Caroline Arbour

Université de Montréal | UdeM · Faculty of Nursing

L'examen neurologique est un aspect important de la pratique infirmière en soins critiques. Au sein de cet examen, l'évaluation des pupilles peut fournir des informations vitales chez la personne gravement malade. À la salle d'urgence spécifiquement, les infirmier.ères jouent un rôle déterminant dans l'identification de changements subtils au nivea...

Objective : This project aimed to train nurses on an oncology unit in hypnotic communication to reduce treatment-related pain and anxiety in their patients. A pilot study was conducted to assess changes in hypnotic communication behaviors associated with the training. Methods : Nurses were recruited and their interactions during a simulated patient...

Background Clinical simulations are complex educational interventions characterized by several design features, which have the potential to influence cognitive load, that is, the mental effort required to assimilate new information and learn. This systematic review and meta-analysis explored the associations between simulation design features and c...

Introduction: Conversational hypnosis (CH) is known to optimize the management of symptoms resulting from antineoplastic treatment. However, the perception of nurses who have been called upon to integrate this practice into their care has yet to be documented. Goal: Describe how nurses perceive the integration of CH into chemotherapy-related care....

Study Objectives Traumatic brain injuries (TBI) cause persistent cerebral damage and cognitive deficits. Because sleep may be a critical factor to brain recovery, we characterized the sleep of patients with traumatic brain injury from early hospitalization to years post-injury, and explored the hypothesis that better sleep during hospitalization pr...

This chapter describes the interactions between pain and sleep and how pain is processed during sleep. It overviews the most frequent sleep disorders in chronic pain and provides advice for clinicians to guide patients in the management of sleep in the absence or in the presence of sleep disorders. Sleep quality can be easily estimated in pain and...

Objective In this proof-of-concept study we sought to explore whether the combination of conditioning procedure based on a surreptitious reduction of a noxious stimulus (SRPS) could enhance rTMS hypoalgesic effects [i.e., increase heat pain threshold (HPT)] and augment intervention expectations in a healthy population. Methods Forty-two healthy vo...

IMPORTANCE Limiting opioid overprescribing in the emergency department (ED) may be associated with decreases in diversion and misuse. OBJECTIVE To review and analyze interventions designed to reduce the rate of opioid prescriptions or the quantity prescribed for pain in adults discharged from the ED. DATA SOURCES MEDLINE, Embase, CINAHL, PsycINFO,...

Purpose This pilot-controlled trial aimed to examine the feasibility and acceptability of hypnosis-derived communication (HC) administered by trained nurses during outpatient chemotherapy to optimize symptom management and emotional support — two important aspects of patient well-being in oncology. Methods The trial was conducted in two outpatient...

BACKGROUND: Analgesia monitoring is essential to preserve comfort in critically ill sedated patients with traumatic brain injury (TBI). Although pupil dilation (PD) and pain behaviors can be used to assess analgesia, these indicators require application of noxious stimulations for elicitation. Recently, the pupillary light reflex (PLR) has emerged...

Rationale: Predicting recovery of consciousness in unresponsive, brain-injured individuals has crucial implications for clinical decision-making. Propofol induces distinctive brain network reconfiguration in the healthy brain as it loses consciousness. In patients with disorders of consciousness, the brain network's reconfiguration to propofol may...

Introduction Agitation and violent behaviours are common conditions developed by patients with acute traumatic brain injury (TBI) in intensive care units (ICUs). Healthcare professionals caring for these patients have various tools to manage these behaviours, but lack of a formal protocol to assess and manage them makes caring for these patients a...

Objective: The objective of this review is to assess the effect of simulation activities and their design features on cognitive load in health care professionals and students. Introduction: Simulation activities are now widely implemented in health care professionals' education. However, the mechanisms by which simulations and their design featu...

