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Aim Despite its importance in nursing, perceived quality of the nurse–patient relationship has seldom been researched. This study sought to examine and compare the quality of caring attitudes and behaviours as perceived by haemodialysis patients and their nurses. Design This comparative descriptive study involved 140 haemodialysis patients and 101 nurses caring for them in ten haemodialysis units in the French‐speaking part of Switzerland. Methods Participants completed a sociodemographic questionnaire and the Caring Nurse‐Patient Interaction Scale (CNPI‐70). Results Both nurses and patients reported a high frequency of caring attitudes and behaviours. Patients gave higher ratings than nurses did on all the caring dimensions, except spirituality. Implications are discussed.

Background Nurses are trained to establish a trusting relationship with patients to create an environment promoting patients’ quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson’s Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design. Methods One hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study. Results The intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention. Conclusions Results support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices. Trial registration NCT03283891.

Empirical evidence suggests that concentrating on patients’ internal and external strengths serves a preventative function against psychopathology. However, standardized tools assessing strengths of patients suffering from mental disorders are rare and often limited to research purposes. As current practice in mental health rarely stresses the importance of patients’ personal resources, the feasibility of strengths-based assessments has rarely been validated within such a population. We designed a new instrument, the Strengths Q-sort Self-Assessment Scale, aimed at identifying patients’ strengths profile. This new scale measures 30 strengths classified in three sections: (i) personal characteristics, (ii) hobbies/passions, (iii) environmental/social strengths. In order to be adjusted for patients with cognitive or language impairments, this instrument is based on a Q-Sort method with figurative items. The aim of this study was to test the feasibility and acceptability of this scale in a sample of 21 psychiatric patients. Preliminary results showed that this tool can easily be administered and is well appreciated by patients. Feedback from clinicians highlight the benefits of identifying the strengths profiles in order to help defining realistic shared clinical objectives based on patients’ strengths.

Hemodialysis patients constitute a vulnerable population. Their health needs are considerable and they often present psychological symptoms such as depression and anxiety. Empirical studies have demonstrated the efficacy of positive psychology interventions to enhance the well-being of patients and alleviate their depressive symptoms. One such intervention consists in identifying and mobilizing patient resources to activate their recovery. An intervention of the sort was implemented in Switzerland with hemodialysis nurses using AERES, a novel self-assessment instrument. AERES covers 31 domains under three dimensions: personal characteristics/qualities, hobbies/passions, and social/environmental resources. The aim of this qualitative study was to explore hemodialysis nurse perceptions of the use of this instrument. Sixteen hemodialysis nurses were recruited in six hospitals in French-speaking Switzerland and interviewed after delivering the intervention. A consensual qualitative research method was used to analyze the data. Results showed that the resources instrument was easy to administer and beneficial to patients and health professionals. Patient wellbeing became the top priority for the nurses and new interventions centered on patient resources were undertaken. Quality of patient care was improved. Nurses perceived this positive psychology instrument as a means of creating a positive relationship with patients and supporting them emotionally. Assessing the resources of this vulnerable population can provide health professionals with a powerful tool to understand patient intact resources, which can be used to alleviate symptoms and foster wellbeing.

IntroductionHemodialysis (HD) patients experience numerous physical and psychological symptoms on a daily basis. These symptoms have a heavy impact on their quality of life, which is a key indicator of their survival in the short term. Numerous empirical studies have shown that the quality of the nurse-patient relationship (NPR) is essential in promoting positive outcomes for patients. When patients receive caring, their autonomy and independence grows, their sense of hope increases, their quality of life improves, and their sense of satisfaction with nursing care received rises. Inversely, the presence of dehumanizing practices in hemodialysis settings can contribute to delay healing for patients. In light of the importance of the quality of the relationship between nurses and HD patients and of the benefits to be had from a quality relationship, an educational intervention based on Watson's Theory of Human Caring was delivered to HD nurses.ObjectiveThe purpose of this study was to explore qualitatively the perceptions of nurses working with HD patients in French-speaking Switzerland regarding changes to their clinical practice after receiving an educational intervention intended to reinforce caring attitudes and behaviors towards patients.MethodsThe method used was that of consensual qualitative research (CQR). Sixteen semi-structured interviews were conducted with hemodialysis nurses post-intervention.ResultsThe results evidence a transformation of clinical nursing practice illustrated by three core ideas: (1) caring practice was reinforced; (2) new practices emerged; and (3) some limitations appeared.ConclusionIn these times of global pandemic where the issue of the humanization of nursing care is front and center, this professional development activity helped reinforce caring-based practice. This practice needs to be developed within the various care units in order to guarantee and promote quality of care and patient safety.

