Résumé à l’intention des gestionnaires. Composantes clés et conditions de succès de mise en œuvre et d’efficacité des réseaux de services intégrés pour les jeunes de 12 à 25 ans
Naïma Bentayeb, Jérémy Boisvert-Viens et Dorian MouketouNaïma Bentayeb (2023)
The Burden of Psychosis in Black Communities in Canada: More than a Feeling, a Black Family Experience. T
Cénat, J. M., Lashley, M., Jarvis, G. E., Williams, M. T., Bernheim, E., Derivois, D., & Rousseau, C.Myrna Lashley, Cécile Rousseau (2023, aout)
In the face of these pervasive problems, solutions must be implemented to create safety in mental health services to build a racially and culturally equitable system. We offer some recommendations:
Implementation of these recommendations would enhance the care for Black patients with psychosis. While this commentary is focusing on members of Black communities, we advocate at the same time for other minority groups that suffer at the hands of an inequitable and culturally unresponsive mental health care system. By reducing the many barriers to psychosis services by developing and implementing anti-racist training, policies and practices, we believe that other minority communities will benefit, with the ultimate objective of ensuring that everyone in Canada, regardless of ethno-racial background, will receive culturally appropriate and equitable care.
Supporting Reassigned Hospital Staff During the COVID-19 Pandemic in the Montreal Region: What Does it say About Leadership Styles?
Gautier, L., Gabet, M., Duhoux, A., Traverson, L., Ridde, V., Zinszer, K., & David, P. M.Lara Gautier (2023, aout)
Abstract
Pratiques de soutien au cours d’un groupe d’intégration sociale et professionnelle : retombées sur les capabilités de personnes réfugiées dans leur parcours d’apprentissage
Dionne, P., Joncas, J. A., & Charette, J. Josée Charette (2023, aout)
Résumé de l’article Au Québec, des centres d’aide à l’emploi offrent des programmes d’intégration sociale et professionnelle (ISP) des personnes réfugiées ou demandeuses d’asile, qui arrivent avec un parcours souvent sinueux, parfois ponctué d’expériences traumatisantes. Ce parcours peut complexifier leur ISP dans leur société d’accueil et les exposer à des situations de vulnérabilité sociale. Nous cherchons à comprendre comment le parcours d’apprentissage au cours d’un programme d’ISP en groupe permet d’ouvrir l’éventail des opportunités réelles et favorise la justice sociale du point de vue opérationnel de l’approche par les capabilités. L’analyse qualitative processuelle des parcours d’apprentissage de ces personnes articule les ressources que rend disponible le programme en vue d’élargir leurs opportunités réelles d’ISP. Sont également analysées, les entraves à la conversion des ressources transmises en instruments pour l’apprentissage.
Self-representation and future perception of youth followed by a specialized intervention team in violent radicalization
Desmarais, C., Rousseau, C. Cécile Rousseau (2023, aout)
Abstract
In response to the increase in ideological and non-ideological mass killings, mental health professionals are beginning to invest in prevention and intervention in violent radicalization situations. The psychological and psychiatric literature proposes multiple psychological theories describing the individual factors at play in the process of violent radicalization: loss of meaning, responses to humiliation, dehumanization of the other as well as serious identity problems are often mentioned, but little is known about the self-representation of individuals attracted or involved in violent radicalization. This qualitative study aims at giving a sense of the complexity and texture of the experience of radicalized youth (18–30 years old), followed by a specialized clinic in Quebec (Canada). Ten patients, 18–30 years old, a significant age group for identity formation, were recruited for the study. An art-based method (self-portrait with a collage) and a projective testing method (the Thematic Apperception Test) were used to elicit the psychic representations of the patient about their identity and document their time perception. The results show that idealization and devaluation processes are central to these patients’ self-representation and are associated with adverse childhood experiences. Regarding time perception, many participants were spontaneously drawn toward a nostalgic past, manifesting significant difficulties in anchoring themselves in the present and imagining a future. These results confirm the vulnerability of this clientele and show that the projective art-based methods are perceived as more soothing than threatening. Clinical implications, tools and approaches to help evaluate and intervene with radicalized youth are discussed.
Community gardens as psychosocial interventions for refugees and migrants: a narrative review
Ramburn, T. T., Wu, Y. M., & Kronick, R.Rachel Kronick (2023, juillet)
Community gardens are increasingly used as interventions during the resettlement of refugees and other migrants. Little is known about how garden programs might support their mental health and wellbeing. Given the links between climate change and forced migration, community gardens are especially relevant, as they can also support climate change mitigation. This study aims to document psychosocial outcomes of gardening programs for refugees and migrants, and mechanisms leading to these outcomes. The authors searched major databases and the grey literature up to 2021, resulting in the inclusion of 17 peer-reviewed and 4 grey literature articles in a thematic, qualitative analysis. Four consistent themes arose from the analysis: community gardening programs promoted continuity and adaptation (81% of articles), social connectedness (81%), overall wellbeing (95%) and a sense of meaning and self-worth (67%). The results suggest that community gardens can strengthen psychosocial pillars that are key to the recovery and resettlement of refugees and migrants. The land-based and social nature of community gardening may enable connections to the land and others, nurture a sense of belonging in the host country and provide a link to the past for those from agricultural backgrounds. Further participatory action research is needed to develop guidelines for the successful implementation of community gardens by resettlement organisations. This review indicates that community gardens can be effective psychosocial interventions as part of a network of services supporting the resettlement of refugees and migrants.Abstract
Purpose
Design/methodology/approach
Findings
Research limitations/implications
Originality/value
Keywords
Are we training our students to be white saviours in global health?
Banerjee, A. T., Bandara, S., Senga, J., González-Domínguez, N., & Pai, M. Ananya Banerjee (2023, aout)
In 2012, the Nigerian-American writer and artist Teju Cole called out the culture of white saviourism in the USA and introduced the concept of the White Saviour Industrial Complex (WSIC). The make-up of global health education perpetuates and feeds into the WSIC, with universities in high-income countries (HICs) accounting for a major share of global health programmes. Global health education is in certain respects a growth industry of whiteness that promotes justice only on paper and remains rooted in harmful colonial worldviews. Cole noted that the WSIC is “not about justice”, rather “it is about a big emotional experience that validates privilege”. This reflection applies to how global health is taught, including by us as educators based in Canada, irrespective of our roots and citizenship in Sri Lanka, Rwanda, Mexico, and India. Those who work in global health in HICs benefit from an imbalance of power that maintains the white supremacist status quo, and consequently an entrenched divide in global health. As global health educators we are then compelled to ask: are we training students to be “white saviours”, irrespective of their ethnicity or country of origin, and how can global health education be reconfigured?
