screening for Distress constitutes a major change in cancer ... more Objective: Implementation of routine Screening for Distress constitutes a major change in cancer care, with the aim of achieving person-centered care.
Oncology Nursing Forum, 2012
Purpose/Objectives: To elaborate, refine, and validate the professional navigation framework in a... more Purpose/Objectives: To elaborate, refine, and validate the professional navigation framework in a Canadian context.
Oncology Nursing Forum, 2004
Purpose/Objectives: To verify the predictive capacity of the stressprocess theory to explain pers... more Purpose/Objectives: To verify the predictive capacity of the stressprocess theory to explain persistent fatigue following completion of breast cancer treatments; to verify the relationship between interleukin-1b and fatigue.