Mélanie Levasseur | Université de Sherbrooke (University of Sherbrooke) (original) (raw)
Papers by Mélanie Levasseur
Introduction. Déterminant d'un vieillissement en santé, la mobilité permet aux aînés de réaliser ... more Introduction. Déterminant d'un vieillissement en santé, la mobilité permet aux aînés de réaliser des activités de participation sociale et de demeurer intégrés dans leur communauté. Récemment adapté au vieillissement et à la perte d'autonomie fonctionnelle, l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC), un suivi hebdomadaire de 6 mois réalisé par un citoyen visant la réalisation d'activités sociales et de loisirs signifiantes, pourrait favoriser la mobilité d'aînés ayant des incapacités. Objectif. Cette étude visait donc à : 1) explorer les changements de mobilité tels que perçus par des aînés en perte d'autonomie à la suite de la réalisation de l'APIC et 2) identifier les facilitateurs et les obstacles à la mobilité. Méthodologie. Un devis mixte comportant un dispositif pré-expérimental et une étude qualitative de type recherche clinique a été utilisé auprès d'aînés recrutés selon une stratégie de convenance. Le changement de la mobilité a été considéré à l'aide de comparaisons du Life-Space Assessment avant et après l'APIC et d'une analyse de contenu thématique d'entretiens individuels semi-dirigés. Résultats. Âgés de 66 à 91 ans, les 16 participants étaient majoritairement des femmes et présentaient des incapacités modérées à graves. Après l'APIC, une amélioration de leurs habitudes de déplacement a été observée (p < 0,01) et les participants rapportaient fréquenter davantage de lieux et se déplacer seuls plus aisément. La confiance en soi, le transport adapté et la disponibilité d'activités dans la communauté étaient des facilitateurs à la mobilité des participants, tandis que les intempéries et la situation familiale étaient perçues par ceux-ci comme étant des obstacles. Conclusion. Puisque la mobilité d'aînés en perte d'autonomie s'est améliorée à la suite de la réalisation de l'APIC, les recherches doivent se poursuivent sur cette intervention prometteuse.
comparatif des modèles conceptuels sous-jacents à l'étude 2. Article sur l'analyse du concept« Qu... more comparatif des modèles conceptuels sous-jacents à l'étude 2. Article sur l'analyse du concept« Qualité de vie» 3. Certificats des comités d'éthique de la recherche 4. Formulaire de consentement du volet quantitatif 5. Formulaire de.consentement du volet qualitatif 6. Formulaire de collecte de données sociodémographiques et cliniques 7. Instruments de mesure 8. Guide d'entrevue 43 43 44 45 45
Background To promote healthy aging, the social participation needs of older adults must be bette... more Background To promote healthy aging, the social participation needs of older adults must be better met. Previous studies have shown the benefits of the Personalized citizen assistance for social participation (APIC), but few explored its influence on attendants. This study explored the assistance experience of attendants when providing the APIC to older adults with disabilities. Methods A qualitative design inspired by a phenomenological approach was used with six female attendants who participated in individual interviews. Results The APIC attendants felt useful, developed meaningful relationships with their older adults, and improved their self-knowledge. Attendants had the opportunity to reflect on their lives and self-aging. They contributed to older adults’ functional independence, motivation, and participation in social activities. Attendants encountered challenges related to withdrawn behavior in older adults, such as refusing to participate in activities. Conclusions Conside...
The American Journal of Occupational Therapy, 2019
Importance: Developed in California to enable community-dwelling older adults to maintain healthy... more Importance: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. Objective: To explore the influence of Lifestyle Redesign on older French-Canadians’ health, social participation, leisure, and mobility. Design: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. Setting: Community. Participants: Sixteen volunteers (10 women) aged 65–90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria...
