Publications (131) View all
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Article: Staff perceptions and organizational factors as predictors of seclusion and restraint on psychiatric wards.
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ABSTRACT: Several factors have been shown to be involved in decisions to use seclusion and restraint in psychiatric inpatient settings. This study examined whether staff perceptions of factors related to the care team and violence on the ward predicted use of seclusion and restraint in psychiatric wards. A total of 309 staff members (nurses, rehabilitation instructors, and nurse's aides) providing care to patients with serious mental disorders were recruited from eight university psychiatric hospitals and general-hospital psychiatric units in the province of Quebec. Factors assessed included sociodemographic characteristics, psychological distress, staff perceptions of aggression and of interaction between members of the psychiatric team (team climate), and organizational factors. Bivariate analyses showed that certain aspects of the team climate, staff perceptions of aggression, and organizational factors were associated with greater use of seclusion and restraint. The final multivariate model indicated that the following factors independently predicted greater use: type of hospital ward (emergency department and intensive care unit), staff perception of a higher level of expression of anger and aggression among team members, perception of the frequency of incidents of physical aggression against the self among patients, and perception of insufficient safety measures in the workplace. These findings represent the first stage of a research program aimed at reducing use of seclusion and restraint in psychiatric settings. They underscore the importance of evaluating a variety of factors, including perceptions of safety and violence, when examining reasons for use of these controversial interventions.Psychiatric services (Washington, D.C.) 05/2011; 62(5):484-91. · 2.81 Impact Factor -
Article: The longitudinal association from obesity to depression: results from the 12-year National Population Health Survey.
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ABSTRACT: Prior observational studies have investigated the association between obesity and depression but evidence remains weak and mixed. There has been a call for high-quality longitudinal studies to elucidate the etiologic relationship from obesity to depression. The main objective of this study was therefore to investigate whether obesity was a risk factor for depression in a nationally representative sample followed for 12 years. Seven waves of data collection (1994-1995 to 2006-2007) were obtained from the National Population Health Survey (NPHS). Our analyses included 10,545 adults without depression at baseline. Past-year major depression episode (MDE) was assessed from the Composite International Diagnostic Interview-Short Form for Major Depression (CIDI-SFMD). Obesity was estimated using baseline BMI from self-reported weight and height (obesity: BMI > or =30 kg/m(2)). Kaplan-Meier survival curves were generated and Cox proportional hazard regression modeling was used to estimate the risk of MDE by obesity status, controlling for sociodemographic and health and lifestyle variables. We found that obesity at baseline did not significantly predict subsequent MDE in women (adjusted hazard ratio (AHR): 1.03, 95% confidence interval (CI) 0.84-1.26) and negatively predicted MDE in men (HR: 0.71, CI 0.51-0.98), after adjusting for important confounders. In summary, our findings suggest that obesity is a significant (negative) predictor of depression in adult men but not in women. These results moderate prior evidence supporting a positive link from obesity to depression.Obesity 10/2009; 18(5):1033-8. · 4.28 Impact Factor -
Article: The psychosocial work environment and evidence utilization by health professionals.
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ABSTRACT: The purpose of this study was to investigate the relationships between dimensions of the psychosocial work environment and health professionals' use of evidence in their practice. A correlational descriptive design was developed. Health professionals working in mental health units at 2 hospitals were asked to complete a questionnaire about their perceptions of the psychosocial work environment and their use of evidence. Correlations and regression analyses were performed. Use of evidence was found to be correlated with social support and decision latitude. Results of multiple regression analyses found perceived social support (beta = .27, p < .01) and perceived decision latitude (beta = .25,p < .01) to be significant predictors of the use of evidence. The authors conclude that good social support and decision latitude among interprofessional groups may promote use of evidence by health professions in their practice.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 12/2008; 40(4):112-28. -
Article: The Psychosocial Work Environment and Evidence Utilization by Health Professionals L'environnement psychosocial au travail et l'utilisation de données probantes par les professionnels de la santé
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ABSTRACT: The purpose of this study was to investigate the relationships between dimensions of the psychosocial work environment and health professionals' use of evidence in their practice. A correlational descriptive design was developed. Health professionals working in mental health units at 2 hospitals were asked to complete a questionnaire about their perceptions of the psychosocial work environment and their use of evidence. Correlations and regression analyses were performed. Use of evidence was found to be correlated with social support and decision latitude. Results of multiple regression analyses found perceived social support (β = .27, p < .01) and perceived decision latitude (β = .25, p < .01) to be significant predictors of the use of evidence. The authors conclude that good social support and decision latitude among interprofessional groups may promote use of evidence by health professions in their practice. French Cette étude a pour but d'étudier les liens entre divers aspects de l'environnement psychosocial au travail et l'utilisation de données probantes par les professionnels de la santé dans le cadre de leur pratique. Une descriptive corrélationnelle a été élaborée et les professionnels de la santé æuvrant dans les unités de santé mentale de deux hôpitaux ont été invités à remplir un questionnaire sur leurs perceptions de leur environnement psychosocial au travail et sur leur utilisation de données probantes. Des corrélations et des analyses de régression ont été réalisées et les résultats indiquent qu'il existe une corrélation entre l'utilisation de données probantes et le soutien social, ainsi que le pouvoir décisionnel. Selon les résultats des multiples analyses de régression, le soutien social perçu (β = 0,27, p < 0,01) et le pouvoir décisionnel perçu (β = 0,25, p < 0,01) constituent d'importantes variables explicatives quant à l'utilisation de données probantes. Les auteurs de l'étude ont conclu que la présence d'un solide soutien social et d'un pouvoir décisionnel certain au sein des groupes interprofessionnels incite les professionnels de la santé à utiliser des données probantes dans le cadre de leur pratique.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 11/2008; 40(4):112-128. -
Article: Psychiatric risk factors for motor vehicle fatalities in young men.
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ABSTRACT: Motor vehicle accident (MVA) fatalities are an important cause of death in young men. Psychiatric disorders have been shown to be risk factors for MVA, but only a few studies have investigated MVA fatalities. A case-control study was carried out comparing 61 young male MVA fatalities in which the subject was the driver with an equal number of living male subjects matched for age (case by case with no more than 1 year's difference between case subjects and control subjects) with the accident group. We assessed both groups, using structured interviews and psychological autopsies. Our results suggest that cluster B personality disorders (borderline and [or] antisocial) (OR 3.54; 95%CI, 1.38 to 16.01) and substance use disorders in the last 6 months (OR 4.33; 95%CI, 1.42 to 9.25) increased the risk of dying in MVAs. In addition, we observed an age effect, where differences in cluster B personality disorders and substance use disorders in the last 6 months were only significantly more prevalent in case subjects aged 26 years or over, compared with control subjects of the same age. Drivers under age 25 years appeared to be comparable with control subjects on all measures of psychopathology. Finally, this interaction between cluster B personality disorders and age over 26 years was the only significant predictor of car fatalities (adjusted OR 16.25; 95%CI, 1.67 to 158.10). Borderline and antisocial personality disorders in which impulsive-aggressive behaviours play a central role and substance use disorders appear to be risk factors for young male deaths in MVAs. Interestingly, this effect seems to be specific to MVA case subjects aged 26 years or over.Canadian journal of psychiatry. Revue canadienne de psychiatrie 12/2005; 50(13):838-44. · 2.42 Impact Factor