Children of extremist parents: Insights from a specialized clinical team
Rousseau, C., Miconi, D., Johnson-Lafleur, J., Desmarais,C., et Hassan, G.Cécile Rousseau, Janique Johnson-Lafleur, Ghayda Hassan (2023, aout)
Abstract
Background
Objective
Methods
Results
Conclusions
Community gardens as psychosocial interventions for refugees and migrants: a narrative review
Ramburn, T. T., Wu, Y. M., & Kronick, R.Rachel Kronick (2023, aout)
Community gardens are increasingly used as interventions during the resettlement of refugees and other migrants. Little is known about how garden programs might support their mental health and wellbeing. Given the links between climate change and forced migration, community gardens are especially relevant, as they can also support climate change mitigation. This study aims to document psychosocial outcomes of gardening programs for refugees and migrants, and mechanisms leading to these outcomes. The authors searched major databases and the grey literature up to 2021, resulting in the inclusion of 17 peer-reviewed and 4 grey literature articles in a thematic, qualitative analysis. Four consistent themes arose from the analysis: community gardening programs promoted continuity and adaptation (81% of articles), social connectedness (81%), overall wellbeing (95%) and a sense of meaning and self-worth (67%). The results suggest that community gardens can strengthen psychosocial pillars that are key to the recovery and resettlement of refugees and migrants. The land-based and social nature of community gardening may enable connections to the land and others, nurture a sense of belonging in the host country and provide a link to the past for those from agricultural backgrounds. Further participatory action research is needed to develop guidelines for the successful implementation of community gardens by resettlement organisations. This review indicates that community gardens can be effective psychosocial interventions as part of a network of services supporting the resettlement of refugees and migrants.Abstract
Purpose
Design/methodology/approach
Findings
Research limitations/implications
Originality/value
Keywords
Sex and gender differences in healthcare utilisation trajectories: a cohort study among Quebec workers living with chronic pain
Lacasse, A., Nguefack, H. L. N., Page, G., Choinière, M., Samb, O. M., Katz, J., Vissandjée, B. & Zerriouh, M. (2023). Bilkis Vissandjée (2023, juillet)
Abstract
Objectives Chronic pain (CP) is a poorly recognised and frequently inadequately treated condition affecting one in five adults. Reflecting on sociodemographic disparities as barriers to CP care in Canada was recently established as a federal priority. The objective of this study was to assess sex and gender differences in healthcare utilisation trajectories among workers living with CP.
Design Retrospective cohort study.
Participants This study was conducted using the TorSaDE Cohort which links the 2007–2016 Canadian Community Health Surveys and Quebec administrative databases (longitudinal claims). Among 2955 workers living with CP, the annual number of healthcare contacts was computed during the 3 years after survey completion.
Outcome Group-based trajectory modelling was used to identify subgroups of individuals with similar patterns of healthcare utilisation over time (healthcare utilisation trajectories).
Results Across the study population, three distinct 3-year healthcare utilisation trajectories were found: (1) low healthcare users (59.9%), (2) moderate healthcare users (33.6%) and (3) heavy healthcare users (6.4%). Sex and gender differences were found in the number of distinct trajectories and the stability of the number of healthcare contacts over time. Multivariable analysis revealed that independent of other sociodemographic characteristics and severity of health condition, sex—but not gender—was associated with the heavy healthcare utilisation longitudinal trajectory (with females showing a greater likelihood; OR 2.6, 95% CI 1.6 to 4.1).
Conclusions Our results underline the importance of assessing sex-based disparities in help-seeking behaviours, access to healthcare and resource utilisation among persons living with CP.
Learning from The Lived Experiences of Aging Immigrants: Extending the Reach of Photovoice Using World Café Methods
Kadowaki, L., Koehn, S. D., Brotman, S., Simard, J., Ferrer, I., Raymond, É., & Orzeck, P. Shari Brotman (2023, juillet)
Abstract
This article reports on a series of Stakeholder Outreach Forums hosted in Canadian communities from 2018 to 2019. These forums built on a previous research project, The Lived Experiences of Aging Immigrants, which sought to amplify the voices of older immigrants through Photovoice and life course narratives analyzed through an intersectional life course perspective. The forums used World Café methods to encourage cumulative discussions among a broad range of stakeholders who work with or influence the lives of immigrant older adults. Participants viewed the previously created Lived Experiences of Aging Immigrants Photovoice exhibit, which provided a springboard for these discussions. The forums’ aim was to increase the stakeholders’ awareness of the experiences of immigrants in Canada as they age and to create space for the stakeholders to reflect upon and discuss the experiences of aging immigrants. Here we illustrate how the forums complement the narrative Photovoice research methodology and highlight the potential of Photovoice and targeted outreach strategies to extend academic research findings to relevant stakeholders. Across all forums, participants identified structural and systemic barriers that shape experiences of and responses to social exclusion in the daily lives of immigrant older adults. They further identified challenges and strengths in their own work specific to the issues of social inclusion, caregiving, housing, and transportation. Intersectoral solutions are needed to address the structural and systemic roots of exclusion at the public policy and organizational levels.
Navigating bureaucratic violence in Canada’s two-step immigration system
Schmidt, C., Bergen, H., Hajjar, O., Larios, L., Nakache, D., Bhuyan, R., & Hanley, J. Jill Hanley (2023, juillet)
ABSTRACT
In recent years, Canada has moved towards a system of ‘two-step’ immigration, wherein a growing proportion of new permanent residents are selected from people who are already in the country on a temporary work permit. While the ‘two-step’ selection approach has been lauded as improving immigrants’ labour market outcomes, the process to achieve permanent residence can be complex and the stringent selection criteria prevent many migrants from attaining permanent status. In this paper, we examine the administrative burden that migrants with precarious status encounter in their interactions with state immigration bureaucracies as they try to attain permanent residence through economic programmes. The research is based on a qualitative analysis of interviews with 20 migrants with precarious status in the provinces of Ontario, Alberta and Quebec. Participants describe the stressful life consequences resulting from confusing and opaque administrative processes, unpredictable wait times, costly application fees, bureaucratic errors and a lack of accountability. We theorise how such experiences of administrative burden can compound into forms of bureaucratic violence that prolong migrant precarity, exacerbating the legal violence inherent in state immigration categories which deny full social rights to migrants without permanent residence.