Canadian Journal of Occupational Therapy, 2018
Abré gé Description. Peu d'outils sont disponibles en français pour mesurer l'engagement dans des... more Abré gé Description. Peu d'outils sont disponibles en français pour mesurer l'engagement dans des activités signifiantes, au coeur de l'ergothérapie. But. Cette étude visait à traduire l'Engagement in Meaningful Activities Survey et, ensuite, à vérifier la validité convergente et la cohérence interne de la version française. Mé thodologie. Une traduction renversée a d'abord été réalisée. Pour ensuite évaluer la validité convergente du Questionnaire sur l'engagement dans des activités signifiantes (QEAS), l'Indice de la qualité de vie et la Mesure des habitudes de vie modifiée (participation sociale) ont été complétés par 84 adultes de la population générale. La cohérence interne a été mesurée avec l'alpha de Cronbach. Résultats. Un meilleur engagement dans les activités signifiantes est significativement associé à une qualité de vie (r ¼ 0,36; p ¼ 0,001) et une satisfaction accrues envers la participation sociale (r ¼ 0,40; p < 0,001). Le QEAS présente une bonne cohérence interne (q ¼ 0,81). Consé quences. Le QEAS est un questionnaire valide qui permettra aux ergothérapeutes francophones de mieux comprendre l'engagement de leurs clients dans l'ensemble de leurs activités.
Archives of Nursing Practice and Care, 2017
Santé Publique, 2016
La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.
Archives of physical medicine and rehabilitation, Dec 25, 2017
To examine the associations between resilience, community belonging and social participation, and... more To examine the associations between resilience, community belonging and social participation, and the moderating effect of resilience on the association between community belonging and social participation among community-dwelling older adults. Cross-sectional; secondary analyses of the Eastern Townships Population Health Survey. Community. A sample of 2485 women and 2056 men aged 60+ was randomly selected according to area. Most participants had less than 14 years of schooling, owned their dwelling, were retired, had 1-2 chronic conditions, and did not have depressive symptoms. Not applicable. Self-reported data on age, education, depressive symptoms, social participation, community belonging and resilience were collected by phone interviewer-administered questionnaire. A social participation scale measured frequency of participation in eight community activities. A 4-point Likert scale ranging from "very strong" to "very weak" estimated sense of belonging to th...
BMC public health, May 25, 2017
To address the challenges of the global aging population, the World Health Organization promoted ... more To address the challenges of the global aging population, the World Health Organization promoted age-friendly communities as a way to foster the development of active aging community initiatives. Accordingly, key components (i.e., policies, services and structures related to the communities' physical and social environments) should be designed to be age-friendly and help all aging adults to live safely, enjoy good health and stay involved in their communities. Although age-friendly communities are believed to be a promising way to help aging Canadians lead healthy and active lives, little is known about which key components best foster positive health, social participation and health equity, and their underlying mechanisms. This study aims to better understand which and how key components of age-friendly communities best foster positive health, social participation and health equity in aging Canadians. Specifically, the research objectives are to: 1) Describe and compare age-fri...
The Handbook of Salutogenesis, 2016
Encyclopedia of Quality of Life and Well-Being Research, 2014
Background: Social participation is critical in fostering community vitality, promoting health, a... more Background: Social participation is critical in fostering community vitality, promoting health, and preventing disabilities, but is restricted for approximately half the older adult population. Social participation involves social and leisure activities, such as visiting friends, bowling, etc., that meet fundamental needs for interaction, wellbeing and self-actualization. Although targeted through interventions by community organizations, healthcare professionals and municipalities, little is known about the needs of older adults to participate socially, especially in rural areas. This study thus aimed to identify and prioritize the social participation needs of older adults living in a rural area. Methods: A participatory action research was conducted in a rural regional county municipality (RCM) in Quebec, Canada with convenience sample of 139 stakeholders, including older adults, caregivers, healthcare and community organization managers, healthcare and community organization workers, RCM partners and key informants. Results: Facilitators and barriers to social participation related to personal factors (e.g., health, interests, motivation), the social environment (e.g., availability of assistance or volunteers) and the physical environment (e.g., distance to resources, recreational facilities and social partners). Nine needs emerged and were prioritized as follows: 1) having access to and being informed about transportation options, 2) being informed about available activities and services, 3) having access to activities, including volunteering opportunities, suited to their interests, schedule, cost, language and health condition, 4) being accompanied to activities, 5) having access to meeting places near home and adapted to their health condition, and 6-9 (no preferred order) being reached when isolated, being personally invited and welcomed to activities, having a social support network, and being valued and recognized. Differences emerged when prioritizing needs of older adults with disabilities (greater need for assistance, accessibility and adapted activities) and older adults living in a rural area (greater need for transportation). Conclusions: To promote active participation in the community, the social participation needs of older women and men living in rural areas must be addressed, especially in regard to transportation, information, adapted activities, assistance and accessibility. The rst part of this action research will be followed by community selection and implementation of initiatives to ultimately foster their social participation.