Aim This study aimed to investigate the transition from hospital to home after elective colorectal surgery performed in an Enhanced Recovery After Surgery (ERAS) programme. Design An integrative review. Methods A search of ten electronic databases was conducted. Data extraction and quality assessment were performed independently by two authors. D...

Background: Agitated behaviors are problematic in intensive care unit (ICU) patients recovering from traumatic brain injury (TBI) as they create substantial risks and challenges for healthcare providers. To date, there have been no studies evaluating their epidemiology and impact in the ICU. Prior to planning a multicenter study, assessment of recr...

Study Objectives Sleep-wake complaints and difficulties in making new learning are among the most persistent and challenging long-term sequelea following moderate-severe traumatic brain injury (TBI). Yet, it is unclear whether, and to what extent, sleep characteristics during the chronic stage of TBI contribute to sleep-wake and cognitive complaint...

Neuroimaging methods have improved the accuracy of diagnosis in patients with disorders of consciousness (DOC), but novel, clinically translatable methods for prognosticating this population are still needed. In this case series, we explored the association between topographic and global brain network properties and prognosis in patients with DOC....

Sleep spindles are an essential part of non-rapid eye movement sleep, notably involved in sleep consolidation, cognition, learning, and memory. These oscillatory waves depend on an interaction loop between the thalamus and the cortex, which relies on a structural backbone of thalamo-cortical white matter tracts. It is still largely unknown if the b...

Introduction Slow waves and spindles are essential oscillations occurring during NREM sleep that may be disrupted by moderate to severe traumatic brain injury (TBI). We investigated these oscillations in the acute and chronic trauma stage. Methods Four groups were tested with whole-night polysomnography: hospitalized patients with acute TBI (n=10,...

AU COURS DES DERNIÈRES ANNÉES, plusieurs études se sont intéressées à la simulation clinique haute-fidélité pour rehausser le travail des équipes interprofessionnelles en traumatologie. Cette stratégie pédagogique gagne également en popularité auprès des formateurs cliniques responsables du développement professionnel des équipes de soins à la sall...

Background Chronic pain after moderate-to-severe traumatic brain injury (TBI) is associated with notable sensory alterations. Although the incidence of TBI is rapidly growing in older populations, elderly individuals have been largely excluded from sensory testing studies, thus limiting evidence regarding the influence of age on pain-related sensor...

Statement: This systematic review synthesizes the relevant evidence about the effectiveness of interprofessional manikin-based simulation training on teamwork among real teams during trauma resuscitation in adult civilian emergency departments. A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, EBM reviews, PsycINFO, and Web...

Introduction: Traumatic brain injury (TBI) is a major public health concern. Persistent post-traumatic headache (PTH) is a common consequence of TBI affecting productivity and quality of life. The only review providing information about headache prevalence after TBI was published in 2008, combined data from civilian and military TBI, and was strict...

Introduction Agitated behaviours (AB) constitute hallmark behaviours of intensive care unit (ICU) patients recovering from traumatic brain injury (TBI). These behaviours create significant challenges for patients and healthcare providers including the need for pharmacologic treatment, delaying mechanical ventilation weaning and mobilization, and co...

The restorative function of sleep partly relies on its ability to deeply synchronize cerebral networks to create large slow oscillations observable with EEG. However, whether a brain can properly synchronize and produce a restorative sleep when it undergoes massive and widespread white matter damage is unknown. Here, we answer this question by test...

Background Central pain associated with changes in sensory thresholds is one of the most enduring consequences of major trauma. Yet it remains sparsely studied among community-dwelling survivors of moderate-to-severe traumatic brain injury (TBI). Purpose To describe and compare thermal and mechanical sensory thresholds in home-based patients with...

Context: Many brain-injured patients are unable to self-report their pain during their hospitalization in the intensive care unit (ICU), and existing behavioral pain scales may not be well suited. Objectives: The objectives of this study were to describe and compare behaviors in brain-injured patients with different levels of consciousness durin...