Réduire le fardeau de l’hépatite C et favoriser la santé des communautés autochtones au moyen d’une pratique infirmière culturellement cohérente : une revue narrative des écrits
Patrice-Quirion, R., Dubé, V., Merry, L., & Caux, C.Lisa Merry (2023, juillet)
Résumé
Introduction : Les populations autochtones au Canada sont disproportionnellement touchées par le virus de l’hépatite C (VHC). L’intégration des cultures et savoirs autochtones aux interventions de santé est fragmentée et la pratique infirmière présente des lacunes à cet égard.
Objectifs : Cette revue narrative des écrits visait à analyser les interventions communautaires de lutte au VHC réalisées auprès de populations autochtones afin de proposer des recommandations pour renforcer la pratique infirmière en matière de VHC et la rendre plus cohérente aux besoins et valeurs des communautés autochtones.
Méthodes : Des méthodes d’examen rapide ont été adoptées. Les bases de données CINAHL, MEDLINE, EMBASE et Cochrane et le moteur de recherche Google ont été consultés. Le modèle de réceptivité communautaire de Stanley et al., (2014), qui favorise le développement d’interventions appropriées selon les forces, la problématique et le contexte, a guidé l’analyse.
Résultats : Au total, 24 sources ont servi à analyser 13 projets d’intervention. Des similarités sont ressorties dans 11/13 projets d’intervention adoptant une approche holistique (n=11) et/ou une approche de réduction des méfaits (n=7), ce qui comprend une relation de confiance, sans jugement et non stigmatisante. La mobilisation communautaire était inhérente aux 13 projets d’intervention et c’est par une approche axée sur l’autodétermination que les infirmières étaient les plus susceptibles d’inciter cette mobilisation nécessaire à l’intervention en matière de VHC.
Discussion et conclusion : Avec une approche holistique de la réduction des méfaits, l’infirmière pourrait davantage soutenir l’autodétermination et la mobilisation communautaire afin de réduire efficacement le fardeau du VHC vécu par les communautés autochtones.
Mots-clés :
- pratique infirmière,
- virus de l’hépatite C (VHC),
- Autochtones,
- réduction des méfaits,
- holistique
Social Media Interventions for Nutrition Education Among Adolescents: Scoping Review
Kulandaivelu, Y., Hamilton, J., Banerjee, A., Gruzd, A., Patel, B., & Stinson, J.Ananya Banerjee (2023, juillet)
Abstract
Background:Adolescence is a critical period for reinforcing healthy dietary behaviors and supporting the development of cooking skills. Social media may be an avenue for supporting these behaviors, as it is popular among adolescents and can improve access to nutrition education interventions. This study sought to understand the optimal implementation of effective social media–based nutrition education interventions to inform the implementation of future social media–based nutrition education interventions.
Objective:A scoping review of the characteristics, feasibility, effectiveness, and factors influencing social media–based nutrition education interventions for adolescents was conducted.
Methods:We searched MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO databases using a predefined search strategy. Primary research articles were independently screened and included if they involved adolescent populations (10-18 years old) and delivered nutrition education through social media. The information on intervention characteristics, feasibility, effectiveness, and factors influencing social media–based nutrition education interventions was extracted.
Results:A total of 28 publications out of 20,557 met the eligibility criteria. Twenty-five nutrition interventions were examined by 28 studies. Fourteen interventions used homegrown social media platforms, 8 used Facebook, and 2 used Instagram. Feasibility outcomes were infrequently reported, and the cost of intervention delivery was not reported. Engagement with interventions was variable; high engagement was not required to elicit significant improvements in dietary behaviors. Tailoring interventions, offering practical content, meaningful peer support, and involving families and communities facilitated successful interventions. Strategies to address engagement and technical issues were varied.
Conclusions:Emerging evidence demonstrates that social media interventions for adolescent nutrition are acceptable and improve nutrition outcomes. Future interventions should strengthen peer support components and tailor delivery to specific populations. Further research should examine engagement, adherence, and the impact of interventions on behavioral and physical outcomes. This review is the first to examine the use of social media as the primary medium for nutrition education for adolescent populations. The analysis used in this review argues the importance of peer support in social media–based nutrition interventions and the need for user-centered design of the interventions.
JMIR Pediatr Parent 2023;6:e36132
I think they should give primary health care a little more priority”. The primary health care in Caribbean SIDS: what can be said about adaptation to the changing climate? The case of Dominica— a qualitative study
Harris-Glenville, F., Cloos, P. Patrick Cloos (2024, juillet)
Background
Climate change (CC) adaptation is considered a priority for Caribbean Small Islands Developing States (SIDS), as these territories and communities are considered particularly vulnerable to climate-related events. The primary health care (PHC) system is an important actor in contributing to climate change adaptation. However, knowledge on how PHC is prepared for CC in Caribbean SIDS is very limited. The objective of this paper is to discuss health adaptation to climate change focusing on the PHC system.
Methods
We explored the perspectives of PHC professionals in Dominica on climate change. Focus group discussions (FGDs) were conducted in each of the seven health districts in Dominica, a Caribbean SIDS, between November 2021 and January 2022. The semi-structured interview guide was based on the Essential Public Health Functions: assessment, access to health care services, policy development and resource allocation. Data coding was organized accordingly.
Results
Findings suggest that health care providers perceive climate change as contributing to an increase in NCDs and mental health problems. Climate-related events create barriers to care and exacerbate the chronic deficiencies within the health system, especially in the absence of high-level policy support. Healthcare providers need to take a holistic view of health and act accordingly in terms of disease prevention and health promotion, epidemiological surveillance, and ensuring the widest possible access to health care, with a particular focus on the ecological and social determinants of vulnerability.
Conclusion
The Primary Health Care system should be a key actor in designing and operationalizing adaptation and transformative resilience. The Essential Public Health Functions should integrate social and climate and ecological determinants of health to guide primary care activities to protect the health of communities. This indicates a need for improved research on the linkages between climate events and health outcomes, surveillance, and development of plans that are guided by contextual knowledge in the SIDS.
Adolescents Exposed to Cumulative Natural Disasters: A Comparison Between their Realities in Rural and Urban Areas
Pouliot, E., Maltais, D., Gervais, C., Tardif-Grenier, K., Simard, A. S., Gauthier, P., ... & Hamel, A.Christine Gervais (2023, juillet)
Over the past years, the Outaouais region (Quebec, Canada) and their residents have had to endure no less than five natural disasters (floods, tornadoes). These disasters are likely to have a variety of consequences on the physical and mental health of adolescents, as well as on their personal, family, school and social lives. The experiences of teenagers are also likely to vary depending on whether they live in rural or urban areas.