BMC Geriatrics, 2015
Background: Participation is a key determinant of successful aging and enables older adults to st... more Background: Participation is a key determinant of successful aging and enables older adults to stay in their homes and be integrated into the community. Assessing participation needs involves identifying restrictions in the accomplishment of daily and social activities. Although meeting participation needs involves older adults, their caregivers and healthcare providers, little is known about their respective viewpoints. This study thus explored the participation needs of older adults having disabilities as perceived by the older adults themselves, their caregivers and healthcare providers. Methods: A qualitative multiple case study consisted of conducting 33 semi-structured interviews in eleven triads, each composed of an older adult, his/her caregiver and a healthcare provider recruited in a Health and Social Services Centre (HSSC) in Québec, Canada. Interview transcripts and reviews of clinical records were analyzed using content analysis and descriptive statistics based on thematic saliency analysis methods. Results: Aged 66 to 88 years, five older adults had physical disabilities, five had mild cognitive impairment and one had psychological problems, leading to moderate to severe functional decline. Caregivers and healthcare providers were mainly women, respectively retired spouses and various professionals with four to 32 years of clinical experience. Participation needs reported by each triad included all domains of participation. Needs related to daily activities, such as personal care, nutrition, and housing, were generally met. Regarding social activities, few needs were met by various resources in the community and were generally limited to personal responsibilities, including making decisions and managing budgets, and some community life activities, such as going shopping. Unmet needs were mainly related to social activities, involving leisure, other community life activities and interpersonal relationships, and some daily activities, including fitness and mobility. Conclusions: This study highlights the complexity of older adults' participation needs, involving daily as well as social activities. Properly assessing and addressing these needs is thus necessary to improve older adults' health and well-being. Discrepancies in the various actors' perceptions of participation needs must be further explored. Additional research would help better understand how to optimize the contribution of community organizations and caregivers.
Scandinavian Journal of Occupational Therapy
Background: To increase homecare efficiency, the Ministry of Health and Social Services in Québec... more Background: To increase homecare efficiency, the Ministry of Health and Social Services in Québec, Canada, encourages standardization of practices, including those of community occupational therapists (COTs). The impact of standardization is not known and might reduce client-centeredness. Aim/objectives. To explore the content and use of a referral form to standardize COTs’ practice. Material/methods. An institutional ethnography inquiry was conducted through observations of work and interviews with 10 COTs working in three homecare programs. Secondary informants were also interviewed and documents collected. Data were analyzed using institutional ethnography procedures. Findings. The referral form, completed by the COTs’ colleagues, includes categories primarily related to safety or autonomy in personal care and mobility. The form organizes COTs’ work, including information collection and interactions with clients and caregivers. Seen as consultants, COTs assess needs and make reco...
Conférence sur invitation. Au Québec, un processus d’optimisation de la performance a été mis en ... more Conférence sur invitation. Au Québec, un processus d’optimisation de la performance a été mis en place dans une vaste majorité de Centres de santé et de services sociaux afin d’améliorer la productivité des professionnels de la santé en CLSC et, ainsi, accroître le nombre d’interventions réalisées auprès des clients. Le choix des interventions du professionnel repose sur son raisonnement clinique, c’est-à-dire le processus cognitif au cœur de la pratique professionnelle qui permet de « planifier, implanter, réaliser et réfléchir sur les soins au client » (Schell, 2009, p.314). Or, on connaît peu les implications du processus d’optimisation de la performance dans le raisonnement clinique du professionnel. Cette conférence présentera les résultats d’une recherche réalisée auprès d’ergothérapeutes en CLSC et permettra de mettre en lumière les impacts du processus d’optimisation sur le raisonnement clinique et le choix des interventions de ces professionnels. Des questionnements seront ...