Introduction: Most adults with moderate to severe traumatic brain injury (TBI) report persistent sleep-wake disturbances. Whether these complaints are either associated with abnormal sleep-wake patterns or can be explained by TBI-related characteristics is unclear. The present study aimed at characterising the subjective and objective sleep-wake p...

Aims: To explore whether traumatic brain injury (TBI) patients have a higher prevalence of sleep bruxism (SB) and a higher level of orofacial muscle activity than healthy controls and whether orofacial muscle activity in the context of mild TBI (mTBI) increases the risk for headache disability. Methods: Sleep laboratory recordings of 24 mTBI pat...

Aim: To examine whether age contributes to functional recovery and resilience after moderate-to-severe traumatic brain injury. Background: The ability to recover may change across the lifespan, but the influence of age on brain injury outcome is understudied. Design: Mixed methods study. Methods: All adults of working-age (18-64 years), disc...

Background: Complementary and alternative medicine (CAM) therapies may be used as a non-pharmacological approach to chronic pain management. While hundreds of trials about individual CAM modality have been conducted, a comprehensive overview of their results is currently lacking for pain clinicians and researchers. Aim: This umbrella review synt...

Introduction Sleep-wake disturbances (SWD) are among the most prevalent and disabling consequences reported after a moderate-to-severe traumatic brain injury (TBI), but remain poorly understood. Our aim was to better characterize post-TBI SWD using a combination of subjective and objective measures. Moreover, we aimed to verify whether specific typ...

Introduction Chronic sleep-wake disturbances are among the most invalidating and frequently reported symptoms following a traumatic brain injury (TBI), but their pathophysiological mechanisms are still poorly understood. We aimed to explore potential mechanisms by which anatomical damage due to TBI, more specifically white matter damage, can cause...

Introduction We recently demonstrated that the sleep-wake cycle is severely altered in the acute stage of moderate to severe traumatic brain injuries (TBI). In general, these patients have short sleep and wake bouts dispersed over the 24 h. This study aimed to explore whether early markers of TBI severity predict acute sleep-wake cycle disturbances...

Objective: To investigate whether the progressive recuperation of consciousness was associated with the reconsolidation of sleep and wake states in hospitalized patients with acute traumatic brain injury (TBI). Methods: This study comprised 30 hospitalized patients (age 29.1 ± 13.5 years) in the acute phase of moderate or severe TBI. Testing sta...

Objective: Hypersomnia is frequently reported after mild traumatic brain injury (mTBI), but its cause(s) remain elusive. This study examined sleep/wake activity after mTBI and its association with pain, a comorbidity often associated with insomnia. Methods: Actigraphy recording was performed for 7 ± 2 consecutive days in 56 individuals at one mo...

Objective: Posttraumatic amnesia is superior to the initial Glasgow Coma Scale score for predicting traumatic brain injury recovery, but it takes days/weeks to assess. Here, we examined whether return of visual fixation-a potential marker of higher cognitive function-within 24 hours of ICU admission could be used as an early predictor of traumatic...

Although many intensive care unit patients experience significant pain, very few studies explored massage to maximize their pain relief. This study aimed to evaluate the preliminary effects of hand massage on pain after cardiac surgery in the adult intensive care unit. A pilot randomized controlled trial was used for this study. The study was condu...

To evaluate changes in regional cerebral blood flow (rCBF) during wakeful rest in older subjects with mild to severe obstructive sleep apnea (OSA) and healthy controls, and to identify markers of OSA severity that predict altered rCBF. High-resolution 99mTc-HMPAO SPECT images during wakeful rest. Research sleep laboratory affiliated with a Universi...

Many patients with a traumatic brain injury (TBI) cannot communicate because of altered level of consciousness. Although observation of pain behaviors (e.g., frowning) is recommended for pain assessment in nonverbal populations, they are attenuated and sometimes even suppressed in patients with TBI receiving high doses of sedatives. This study expl...