Introduction Doing a strength-based assessment is a therapeutic process that can foster recovery. However, standardized resources tools adapted to the specificities of patients suffering from psychiatric disorders are rare and not routinely used in mental health services. Objective Therefore, a new resources self-assessment scale (AERES) has been specifically developed for this population. The first objective of this current paper is to identify descriptive profiles of patients’ resources with the AERES. The second objective is to explore the impact of a resources assessment on patients’ self-esteem and well-being. Method This tool was administered to 213 patients suffering from severe psychiatric disorders and coming from four mental health centers in Switzerland and France. Patients’ level of self-esteem and well-being was measured before and after the administration of the AERES with the Rosenberg Self-esteem scale and the Visual analogue Scale for well-being. Results Results showed that the AERES can easily be administered with these patients and with important benefits. The most common resources found were gratitude, listening to music, and professional healthcare. The resources patients wanted to develop the most were self-esteem, travelling and friends. Results indicated an increase in self-esteem, happiness, serenity, life satisfaction and meaning in life after the patients identified their personal resources. Conclusion This tool can provide clinicians and researchers with new information regarding patients’ intact resources despite their psychopathology. This strength assessment consists in a first step of a therapeutic process. The identified resources can then be activated in order to alleviate patients’ symptoms and foster their quality of life.

Resume La recherche empirique a montre qu’une focalisation sur les ressources des patients psychiatriques est protectrice face a une chronicisation de leurs symptomes. L’utilisation en pratique clinique d’outils standardises mesurant les ressources est neanmoins rare du fait d’un manque d’instruments adaptes. Pour pallier a cette lacune, nous avons developpe un outil d’auto-evaluation des ressources adapte aux patients psychiatriques (l’AERES). Cet outil dresse le profil general des ressources internes et externes pouvant contribuer a leur retablissement. Cet article presente l’outil AERES et analyse dix entretiens afin d’evaluer l’impact sur les patients d’une perspective centree sur le retablissement. La methode de recherche qualitative consensuelle de Hill est utilisee. Les resultats montrent que l’AERES est percu par les patients comme exhaustif, utile, comprehensible, agreable et nouveau.

Background: Chronic kidney disease (CKD) is a fast-growing cause of morbidity and mortality worldwide. Patients suffering from CKD almost always develop end-stage renal disease (ESRD) that is often treated with haemodialysis (HD). In this context, the quality of the nurse-patient relationship (NPR) plays a major role in supporting the quality of life (QoL) of HD patients. This study examined the relationship between quality of nurse behaviours and attitudes as perceived by HD patients and QoL of these patients.Methods: The study used a cross-sectional correlational design. The sample consisted of 140 patients recruited in 10 HD units in French-speaking Switzerland. The Caring Nurse-Patient Interaction Scale (CNPI-70) was used to assess the NPR, and the French version of the WHOQOL-Bref was used to evaluate different dimensions of QoL. Random-intercept linear regressions adjusted for sociodemographic characteristics were used to study the relationship between patient-perceived quality of nurse caring attitudes and behaviours and patient QoL.Results: Patients reported a high frequency of caring attitudes and behaviours from their attending nurses, except relative to the dimension of spirituality. All the dimensions of patient QoL were positively influenced by the caring factor composing the CNPI-70. In particular, nurse attention to patient dignity when providing support for basic human needs seemed to be a major factor in patient QoL.Conclusions: Quality of NPR is essential to improving patient QoL. Interventions need to be developed to support quality of NPR.