Data were collected via a self-administered questionnaire in February 2022. A total of 1307 teenagers from two high schools participated in the study by completing an online survey. The questionnaire measured various aspects of the youth’s mental health using validated tests, such as manifestations of post-traumatic stress, anxiety and depression, as well as the presence of suicidal thoughts and self-harm. Other aspects of the youth’s experience were measured, including their level of social support, school engagement, alcohol and drug use, and coping strategies.
One third of young students (n=1307) were experiencing depressive symptoms and suicidal thoughts, as well as significant daily stress. More than 25% of the students had moderate or severe anxiety and thoughts of self-harm. These problems were significantly more prevalent among youths with prior exposure to a natural disaster. The study data also revealed that youths living in rural areas had a more worrying profile than those living in urban areas.
Similar to other studies (Ran et al., 2015; Stratta et al., 2014), our research data revealed that youths living in rural areas presented a more concerning profile than those residing in urban areas. It therefore seems important, in future studies and services, to focus more specifically on these teenagers to better understand their needs and to develop adapted services more likely to meet them.
Continuing professional development (CPD) system development, implementation, evaluation and sustainability for healthcare professionals in low-and lower-middle-income countries: a rapid scoping review.
Merry, L., Castiglione, S. A., Rouleau, G., Létourneau, D., Larue, C., Deschênes, M. F., ... & Ahmed, L. Lisa Merry (2023, juillet)
Embedding anti-racism in Schools of Public Health: a pathway to accountability for progress towards equity
Banerjee, A. T., Tan, A., Boston-Fisher, N., Dubois, C. A., LaFontaine, A., Cloos, P., ... & Evans, T. Ananya Banerjee, Patrick Cloos (2023, juillet)
Résumé
L’importance de voir la race comme une idée socialement construite continue de produire des différences inéquitables entre les gens et d’établir des relations de pouvoir qui mènent à l’injustice et à l’exposition à la mort. Depuis que le mouvement pour la justice raciale s’est enclenché au début de 2020, il existe une conscience aiguë des disparités raciales historiques entre les écoles de santé publique (ESP) du Canada et un intérêt accru pour le redressement de ces disparités. Des mesures ont été prises pour reconnaître le racisme systémique et accroître la diversité par des réformes structurelles visant à promouvoir l’équité et l’inclusion; cependant, pour aborder le racisme, il faut collectivement arracher les modèles institutionnels racistes qui font encore partie intégrante de l’apprentissage, de l’enseignement, de la recherche, des services et de la participation de la communauté. Dans notre commentaire, nous soulignons le besoin d’un engagement soutenu à établir des repères longitudinaux pour une plus grande équité raciale dans la population étudiante, au sein du personnel et dans le corps professoral, à revoir les programmes d’études pour y inclure les discours historiques et contemporains du colonialisme et de l’esclavage, et à offrir des possibilités d’enseignement faisant appel aux communautés, car elles contribueront à démanteler les moteurs systémiques des iniquités raciales en santé à l’échelle locale et mondiale. Nous promulguons aussi la collaboration intersectorielle, l’apprentissage mutuel et le partage des ressources entre les ESP et les organismes partenaires afin de concrétiser un plan d’action collective continue en faveur de l’équité raciale en santé et de l’inclusion – un plan qui sera intersectionnel au Canada et qui rendra des comptes aux communautés autochtones et racisées.
Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review
Hynie, M., Oda, A., Calaresu, M., Kuo, B. C., Ives, N., Jaimes, A., ... & McKenzie, K.Nicole Ives, Annie Jaimes (2023, juillet)
Immigrant and refugee populations face multiple barriers to accessing mental health services. This scoping review applies the (Levesque et al. in Int J Equity Health 12:18, 2013) Patient-Centred Access to Healthcare model in exploring the potential of increased access through virtual mental healthcare services VMHS for these populations by examining the affordability, availability/accommodation, and appropriateness and acceptability of virtual mental health interventions and assessments. A search in CINAHL, MEDLINE, PSYCINFO, EMBASE, SOCINDEX and SCOPUS following (Arksey and O’Malley in Int J Soc Res Methodol 8:19–32, 2005) guidelines found 44 papers and 41 unique interventions/assessment tools. Accessibility depended on individual (e.g., literacy), program (e.g., computer required) and contextual/social factors (e.g., housing characteristics, internet bandwidth). Participation often required financial and technical support, raising important questions about the generalizability and sustainability of VMHS’ accessibility for immigrant and refugee populations. Given limitations in current research (i.e., frequent exclusion of patients with severe mental health issues; limited examination of cultural dimensions; de facto exclusion of those without access to technology), further research appears warranted.
Interpellations policières et profilage racial: Contextualisation de la pratique d’interpellation à la lumière de l’identité racisée des personnes interpellées et évaluation de la nouvelle politique d’interpellation
Armony, V., Boatswain-Kyte, A., Hassaoui, M., & Mulone, M. Alicia Boatswain-Kyte (2023, juillet)
Le mandat
Le deuxième mandat de l’équipe de recherche indépendante découle directement des conclusions et des recommandations du premier mandat complété en 2019. Ce deuxième mandat a visé à « avoir une meilleure compréhension des interpellations afin de mieux définir leur usage et mieux prévenir les interpellations aléatoires »; à « comprendre les motivations des policiers dans le cadre des interpellations; à « évaluer l’impact de la politique sur les interpellations; à « déterminer si les interpellations sont réalisées conformément aux prescriptions de la politique »; à « évaluer la capacité [des nouveaux outils servant] à contextualiser l’interpellation policière ». Outre les nombreuses analyses statistiques à déployer, le Plan d’action soumis et approuvé par la direction du SPVM prévoyait un important volet qualitatif du mandat visant à « aborder les questions du contexte organisationnel qui sont à l’origine du mandat même et dont les policières et policiers qui seront sollicités seront évidemment conscients : l’observation de disparités ethnoculturelles dans les statistiques de l’interpellation ».
Cultural and Social Context of Clinical Assessment
Kirmayer, L. J., Rousseau, C., Jarvis,G. E. & Guzder, J. Cécile Rousseau (2023, mai)
Abstract
Careful assessment of the social and cultural context of psychiatric problems must form a central part of any clinical evaluation. Beyond this, culturally based attitudes and assumptions govern the perspectives that patient and clinician bring to the clinical encounter. Patients articulate their suffering and concerns through cultural models, idioms, and practices located with social networks and systems of meaning. Awareness of differences in the social and positions and cultural perspectives of patient and clinician is important for the development of a clinical alliance, the negotiation of treatment, and the delivery of effective care. This chapter introduces key concepts and approaches to culturally and structurally competent and safe clinical practice, including: notions of culture, ethnicity, and racialized identity; the intersectionality of culture with age, gender, sexual orientation; the use of the cultural formulation interview; working with interpreters and culture brokers; and issues of stigma, coping, and recovery.