L’occurrence d’un traumatisme craniocérébral (TCC) est un problème de santé publique majeure. Les troubles du sommeil et de l’éveil sont parmi les symptômes les plus persistants et les plus déshabilitants à la suite d’un TCC. Or, les études empiriques portant sur l’apparition de ces symptômes, leur chronicisation et leur traitement demeurent non co...

Pain behaviors such as grimacing and muscle rigidity are recommended for pain assessment in nonverbal populations. However, these behaviors may not be appropriate for critically ill patients with a traumatic brain injury (TBI) depending on their level of consciousness (LOC). This study aimed to validate the use of behaviors for assessing pain of cr...

Background. Many critically ill patients with a traumatic brain injury (TBI) are unable to communicate. While observation of behaviors is recommended for pain assessment in nonverbal populations, they are undetectable in TBI patients who are under the effects of neuroblocking agents. Aim. This study aimed to validate the use of vital signs for pain...

Pain is a major stressor for critically ill patients. To maximize pain relief, non-pharmacological interventions are an interesting avenue to explore. The study aim was to describe the perspectives of patients/family members and nurses about the usefulness, relevance and feasibility of non-pharmacological interventions for pain management in the in...

Pain in vegetative state patients : current status and critical reflections Introduction : According to experts, vegetative state (VS) patients are unable to perceive pain. Background : Still, a large portion of nurses believe that VS patients can perceive pain and are uncomfortable when pain is not treated. Aim : To identify the criteria used in c...

According to experts, vegetative state (VS) patients are unable to perceive pain. Still, a large portion of nurses believe that VS patients can perceive pain and are uncomfortable when pain is not treated. To identify the criteria used in clinical practice and in research to detect the presence or the absence of conscious perception of pain in VS p...

ABSTRACT: The use of behavioral and physiologic indicators is recommended for pain assessment in nonverbal patients. Traumatic brain injuries (TBI) can lead to neurologic changes and affect the way patients respond to pain. As such, commonly used indicators of pain may not apply to TBI patients. This study aimed to review the literature about behav...

ABSTRACT: Behavioral indicators are strongly recommended for pain assessment in nonverbal patients. Although pain-related behaviors have been studied in critically ill patients, those with a traumatic brain injury (TBI) have been either excluded or underrepresented. Because these patients also likely experience pain, research is urgently needed to...

QMy facility will be starting to use the Critical-Care Pain Observation Tool (CPOT) in the next month. We currently titrate the dosages of our infused pain medications to meet the goal of a score of 0 to 2 on a nonverbal pain scale. I need to put a goal for the CPOT on our pain doctor's order form-do you have a suggestion? I know that if the patien...

The Critical-Care Pain Observation Tool (CPOT) is one of the few behavioural pain scales which have been developed and validated for the purpose of detecting pain in nonverbal critically ill adults. This study aimed to complete a pre and post evaluation of the implementation of the CPOT on pain assessment/management nursing practices in the Intensi...

This pilot study was aimed to explore the impact of the implementation of the Critical-Care Pain Observation Tool on pain management and clinical outcomes in mechanically ventilated trauma intensive care unit patients. Thirty medical fi les were reviewed in this preexperimental before-and-after study design. Pain assessments and identifi cation of...

The aim of this study was to examine the discriminant and criterion validity of vital signs (mean arterial pressure [MAP], heart rate [HR], respiratory rate [HR], transcutaneous oxygen saturation [SpO(2)], and end-tidal CO(2)) for pain assessment in postoperative cardiac surgery ICU adults. A repeated-measure within-subject design was used. A conve...

The purpose of this study was to describe behavioral and physiologic indicators to a nociceptive procedure in conscious and unconscious mechanically ventilated adults and to examine their association with the patients' self-reports of pain. A total of 257 intensive care unit patients (144 conscious and 113 unconscious) from 4 clinical settings in C...