Canadian journal of occupational therapy. Revue canadienne d'ergothérapie, 2015
Occupational therapists can bring a unique and valuable perspective to the national dialogue on h... more Occupational therapists can bring a unique and valuable perspective to the national dialogue on health promotion. Current approaches have a narrow focus on diet and exercise; a broader focus on occupation has the potential to enrich understanding regarding forces that contribute to health and well-being. A new "Do-Live-Well" framework will be presented that is grounded in evidence regarding the links between what people do every day and their health and well-being. Elements of the framework include eight different dimensions of experience and five key activity patterns that impact health and well-being outcomes. Personal and social forces that shape activity engagement also affect the links to health and well-being. The framework is designed to facilitate individual reflection, community advocacy, and system-level dialogue about the impact of day-to-day occupations on the health and well-being of Canadians.
Scandinavian journal of occupational therapy, Jan 15, 2015
To increase homecare efficiency, the Ministry of Health and Social Services in Québec, Canada, en... more To increase homecare efficiency, the Ministry of Health and Social Services in Québec, Canada, encourages standardization of practices, including those of community occupational therapists (COTs). The impact of standardization is not known and might reduce client-centeredness. Aim/objectives. To explore the content and use of a referral form to standardize COTs' practice. An institutional ethnography inquiry was conducted through observations of work and interviews with 10 COTs working in three homecare programs. Secondary informants were also interviewed and documents collected. Data were analyzed using institutional ethnography procedures. The referral form, completed by the COTs' colleagues, includes categories primarily related to safety or autonomy in personal care and mobility. The form organizes COTs' work, including information collection and interactions with clients and caregivers. Seen as consultants, COTs assess needs and make recommendations to keep clients ...
American journal of public health, Jan 17, 2015
Objectives. We compared the social participation of older adults living in metropolitan, urban, a... more Objectives. We compared the social participation of older adults living in metropolitan, urban, and rural areas, and identified associated environmental factors. Methods. From 2004 to 2006, we conducted a cross-sectional study using an age-, gender-, and area-stratified random sample of 1198 adults (aged 67-82 years). We collected data via interviewer-administered questionnaires and derived from Canadian censuses. Results. Social participation did not differ across living areas (P = .09), but after controlling for potential confounding variables, we identified associated area-specific environmental variables. In metropolitan areas, higher social participation was associated with greater proximity to neighborhood resources, having a driver's license, transit use, and better quality social network (R(2) = 0.18). In urban areas, higher social participation was associated with greater proximity to neighborhood resources and having a driver's license (R(2) = 0.11). Finally, in ru...
Introduction. Déterminant d'un vieillissement en santé, la mobilité permet aux aînés de réaliser ... more Introduction. Déterminant d'un vieillissement en santé, la mobilité permet aux aînés de réaliser des activités de participation sociale et de demeurer intégrés dans leur communauté. Récemment adapté au vieillissement et à la perte d'autonomie fonctionnelle, l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC), un suivi hebdomadaire de 6 mois réalisé par un citoyen visant la réalisation d'activités sociales et de loisirs signifiantes, pourrait favoriser la mobilité d'aînés ayant des incapacités. Objectif. Cette étude visait donc à : 1) explorer les changements de mobilité tels que perçus par des aînés en perte d'autonomie à la suite de la réalisation de l'APIC et 2) identifier les facilitateurs et les obstacles à la mobilité. Méthodologie. Un devis mixte comportant un dispositif pré-expérimental et une étude qualitative de type recherche clinique a été utilisé auprès d'aînés recrutés selon une stratégie de convenance. Le changement de la mobilité a été considéré à l'aide de comparaisons du Life-Space Assessment avant et après l'APIC et d'une analyse de contenu thématique d'entretiens individuels semi-dirigés. Résultats. Âgés de 66 à 91 ans, les 16 participants étaient majoritairement des femmes et présentaient des incapacités modérées à graves. Après l'APIC, une amélioration de leurs habitudes de déplacement a été observée (p < 0,01) et les participants rapportaient fréquenter davantage de lieux et se déplacer seuls plus aisément. La confiance en soi, le transport adapté et la disponibilité d'activités dans la communauté étaient des facilitateurs à la mobilité des participants, tandis que les intempéries et la situation familiale étaient perçues par ceux-ci comme étant des obstacles. Conclusion. Puisque la mobilité d'aînés en perte d'autonomie s'est améliorée à la suite de la réalisation de l'APIC, les recherches doivent se poursuivent sur cette intervention prometteuse.