Keywords
- Culture
- Ethnicity
- Cultural formulation
- Social determinants of health
- Racism
- Idioms of distress
- Explanatory models
- Cultural syndromes
- Cultural competence
- Cultural safety
Reconfiguring Health: The Importance of Recognizing Embodied Subjectivity and Social Dynamics in Health
Sturm, G., & Zoldan, Y. Yann Zoldan (2023, juin)
Learning from intersectoral initiatives to respond to the needs of refugees, asylum seekers, and migrants without status in the context of COVID-19 in Quebec and Ontario: a qualitative multiple case study protocol
Gautier, L., Di Ruggiero, E., Jackson, C., Bentayeb, N., Blain, M. J., Chowdhury, F., ... & Touati, N. Lara Gautier, Naïma Bentayeb (2023, juin)
Background
Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants.
Bricoleurs de rites et artistes-ritualistes au Québec : figures de proue d’un régime religieux en émergence
Kostecki, I., & Mossière, G. Géraldine Mossière (2023, juin)
Expériences de fin de vie dans un Montréal pluriel : mieux comprendre pour mieux accompagner
Symposium Depuis quelques années, une vaste recherche a été menée afin de documenter l’expérience de la fin de vie et de la mort de familles et de proches, migrants et non-migrants, qui ont perdu un être cher, à Montréal. Comment se déclinent les trajectoires de fin de vie, quels conflits et négociations engagent-elles, au sein […]
Fathering Here, Fathering There… A Phenomenological Study of the Impact of Forced Migration and Resettlement on Syrian Refugee Fathers in Canada
Al Mhamied, A., Bogossian, A., & Hanley, J.Jill Hanley (2023, juin)
Abstract
Are Healthcare Systems Failing Immigrants? Transnational Migration and Social Exclusion in the Workers’ Compensation Process in Québec
Côté, D., White, B., Dubé, J., & Gravel, S.Daniel Côté (2023, juin)
Abstract
Social and individual grievances and attraction to extremist ideologies in individuals with autism: Insights from a clinical sample
Rousseau, C., Johnson-Lafleur, J., Ngov, C., Miconi, D., Mittermaier, S., Bonnel, A., Savard, C., & Veissière, S. Cécile Rousseau, Janique Johnson-Lafleur (2023, juin)
Abstract
Background
Addressing the lack of empirical data on autistic individuals referred to clinical services because of concerns about violent extremism (VE), this paper sketches a portrait of autistic patients referred to a specialized clinical team dealing with VE in Montreal (Canada).
Methods
We draw on a mixed methods concurrent triangulation design to complement a quantitative file review with qualitative data from focus groups with clinicians.
Results
Results highlight the role of isolation, stigmatization, and social grievances as risk factors. They also emphasize the role of education, law enforcement, and justice-system professionals who frequently miss or misinterpret specific features of autism, leading to problematic risk assessments and interventions with further risks of stigmatization, trauma, and disengagement from services.
Conclusion
We suggest preliminary avenues to improve intervention for autistic individuals displaying interests for VE. Addressing social isolation and promoting environments adapted to neurodiversity could decrease despair and prevent attraction to extremist discourses. Better collaboration between the different sectors involved in prevention could promote better adapted, less stigmatizing interventions.
Le projet de loi 23: une vision de la recherche et de la formation qui renforce et invisibilise les inégalités éducatives et sociales
Borri-Anadon, C., Hirsch, S., Koubeissy, R., Larochelle-Audet, J., Magnan, M. O., Maynard, C., Audet, G. & Charette, J. Geneviève Audet, Josée Charette (2023, mai)
Ce mémoire a été élaboré par des membres chercheuses de l’équipe Inclusion et diversité ethnoculturelle en éducation (IDEÉ) financée par le Fonds de recherche du Québec – Société et Culture. Cette équipe a pour principaux objectifs :
1. de comprendre comment le personnel scolaire contribue à produire ou à réduire les inégalités éducatives en contexte de diversité ethnoculturelle ;
2. d’identifier comment les institutions éducatives, du préscolaire jusqu’à l’université, et leurs agents peuvent contribuer à réduire les inégalités et favoriser la justice sociale ;
3. de contribuer à éclairer les politiques en éducation et en immigration, les initiatives communautaires, la formation initiale et continue du personnel scolaire et les pratiques des milieux éducatifs. L’équipe IDEÉ adopte une posture critique afin de comprendre comment certaines pratiques et certains processus structurels agissent sur la réussite éducative et sur l’expérience de tou.te.s les actrices et acteurs de l’école, notamment les actrices et acteurs de groupes minorisés ou racisés. L’équipe IDEÉ rassemble :
● 11 chercheuses régulières mobilisant une diversité d’approches de recherche et de disciplines dont la sociologie, la psychopédagogie, la psychologie sociale, la didactique et l’administration scolaire;
● 40 étudiantes et étudiants à la maitrise et au doctorat;
● 11 collaboratrices et collaborateurs des milieux de pratique travaillant dans les institutions éducatives et gouvernementales ainsi que dans des organismes communautaires.
Empowerment and intervention strategies to strengthen the use of sexual and reproductive health services by ensuring continuity of care for adolescent girls and internally displaced women in Burkina Faso
Sawadogo, P. M., Ngeumeleu, E. T., Onadja, Y., & Sia, D.Drissa Sia (2023, mai)
Abstract
Background: In Burkina Faso, a security crisis has displaced families within the country, fleeing high-risk areas. One of the major consequences of this displacement is the low use of sexual and reproductive health care and services, and the reduced empowerment of adolescent girls and internally displaced women (IDP). This research aims to analyze the situation and co-develop intervention strategies to strengthen the empowerment of these adolescent girls and IDP women for the use of these services by ensuring the continuity of this care.
Methods: This study is based on a mixed approach (quantitative and qualitative). The quantitative component is based on a survey of 1,474 randomly selected households in temporary IDP reception sites in the cities of Kaya and Kongoussi in Burkina Faso. Empowerment was analyzed in terms of motivational autonomy and exercise of choice in family planning. Descriptive analysis and multivariate logistic regression have allowed us to describe the empowerment of IDP women and adolescent girls and identify the determinants of the use of modern contraception among IDP adolescents and women. The qualitative component has enabled to co-construct intervention strategies to strengthen empowerment and also ensure continuity of care, using a participatory approach supported by a deliberative workshop.
