Transfert de connaissances sur les interventions infirmières pour la prévention du suicide auprès des gens vivant avec un trouble concomitant de santé mentale et de toxicomanie
Based on the numbers of the Institut national de santé publique du Québec (2010), the province of Québec ranks fourth among a total of twenty-one countries with its suicidal rate. Suicide is considered a public health problem, its prevention is a priority since 1994 (Cliniques psychiatriques de France, 2010) and it is seen as an avoidable major problem by the World Health Organisation (Organisation mondiale de la santé, 2011). The evaluation of the suicidal risk is only a first step that must lead to an adequate outreach. Despite the fact that tools and knowledge are now available, standardized and implemented in the organisation of the Centre Hospitalier de l’Université de Montréal (CHUM), they are not always adequately put into practice. As long as the nurses do not apply correctly the follow-ups, improvements will never be seen in the efficiency of the healthcare. The objectives of the present work are to find-out ways to help all of the outreach workers of the Unité de Psychiatrie des toxicomanies (UPT) of the CHUM in their evaluation process as well as in their practice, and thus ameliorating the prevention of suicides amongst people living with concurrent disorders. In order to achieve this goal, the transmission of suicidal prevention knowledge appears to be a key to improve the nursing work as well as the quality and the security of the healthcare. This study proposes to determine which model or models of knowledge transmission are more adequate for those working in the suicidal prevention section of the UPT. After a critical analysis of diverse models of knowledge transmission found in theoretical and empirical writings, and keeping in mind that changing a clinical practice is a complex and difficult process, we propose a combination of various models. The major theoretical models are the RNAO (2002), the NICE (2007) as well as the Oxman, Thomson, Davis & Haynes strategies (1995), and they should allow the implementation of the knowledge transmission principle in the nursing outreach work oriented towards suicidal prevention, beneficing those living with concurrent disorders of mental health and drug addiction. Some recommendations for the nursing work and research are also presented.
Suicide Toxicomanie Knowledge transmission Mental health Drug addiction Nurse outreach Suicidal prevention Concurrent disorders