Humanistic nursing practice constitutes the cornerstone of the nursing profession. However, according to some authors, such practice tends to fade over time in favour of non-humanistic behaviours. To contrast this tendency, an educational intervention (EI) based on Watson’s Theory of Human Caring was developed and tested in two pilot studies involving, respectively, rehabilitation nurses in Quebec (Canada) and haemodialysis (HD) nurses in Switzerland. In light of the positive results obtained in these, another study is being undertaken to examine more in depth the EI’s effects on both HD nurses and patients in French Switzerland. The EI is expected to have positive effects on quality of nurse-patient relationship (NPR), team cohesion, nurse quality of working life (QoWL), and patient quality of life (QoL). The study described in this protocol will use a mixed-method cluster randomised controlled trial design. For the quantitative component, nurse and patient data will be collected through questionnaires. The accessible population of 135 nurses and 430 patients will be clustered into 10 HD units. These units will be randomised into an experimental group (EG) and a waiting-list control group (WLCG). Measurements will be taken at baseline (pre-intervention) and repeatedly over time (post-intervention): immediately at EI completion and six and 12 months thereafter. For the qualitative portion of the study, 18 semi-structured interviews will be conducted with EG nurses picked at random two months after EI completion to explore perceived changes in nurse humanistic practice. Qualitative data will be analysed through the relational caring inquiry method, a phenomenological approach. Descriptive and inferential statistics will be computed from the quantitative data. The study described in this protocol will determine if and how the proposed EI promotes humanistic nursing practice and how this practice affects quality of NPR, nurse QoWL, and patient QoL. Moreover, it will lay the groundwork for offering the EI to nurses in other healthcare sectors. This clinical study was registered with ClinicalTrials.gov [ NCT03283891 , 14/09/2017].

Purpose – Despite increasing numbers of women attaining higher levels in academic degrees, gender disparities remain in higher education and among university faculty. Authors have posited that this may stem from inadequate academic identity development of women at the doctoral level. While gender differences may be explained by multiple and variable factors, mentoring has been proposed as a viable means to promote academic identity development and address these gender gaps. A “StartingDoc program” was launched and supported by four universities in French-speaking Switzerland. The purpose of this paper is to report the experience of one of the six “many-to-one” mentoring groups involved in the StartingDoc program in 2012-2013. Design/methodology/approach – This study is based on the description of a group experience within a university-based mentoring scheme offered to women entering in their PhD program in French-speaking Switzerland. It is examined using a qualitative, narrative case study design. Findings – Themes from the narrative analysis included the four dimensions of the Clutterbuck model of mentoring (guiding, coaching, counselling, networking), as well as an additional five emerging themes: first expectations, process, sharing, building identity, and unmet expectations. The qualitative analyses suggest that mentoring can be an effective tool in supporting professional identity development among female doctoral students. However, further work is needed to elucidate the most effective strategies for developing and retaining women in academia. Originality/value – While a many-to-one mentoring group has been theorized and is recognized as an effective means of supporting doctoral experience, its implementation in French-speaking Switzerland is in its infancy. This study provides insights into the value of such a mentoring scheme dedicated to women at the very beginning of their doctoral studies. Most notably it created opportunities for mentees to: discover aspects of academic life; break isolation; and develop some of the soft skills required to facilitate their doctoral journey.

Purpose Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients’ needs are organized. This study investigates both general and specific dimensions of patients’ needs for care. Methods Patients’ needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients’ perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients’ personal motivations, needs, and wants. Four seventy-one patients’ profiles were analyzed through exploratory factor analysis. Results A four-factor bifactor model, including one general factor and three specific factors of needs, was most adequate. Specific factors were (a) “finances” and “administrative tasks”; (b) “transports,” “public places,” “self-care,” “housework,” and “food”; and (c) “family,” “children,” “intimate relationships,” and “friendship.” Conclusion As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management, functional disabilities, and familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.

Because increasing evidence point to the convergence of environmental and genetic risk factors to drive redox dysregulation in schizophrenia, we aim to clarify whether the metabolic anomalies associated with early psychosis reflect an adaptation to oxidative stress. Metabolomic profiling was performed to characterize the response to oxidative stress in fibroblasts from control individuals (n = 20) and early psychosis patients (n = 30), and in all, 282 metabolites were identified. In addition to the expected redox/antioxidant response, oxidative stress induced a decrease of lysolipid levels in fibroblasts from healthy controls that were largely muted in fibroblasts from patients. Most notably, fibroblasts from patients showed disrupted extracellular matrix- and arginine-related metabolism after oxidative stress, indicating impairments beyond the redox system. Plasma membrane and extracellular matrix, 2 regulators of neuronal activity and plasticity, appeared as particularly susceptible to oxidative stress and thus provide novel mechanistic insights for pathophysiological understanding of early stages of psychosis. Statistically, antipsychotic medication at the time of biopsy was not accounting for these anomalies in the metabolism of patients' fibroblasts, indicating that they might be intrinsic to the disease. Although these results are preliminary and should be confirmed in a larger group of patients, they nevertheless indicate that the metabolic signature of reactivity to oxidative stress may provide reliable early markers of psychosis. Developing protective measures aimed at normalizing the disrupted pathways should prevent the pathological consequences of environmental stressors.