Accessible summary• Support workers' attitudes towards the sexuality of people with intellectual disabilities are important. They can influence the support people with intellectual disabilities receive regarding their affective and sexual life.• Six support workers talked about their personal experiences. They talked about what they found easy and difficult when helping people with intellectual disabilities express their sexual life and needs.• They said that sexuality is a right, a health matter and an important need. They also said it was sometimes difficult to include sexuality in their work.• They also said they often feel insecure and uncertain about how to help because sexuality is a difficult subject to talk about. They wanted to help people make their own decisions, but also wanted to protect them if needed. AbstractBackground: In the last decade, the evolution of support workers' attitudes towards the affective and sexual lives of people with intellectual disabilities has been described as increasingly positive. However, restrictive attitudes targeting affective and sexual life are still documented. Material and methods:This study aimed to explore the ethical implications of support workers' experiences concerning sexuality in the context of intellectual disabilities in everyday practice. This inquiry was guided by the following research questions: (a) In the context of intellectual disabilities, what meanings do service users' sexuality have for support workers? (b) How are those meanings translated into practice? Inspired by critical phenomenology, in-depth individual interviews with support workers were conducted and analysed. Results: One superordinate theme (Negotiating Interventions) and three themes were identified: "Crossing Organizational Borders," "A Duty to Act Despite Uncertainty" and "Navigating Competing and Contradictory Discourses." Conclusion: Support workers' experiences related to sexuality in the context of intellectual disabilities are influenced by how they define their role in a clinical context. | 117 PARISEAU-LEGAULT ET AL.
Background: The World Health Organization describes the perpetuation of human rights violations against people with mental health problems as a global emergency. Despite this observation, recent studies suggest that coercive measures, such as seclusion, restraints, involuntary hospitalization, or involuntary treatment, are steadily or increasingly being used without proof of their effectiveness. In nursing, several literature reviews have focused on understanding nurses' perspectives on the use of seclusion and restraints. Although many studies describe the ethical dilemmas faced by nurses in this context, to this date, their perspectives on patient's rights when a broad variety of coercive measures are used are not well understood. The aim of this review is to produce a qualitative synthesis of how human rights are actually integrated into psychiatric and mental health nursing practice in the context of coercive work. Methods: Noblit and Hare's meta-ethnographic approach will be used to conduct this systematic review. The search will be conducted in CINAHL, Medline, PsycINFO, ERIC, and Scopus databases, using the PICo model (Population, phenomenon of Interest, Context) and a combination of keywords and descriptors. It will be complemented by a manual search of non-indexed articles, gray literature, and other applicable data sources, such as human rights related documents. Qualitative and mixed-method study designs will be included in this review. Empirical and peer-reviewed articles published between 2008 and 2019 will be selected. Articles will be evaluated independently by two reviewers to determine their inclusion against eligibility criteria. The quality of the selected papers will then be independently evaluated by two reviewers, using the Joanna Briggs Institute's Checklist for Qualitative Research. Data extraction and content analysis will focus on first-and second-order constructs, that is, the extraction of research participants' narratives and their interpretation. Discussion: This review will provide a synthesis of how psychiatric and mental health nurses integrate human rights principles into their practice, as well as it will identify research gaps in this area. The results of this review will then provide qualitative evidence to better understand how nurses can contribute to the recognition, protection, and advocate for human rights in a psychiatric context. Systematic review registration: PROSPERO, CRD42019116862
Contexte : la dernière décennie témoigne d’un usage régulier ou croissant de la coercition en santé mentale et de la multiplication de ses formes. L’application de ces mesures s’appuie très souvent sur le travail du personnel infirmier, mais peu d’études ont analysé les enjeux aux droits humains soulevés par ces pratiques. Objectif : l’objectif général de cette recherche est de produire une synthèse qualitative de la manière dont les droits humains sont intégrés dans la pratique du personnel infirmier faisant usage de coercition en santé mentale. Méthodologie : une recension systématique des écrits scientifiques employant un devis qualitatif publiés entre 2008 et 2018 a été réalisée et complétée par une analyse méta-ethnographique. Résultats : l’analyse des 46 études retenues a fait ressortir quatre thématiques distinctes : la coercition en santé mentale comme objet sociojuridique, les enjeux de reconnaissance des droits humains en santé mentale, le conflit de rôle vécu par le personnel infirmier, la signification de la coercition comme mal nécessaire ou comme incident critique. Discussion et conclusion : des efforts de recherche supplémentaires doivent être consacrés à comprendre les particularités du continuum de soutien et de contrôle caractérisant le travail coercitif du personnel infirmier en psychiatrie.
Background The COVID-19 pandemic and the quarantine measures implemented have profoundly impacted parents and families. The stress and uncertainty generated by the COVID-19 virus, as well as the disruption of routines and social relationships, have weakened both individual and family health and functioning. Objective The present research is part of a larger study that aims to understand, with a family systems theory, the longitudinal effects of the COVID-19 pandemic on school-aged children, adolescents, and their parents. More specifically, this paper aims to investigate parents’ experience of the first months of the pandemic as a predictor of perceived social support, parental ill-being (aggregate score of well-established poor psychological functioning indicators), parental satisfaction, and family functioning. Method During the first lockdown (April-May 2020), 203 parents of school-aged children living in Quebec completed an online questionnaire. Results Path analysis indicates that the impact of COVID-19 and health preoccupation due to COVID-19 are both positively associated with individual parental ill-being, which in turn detracts from family functioning and parental satisfaction. Furthermore, perceptions about positive effects of the pandemic are negatively associated with parental ill-being, and positively with perceived social support, which in turn significantly contributes to family functioning and parental satisfaction. Conclusion The findings highlight the importance of adopting a systemic perspective to best understand the effects of the pandemic and the social and health measures on individuals, families, and systems, as well as to better support parents and family health through periods of uncertainty.
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