comparatif des modèles conceptuels sous-jacents à l'étude 2. Article sur l'analyse du concept« Qu... more comparatif des modèles conceptuels sous-jacents à l'étude 2. Article sur l'analyse du concept« Qualité de vie» 3. Certificats des comités d'éthique de la recherche 4. Formulaire de consentement du volet quantitatif 5. Formulaire de.consentement du volet qualitatif 6. Formulaire de collecte de données sociodémographiques et cliniques 7. Instruments de mesure 8. Guide d'entrevue 43 43 44 45 45
Background To promote healthy aging, the social participation needs of older adults must be bette... more Background To promote healthy aging, the social participation needs of older adults must be better met. Previous studies have shown the benefits of the Personalized citizen assistance for social participation (APIC), but few explored its influence on attendants. This study explored the assistance experience of attendants when providing the APIC to older adults with disabilities. Methods A qualitative design inspired by a phenomenological approach was used with six female attendants who participated in individual interviews. Results The APIC attendants felt useful, developed meaningful relationships with their older adults, and improved their self-knowledge. Attendants had the opportunity to reflect on their lives and self-aging. They contributed to older adults’ functional independence, motivation, and participation in social activities. Attendants encountered challenges related to withdrawn behavior in older adults, such as refusing to participate in activities. Conclusions Conside...
The American Journal of Occupational Therapy, 2019
Importance: Developed in California to enable community-dwelling older adults to maintain healthy... more Importance: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. Objective: To explore the influence of Lifestyle Redesign on older French-Canadians’ health, social participation, leisure, and mobility. Design: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. Setting: Community. Participants: Sixteen volunteers (10 women) aged 65–90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria...
Canadian Journal of Occupational Therapy, 2018
Abré gé Description. Peu d'outils sont disponibles en français pour mesurer l'engagement dans des... more Abré gé Description. Peu d'outils sont disponibles en français pour mesurer l'engagement dans des activités signifiantes, au coeur de l'ergothérapie. But. Cette étude visait à traduire l'Engagement in Meaningful Activities Survey et, ensuite, à vérifier la validité convergente et la cohérence interne de la version française. Mé thodologie. Une traduction renversée a d'abord été réalisée. Pour ensuite évaluer la validité convergente du Questionnaire sur l'engagement dans des activités signifiantes (QEAS), l'Indice de la qualité de vie et la Mesure des habitudes de vie modifiée (participation sociale) ont été complétés par 84 adultes de la population générale. La cohérence interne a été mesurée avec l'alpha de Cronbach. Résultats. Un meilleur engagement dans les activités signifiantes est significativement associé à une qualité de vie (r ¼ 0,36; p ¼ 0,001) et une satisfaction accrues envers la participation sociale (r ¼ 0,40; p < 0,001). Le QEAS présente une bonne cohérence interne (q ¼ 0,81). Consé quences. Le QEAS est un questionnaire valide qui permettra aux ergothérapeutes francophones de mieux comprendre l'engagement de leurs clients dans l'ensemble de leurs activités.
Archives of Nursing Practice and Care, 2017
Santé Publique, 2016
La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que d... more La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.
Archives of physical medicine and rehabilitation, Dec 25, 2017
To examine the associations between resilience, community belonging and social participation, and... more To examine the associations between resilience, community belonging and social participation, and the moderating effect of resilience on the association between community belonging and social participation among community-dwelling older adults. Cross-sectional; secondary analyses of the Eastern Townships Population Health Survey. Community. A sample of 2485 women and 2056 men aged 60+ was randomly selected according to area. Most participants had less than 14 years of schooling, owned their dwelling, were retired, had 1-2 chronic conditions, and did not have depressive symptoms. Not applicable. Self-reported data on age, education, depressive symptoms, social participation, community belonging and resilience were collected by phone interviewer-administered questionnaire. A social participation scale measured frequency of participation in eight community activities. A 4-point Likert scale ranging from "very strong" to "very weak" estimated sense of belonging to th...
BMC public health, May 25, 2017
To address the challenges of the global aging population, the World Health Organization promoted ... more To address the challenges of the global aging population, the World Health Organization promoted age-friendly communities as a way to foster the development of active aging community initiatives. Accordingly, key components (i.e., policies, services and structures related to the communities' physical and social environments) should be designed to be age-friendly and help all aging adults to live safely, enjoy good health and stay involved in their communities. Although age-friendly communities are believed to be a promising way to help aging Canadians lead healthy and active lives, little is known about which key components best foster positive health, social participation and health equity, and their underlying mechanisms. This study aims to better understand which and how key components of age-friendly communities best foster positive health, social participation and health equity in aging Canadians. Specifically, the research objectives are to: 1) Describe and compare age-fri...