Results: Out of a sample of 1,220, adolescent girls (12-19 years old) and women (20-49 years old) represented respectively 17.5% and 82.5%. The analysis showed that 42.5% of IDP adolescent girls and women were using a modern method of contraception at the time of the survey. The analysis also showed that 89.2% and 79.5% of adolescent girls and IDP women have low levels of motivational autonomy and exercise of choice in family planning, respectively. A poor perception of contraceptives side effects and possible difficulties with the partner or even the fear of having difficulties returning to fertility after contraception « »damage » » women’s motivation to use contraception methods. In addition, the ability to discuss with the partner hinders the exercise of choice in contraception. Intervention strategies based on community dialogue and communication with IDPs and community members have emerged as those promoted to facilitate the use and continuity of health services.
Recommendations: Empowerment appears as a determining factor to enhance the contraceptive demand by adolescent girls and internally displaced women. Community dialogue and communication sessions on family planning for IDPs and the population must be well implemented.
Family Functioning and the Pandemic: How Do Parental Perceived Social Support and Mental Health Contribute to Family Health?
Gervais, C., Côté, I., Pierce, T., Vallée-Ouimet, S., de Montigny, F. Christine Gervais (2023, mai)
Background
Objective
Method
Results
Conclusion
Taking Action on Racism and Structural Violence in Psychiatric Training and Clinical Practice
Jarvis G.E., Andermann L., Ayonrinde O.A., Beder, M., Cénat, J. M., Ben-Cheikh, I., Fung, K., Gajaria, A., Gómez-Carrillo,A., Guzder, J., Hanafi, S., Kassam, A., Kronick, R., Lashley, M., Lewis-Fernández, R., McMahon, A., Measham, T., Nadeau, L., Rousseau,C., Sadek,J., Schouler-Ocak, M., Wieman, C., Kirmayer, L.Rachel Kronick, Myrna Lashley, Lucie Nadeau, Cécile Rousseau (2023, mai)
Introduction
Recent events in Canada, such as the discovery of graves of Indigenous children at former residential schools and the emergence of Black Lives Matter, have highlighted inequities long endured by Black, Indigenous, Asian and other racialized minorities, and mobilized efforts to address the effects of racism on health, mental health and well-being.1–8 The Canadian Psychiatric Association published a position statement, A Call to Action on Racism and Social Justice in Mental Health, which was prepared by the Transcultural Psychiatry Section, to advocate for diversification of the mental health workforce, cultural and structural safety in educational and clinical environments, dismantling of racist mental health theory and practice, and transformation of institutional structures to make them more equitable and responsive.9 This paper advances that call by taking the position that Canadian psychiatry must act now to redress the ongoing problem of systemic racism through concerted changes in training and mental health services as outlined in this paper. The objectives of this position paper are to:
Enjeux et pratiques auprès des personnes LGBTQI+ migrantes et racisées
Colloque Dans le cadre du 90e congrès de l’ACFAS. Les réalités des personnes lesbiennes, gaies, bisexuelles, trans, queer et intersexuées (LGBTQI+) migrantes et racisées sont complexes, du fait notamment des violences qu’elles ont pu subir tout au long de leur parcours migratoire. Souvent elles ont été contraintes de quitter leur pays d’origine en raison de […]
Evaluating the feasibility and outcomes of a resident-led school-based pediatric clinic
D’Arienzo, D., Xu, S., Shahid, A., Meloche, D., Hebert, J., Dougherty, G., Li, P., & Sternszus, R.Patricia Li (2023, mai)
Abstract
A resident-led school-based clinic to serve low-income populations was established in 2019 and served as a continuity clinic for pediatric residents at a single university. Our aim was to assess the feasibility, clinic outcomes, and resident experience of a resident-led school-based clinic (RLSBC), established in an elementary school that serves an underserved population.
A retrospective chart review for the first 6 months (October 2019 to March 2020) of clinic operations was conducted. Feasibility metrics included the number of patients, visits and planned follow-ups; clinic outcomes included the number and type of presenting complaint, new diagnoses and interventions. Residents were also surveyed to assess their satisfaction and perceived learning in training at the school-based clinic.
Over the first 19 clinic days, 48 children were seen at the school-based clinic. Of the clinic users, 60% did not have a primary care physician, 46% received a new diagnosis, 46% received an intervention in the form of medication prescription, laboratory/imaging requisitions or referrals, and 96% received a treatment plan. Residents positively rated the experience of staffing the school-based clinic in all aspects, including learning environment, clinic and team environment, teaching obtained, practice management, and overall experience.
A RLSBC is feasible and our outcomes suggest that such clinics may address health care needs of low-income families and children, while being a positively rated educational experience for pediatric residents.
Revisiter l’intervention en contexte interculturel : état des lieux, promesses et défis dans un monde en tensions
Journées d’étude Voir le programme
Have public health responses to COVID-19 considered social inequalities in health? Insights from Brazil, Canada, France & Mali
Gagnon-Dufresne, M.-C., Gautier, L., Beaujoin, C., Richard, Z., Boivin, P., Medeiros, S. G. de, Ridde, V., & Zinszer, K. Lara Gautier (2023, mai)
Travailler en zone rouge : préposés aux bénéficiaires migrants et contexte pandémique
CATHERINE MONTGOMERY, professeure, Département de communication sociale et publique, UQAM ALEXIA PILON, doctorante, Institut santé et société, UQAM MARIE-JEANNE BLAIN, chercheure, Centre de recherche et de partage des savoirs InterActions CIUSSS du Nord-de-l’Île-de-Montréal. Professeure associée, département d’anthropologie, Université de Montréal ÉMILIE TREMBLAY, doctorante, Département de communication sociale et publique, UQAM, MARIE-EMMANUELLE LAQUERRE, professeure, Département de […]
Transnational prenatal care among migrant women from low-and-middle-income countries who gave birth in Montreal, Canada
Merry, L., Kim, Y. N., Urquia, M. L., Goulet, J., Villadsen, S. F., & Gagnon, A.Lisa Merry (2023, avril)
Abstract
Objectives
There is little research examining transnational prenatal care (TPC) (i.e., prenatal care in more than one country) among migrant women. Using data from the Migrant-Friendly Maternity Care (MFMC) – Montreal project, we aimed to: (1) Estimate the prevalence of TPC, including TPC-arrived during pregnancy and TPC-arrived pre-pregnancy, among recently-arrived migrant women from low- and middle-income countries (LMICs) who gave birth in Montreal, Canada; (2) Describe and compare the socio-demographic, migration and health profiles and perceptions of care during pregnancy in Canada between these two groups and migrant women who received no TPC (i.e., only received prenatal care in Canada); and (3) Identify predictors of TPC-arrived pre-pregnancy vs. No-TPC.