The Handbook of Salutogenesis, 2016
Encyclopedia of Quality of Life and Well-Being Research, 2014
Background: Social participation is critical in fostering community vitality, promoting health, a... more Background: Social participation is critical in fostering community vitality, promoting health, and preventing disabilities, but is restricted for approximately half the older adult population. Social participation involves social and leisure activities, such as visiting friends, bowling, etc., that meet fundamental needs for interaction, wellbeing and self-actualization. Although targeted through interventions by community organizations, healthcare professionals and municipalities, little is known about the needs of older adults to participate socially, especially in rural areas. This study thus aimed to identify and prioritize the social participation needs of older adults living in a rural area. Methods: A participatory action research was conducted in a rural regional county municipality (RCM) in Quebec, Canada with convenience sample of 139 stakeholders, including older adults, caregivers, healthcare and community organization managers, healthcare and community organization workers, RCM partners and key informants. Results: Facilitators and barriers to social participation related to personal factors (e.g., health, interests, motivation), the social environment (e.g., availability of assistance or volunteers) and the physical environment (e.g., distance to resources, recreational facilities and social partners). Nine needs emerged and were prioritized as follows: 1) having access to and being informed about transportation options, 2) being informed about available activities and services, 3) having access to activities, including volunteering opportunities, suited to their interests, schedule, cost, language and health condition, 4) being accompanied to activities, 5) having access to meeting places near home and adapted to their health condition, and 6-9 (no preferred order) being reached when isolated, being personally invited and welcomed to activities, having a social support network, and being valued and recognized. Differences emerged when prioritizing needs of older adults with disabilities (greater need for assistance, accessibility and adapted activities) and older adults living in a rural area (greater need for transportation). Conclusions: To promote active participation in the community, the social participation needs of older women and men living in rural areas must be addressed, especially in regard to transportation, information, adapted activities, assistance and accessibility. The rst part of this action research will be followed by community selection and implementation of initiatives to ultimately foster their social participation.
BMC Geriatrics, 2015
Background: Participation is a key determinant of successful aging and enables older adults to st... more Background: Participation is a key determinant of successful aging and enables older adults to stay in their homes and be integrated into the community. Assessing participation needs involves identifying restrictions in the accomplishment of daily and social activities. Although meeting participation needs involves older adults, their caregivers and healthcare providers, little is known about their respective viewpoints. This study thus explored the participation needs of older adults having disabilities as perceived by the older adults themselves, their caregivers and healthcare providers. Methods: A qualitative multiple case study consisted of conducting 33 semi-structured interviews in eleven triads, each composed of an older adult, his/her caregiver and a healthcare provider recruited in a Health and Social Services Centre (HSSC) in Québec, Canada. Interview transcripts and reviews of clinical records were analyzed using content analysis and descriptive statistics based on thematic saliency analysis methods. Results: Aged 66 to 88 years, five older adults had physical disabilities, five had mild cognitive impairment and one had psychological problems, leading to moderate to severe functional decline. Caregivers and healthcare providers were mainly women, respectively retired spouses and various professionals with four to 32 years of clinical experience. Participation needs reported by each triad included all domains of participation. Needs related to daily activities, such as personal care, nutrition, and housing, were generally met. Regarding social activities, few needs were met by various resources in the community and were generally limited to personal responsibilities, including making decisions and managing budgets, and some community life activities, such as going shopping. Unmet needs were mainly related to social activities, involving leisure, other community life activities and interpersonal relationships, and some daily activities, including fitness and mobility. Conclusions: This study highlights the complexity of older adults' participation needs, involving daily as well as social activities. Properly assessing and addressing these needs is thus necessary to improve older adults' health and well-being. Discrepancies in the various actors' perceptions of participation needs must be further explored. Additional research would help better understand how to optimize the contribution of community organizations and caregivers.