Methods
The MFMC study used a cross-sectional design. Data were gathered from recently-arrived (< 8 years) migrant women from LMICs via medical record review and interview-administration of the MFMC questionnaire postpartum during the period of March 2014-January 2015 in three hospitals, and February-June 2015 in one hospital. We conducted a secondary analysis (n = 2595 women); descriptive analyses (objectives 1 & 2) and multivariable logistic regression (objective 3).
Results
Ten percent of women received TPC; 6% arrived during pregnancy and 4% were in Canada pre-pregnancy. The women who received TPC and arrived during pregnancy were disadvantaged compared to women in the other two groups (TPC-arrived pre-pregnancy and No-TPC women), in terms of income level, migration status, French and English language abilities, access barriers to care and healthcare coverage. However, they also had a higher proportion of economic migrants and they were generally healthier compared to No-TPC women. Predictors of TPC-arrived pre-pregnancy included: ‘Not living with the father of the baby’ (AOR = 4.8, 95%CI 2.4, 9.8), ‘having negative perceptions of pregnancy care in Canada (general experiences)’ (AOR = 1.2, 95%CI 1.1, 1.3) and younger maternal age (AOR = 1.1, 95%CI 1.0, 1.1).
Conclusion
Women with more capacity may self-select to migrate during pregnancy which results in TPC; these women, however, are disadvantaged upon arrival, and may need additional care. Already-migrated women may use TPC due to a need for family and social support and/or because they prefer the healthcare in their home country.
Mobilités transnationales et changement religieux
Mossière, G.Géraldine Mossière (2023, avril)
Cet article traite de la conversion à l’islam comme d’une expérience initiatique qui s’inscrit dans le parcours de mobilité transnationale de jeunes Français séjournant au Québec. En nous appuyant sur des données ethnographiques collectées auprès de jeunes adoptant des croyances et pratiques liées à l’islam, nous montrons que la mobilité physique agit parfois comme un déclencheur pour rendre concrètes une situation et une identification auparavant vécues de façon floue ou non assumée. Cette mobilité s’appuie sur des mythscapes (Bell) c’est-à-dire des représentations spécifiques des pays de départ, des pays visités et des pays de destination nourris de fantasmes, d’exotisme, de désirs mais aussi de mal-être, et de désirs d’un ailleurs. L’étude de quelques cas suggère que ce mouvement participe de l’émergence d’une sous-culture que les jeunes rencontrés décrivent en recourant aux narratifs de l’« inter- » (interreligieux, intersectionnel). Ces vignettes offrent un aperçu des multiples façons dont les jeunes s’approprient les ressources et les outils offerts par la mondialisation en s’attribuant certaines identifications religieuses mobiles.Résumé
Adapting Hospital Work During COVID-19 in Quebec (Canada)
David P. , Gabet, M., Duhoux, A.,Traverson, L., Ridde,V., Zinszer, K. & Gautier, L.Lara Gautier (2023, avril)
ABSTRACT
Among hospital responses to the COVID19 pandemic worldwide, service reorganization and staff reassignment have been some of the most prominent ways of adapting hospital work to the expected influx of patients. In this article, we examine work reorganization induced by the pandemic by identifying the operational strategies implemented by two hospitals and their staff to contend with the crisis and then analyzing the implications of those strategies. We base our description and analysis on two hospital case studies in Quebec. We used a multiple case study approach, wherein each hospital is considered a unique case. In both cases, work adaptation through staff reassignment was one of the critical measures undertaken to ensure absorption of the influx of patients into the hospitals. Our results showed that this general strategy was designed and applied differently in the two cases. More specifically, the reassignment strategies revealed numerous healthcare resource disparities not only between health territories, but also between different types of facilities within those territories. Comparing the two hospitals’ adaptation strategies showed that past reforms in Quebec determined what these reorganizations could achieve, as well as how they would affect workers and the meaning they gave to their work.
KEYWORDS:
Le vécu des parents d’enfants trans et non-binaires au Saguenay-Lac-Saint-Jean : Rapport de recherche
Yann Zoldan (2023, avril)
Zoldan, Y., Rambeaud-Collin, D., Bergeron, C., Boulianne, N. et Desmarais, F.
Le rapport présente notre recherche sur l’expérience des parents d’enfants trans ou non-binaires dans la région du Saguenay-Lac-Saint-Jean. La méthodologie utilisée est qualitative et phénoménologique, entretiens et analyses herméneutiques contextuelles critiques. Nous avons rencontré quinze parents de la région. Les résultats ont montré que les parents ont vécu un stress parental accru lié à la transphobie, aux normes de binarité de genre et à la cisnormativité, mais aussi en raison de l’absence de services adaptés pour répondre à leurs besoins d’information, de soutien, notamment psychologiques et de soins trans affirmatifs pour leurs enfants. Les résultats décrivent plusieurs dynamiques psychologiques : un choc initial lié au coming out, vécu par les parents et pouvant affecter leur capacité de mentalisation, entraînant parfois des difficultés sur le moment à comprendre, à maintenir une relation et à réagir de manière ajustée à la situation. Les résultats ont également montré des temporalités et des rythmes dysharmoniques entre parents et enfants ainsi que la nécessité de négocier une temporalité et une expérience commune. Les facteurs concomitants majorant le stress parental présents dans cette recherche incluent les inégalités économiques, la présence de trauma dans l’histoire familiale et les troubles de santé mentale au sein de la famille. Le rapport met en évidence la richesse des expériences parentales et l’importance de respecter leur caractère unique. Le rapport propose des recommandations pour les parents, les professionnel·le·s de la santé et pour promouvoir l’inclusivité dans la société.
Expérience des réfugiés, demandeurs d’asile et migrants sans statut et offre de services de santé et sociaux pendant la pandémie au Québec
Gautier, L., Bentayeb, N., Cleveland J., Hanley, J., Cloos, P., Gagnon, M. et Dufour, A.Lara Gautier, Naïma Bentayeb, Janet Cleveland, Jill Hanley, Patrick Cloos, Mélanie M. Gagnon, Andréanne Dufour (2023, avril)
Nos membres Naïma Bentayeb et Lara Gautier sont les responsables du dernier numéro de la revue Alterstice sous le thème « Expérience des réfugiés, demandeurs d’asile et migrants sans statut et offre de services de santé et sociaux pendant la pandémie au Québec ».