Scandinavian Journal of Occupational Therapy
Background: To increase homecare efficiency, the Ministry of Health and Social Services in Québec... more Background: To increase homecare efficiency, the Ministry of Health and Social Services in Québec, Canada, encourages standardization of practices, including those of community occupational therapists (COTs). The impact of standardization is not known and might reduce client-centeredness. Aim/objectives. To explore the content and use of a referral form to standardize COTs’ practice. Material/methods. An institutional ethnography inquiry was conducted through observations of work and interviews with 10 COTs working in three homecare programs. Secondary informants were also interviewed and documents collected. Data were analyzed using institutional ethnography procedures. Findings. The referral form, completed by the COTs’ colleagues, includes categories primarily related to safety or autonomy in personal care and mobility. The form organizes COTs’ work, including information collection and interactions with clients and caregivers. Seen as consultants, COTs assess needs and make reco...
Conférence sur invitation. Au Québec, un processus d’optimisation de la performance a été mis en ... more Conférence sur invitation. Au Québec, un processus d’optimisation de la performance a été mis en place dans une vaste majorité de Centres de santé et de services sociaux afin d’améliorer la productivité des professionnels de la santé en CLSC et, ainsi, accroître le nombre d’interventions réalisées auprès des clients. Le choix des interventions du professionnel repose sur son raisonnement clinique, c’est-à-dire le processus cognitif au cœur de la pratique professionnelle qui permet de « planifier, implanter, réaliser et réfléchir sur les soins au client » (Schell, 2009, p.314). Or, on connaît peu les implications du processus d’optimisation de la performance dans le raisonnement clinique du professionnel. Cette conférence présentera les résultats d’une recherche réalisée auprès d’ergothérapeutes en CLSC et permettra de mettre en lumière les impacts du processus d’optimisation sur le raisonnement clinique et le choix des interventions de ces professionnels. Des questionnements seront ...
Canadian journal of occupational therapy. Revue canadienne d'ergothérapie, 2015
Occupational therapists can bring a unique and valuable perspective to the national dialogue on h... more Occupational therapists can bring a unique and valuable perspective to the national dialogue on health promotion. Current approaches have a narrow focus on diet and exercise; a broader focus on occupation has the potential to enrich understanding regarding forces that contribute to health and well-being. A new "Do-Live-Well" framework will be presented that is grounded in evidence regarding the links between what people do every day and their health and well-being. Elements of the framework include eight different dimensions of experience and five key activity patterns that impact health and well-being outcomes. Personal and social forces that shape activity engagement also affect the links to health and well-being. The framework is designed to facilitate individual reflection, community advocacy, and system-level dialogue about the impact of day-to-day occupations on the health and well-being of Canadians.
Scandinavian journal of occupational therapy, Jan 15, 2015
To increase homecare efficiency, the Ministry of Health and Social Services in Québec, Canada, en... more To increase homecare efficiency, the Ministry of Health and Social Services in Québec, Canada, encourages standardization of practices, including those of community occupational therapists (COTs). The impact of standardization is not known and might reduce client-centeredness. Aim/objectives. To explore the content and use of a referral form to standardize COTs' practice. An institutional ethnography inquiry was conducted through observations of work and interviews with 10 COTs working in three homecare programs. Secondary informants were also interviewed and documents collected. Data were analyzed using institutional ethnography procedures. The referral form, completed by the COTs' colleagues, includes categories primarily related to safety or autonomy in personal care and mobility. The form organizes COTs' work, including information collection and interactions with clients and caregivers. Seen as consultants, COTs assess needs and make recommendations to keep clients ...
American journal of public health, Jan 17, 2015
Objectives. We compared the social participation of older adults living in metropolitan, urban, a... more Objectives. We compared the social participation of older adults living in metropolitan, urban, and rural areas, and identified associated environmental factors. Methods. From 2004 to 2006, we conducted a cross-sectional study using an age-, gender-, and area-stratified random sample of 1198 adults (aged 67-82 years). We collected data via interviewer-administered questionnaires and derived from Canadian censuses. Results. Social participation did not differ across living areas (P = .09), but after controlling for potential confounding variables, we identified associated area-specific environmental variables. In metropolitan areas, higher social participation was associated with greater proximity to neighborhood resources, having a driver's license, transit use, and better quality social network (R(2) = 0.18). In urban areas, higher social participation was associated with greater proximity to neighborhood resources and having a driver's license (R(2) = 0.11). Finally, in ru...