Plusieurs autres membres de SHERPA ont contribué à ce numéro dont Janet Cleveland, Jill Hanley, Patrick Cloos, Mélanie M. Gagnon et Andréanne Dufour, membre de notre équipe.
Attributes and Organizational Factors that Enabled Innovation in Health Care Service Delivery during the COVID-19 Pandemic – Case Studies from Brazil, Canada and Japan
Honda, A., de Araujo Oliveira, S. R., Ridde, V., Zinszer, K., & Gautier, L. Lara Gautier (2023, avril)
Abstract
Innovation by health service organizations can enable adaptation to and transformation of challenges caused by health shocks. Drawing on results from case studies in Brazil, Canada, and Japan, this study looked at innovations the study hospitals introduced in response to challenges caused by COVID-19 to identify: 1) attributes of the innovations that make them conducive to adoption; and 2) organizational factors that facilitate the creation and implementation of innovative health care approaches during health system shocks. Qualitative information was gathered using key informant interviews, participatory observations at the study hospitals and a review of relevant documentation. A thematic approach was used for analysis, and a cross-country comparison framework was prepared to synthesize findings from the case studies in the three countries. In response to the disruptions caused by COVID-19, the study hospitals undertook innovative changes in services, processes, organizational structures, and operational policy. The driving force behind the innovations was the need and urgency generated by the unprecedented nature of the pandemic. With COVID-19, if an innovation met the perceived needs of hospitals and provided an operational advantage, some level of complexity in the implementation appeared to be acceptable. The study findings suggest that for hospitals to create and implement innovations in response to health shocks, they need to: have adaptive and flexible organizational structures; build and maintain functioning communication systems; have committed leadership; ensure all staff share an understanding of hospital organizational and professional missions; and establish social networks that facilitate the creation and implementation of new ideas.
Sexual Regulation and Liberation in Quebec: Gender Relationships as a Driving Force for Social Change.
Mossière, G. Géraldine Mossière (2023, avril)
Le curatif, le palliatif… quelle importance ? L’expérience de parents ayant accompagné leur enfant dans la grande maladie et la fin de vie
Fortin, S., Lessard, S. et Lajeunesse, A.Sylvie Fortin (2023)
Cadre de la recherche : Dans la grande maladie, la prolifération des possibilités thérapeutiques retarde souvent le moment où la mort est envisagée et où les soins palliatifs, trop souvent associés à la fin de vie et à la mort, sont introduits dans les trajectoires des malades. Dans ce contexte, les soins palliatifs pédiatriques tentent de jouer un rôle actif dans la relation de soins, au-delà de l’idée de traitements pour la guérison.
Objectifs : Notre article cherche à mieux comprendre le moment où les soins palliatifs deviennent une possibilité dans la trajectoire de la grande maladie, et comment ils sont représentés. Nous nous intéressons à la place que ces soins occupent dans le vécu des parents, ainsi que la manière dont s’exprime leur expérience de la grande maladie, et plus précisément la dimension relationnelle de la fin de vie.
Méthodologie : Nous nous appuyons sur les témoignages de parents dont les enfants ont souffert de maladies graves et de décès. Par le biais d’entretiens individuels semi-dirigés entre 2017 et 2019, nous avons recueilli les histoires de 16 enfants et adolescents montréalais d’origine migrante ou non-migrante (10 garçons et 6 filles âgés de quelques semaines à 19 ans), atteints d’une maladie génétique ou rare, d’un cancer ou de plusieurs maladies chroniques.
Résultats : Non seulement le type de maladie est une composante importante dans le parcours des soins palliatifs, mais le care et le profil des familles sont également déterminants dans la perception d’une expérience (néanmoins) positive de la fin de vie de leur enfant.
Conclusions : Les perspectives thérapeutiques curatives/palliatives ont peu d’influence sur la satisfaction de nos participants quant aux soins de fin de vie, tant qu’un lien de confiance thérapeutique est présent entre la famille et l’équipe soignante. Que ce soit positif ou négatif, ce lien de confiance influence les relations de soins pédiatriques et les trajectoires de maladies graves, ainsi que les expériences de fin de vie vécues par les proches.
Contribution : À travers les expériences d’enfants en fin de vie telles que partagées (principalement) par les mères, cet article aborde les perspectives curatives et palliatives telles que choisies par les parents d’enfants confrontés à un sombre pronostic. Au-delà des différentes philosophies qui habitent ces approches, la qualité (et la continuité) des relations établies avec les soignants est un facteur déterminant dans la qualité des expériences documentées par notre étude.
How Did an Integrated Health and Social Services Center in the Quebec Province Respond to the COVID-19 Pandemic? A Qualitative Case Study
Gabet, M., Duhoux, A., Ridde, V., Zinszer, K., Gautier, L., & David, P.-M. Lara Gautier (2023, mars)
ABSTRACT
During the first and second waves of the pandemic, Quebec was among the Canadian provinces with the highest COVID-19 mortality rates. Facing particularly large COVID-19 outbreaks in its facilities, an integrated health and social services center in the province of Quebec (Canada), developed resilience strategies. To explore these diverse responses to the crisis, we conducted a case study analysis of a Quebec integrated health and social services center, building on a conceptualization of resilience strategies using “configurations” of effects, strategies, and impacts. Qualitative data from 14 indepth interviews conducted in the summer and fall of 2020 with managers and frontline practitioners were analyzed through the lens of situations of “anticipation,” “reaction,” or “inaction.” The findings were discussed in three results dissemination workshops, two with practitioners and one with managers, to discern lessons they learned. Three major configurations emerged: 1) reorganization of services and spaces to accommodate more COVID-19 patients; 2) management of contamination risks for patients and professionals; and 3) management of personal protective equipment (PPE), supplies, and medications. Within these configurations, the responses to the crisis were strongly shaped by the 2015 health care system reforms in Quebec and were constrained by organizational challenges that included a centralized model of governance, a history of substantial budget cuts to longterm care facilities, and a systematic lack of human resources.
Protection de travailleuses migrantes et précaires contre le harcèlement sexuel et les agressions sexuelles en milieu de travail. Avis au comité d’expertes, harcèlement et agression sexuelle
Groupe de travail sur les travailleurs (im)migrants : Sonia Ben Soltane, Marie-Jeanne Blain, Daniel Côté, Jill Hanley, Mostafa Henaway, Rabih Jamil, Jacques Rhéaume, Manuel Salamanca Cardona, Cheolki YoonJill Hanley, Sonia Ben Soltane, Daniel Côté, Jacques Rhéaume (2023, mars)
9. Islamophobia in the portugese opinion press