This text is part of the special notebook Université du Québec à Rimouski
From nursing to community health, health research at the University of Quebec at Rimouski (UQAR) has a common goal: improving the quality of patient care.
“There are two key words to remember when we talk about health research at UQAR: proximity and interdisciplinarity,” says Lily Lessard, professor in the Department of Health Sciences at the University of Quebec at Rimouski, on campus. of Lévis. The trained nurse is co-holder of the Interdisciplinary Chair in Health and Social Services for Rural Populations (CIRUSS) with Marie-Hélène Morin, professor in the Department of Psychosociology and Social Work.
Breaking down work in isolation and anchoring themselves in their environment, their work in community health contributes to improving services for patients and their loved ones. Because if research contributes to the advancement of knowledge, one of UQAR’s major concerns is to make it useful and applicable. “We want to bring knowledge to the field, so that it can be operationalized as quickly as possible,” emphasizes M.me Lessard.
A look at rural populations
In Quebec, 18% of the population lives in rural areas; “it is therefore relevant to have a research chair dedicated to their health”, believes Mme Lessard. “Urban areas will need strong rural areas to meet the energy and food needs in Quebec,” she adds. In a context where the social fabric is modified by the exodus from centers and the aging of the population, it is high time to look into it, believes the researcher.
The first line of research of the CIRUSS chair is the study of the influence of the rural environment on the health of the population. Rurality, beyond being in the region, has its share of challenges. Certain illnesses or certain specific health conditions are more common there and, yet, health care is often less accessible there. Rural populations are also more exposed to the consequences of climate change, even in their glass of water. A large part of the Quebec population obtains its water supply from an artesian well; Coastal erosion will have dramatic consequences by salinizing their drinking water sources.
Researchers also work in close collaboration with the Integrated Health and Social Services Centers (CISSS) of Chaudière-Appalaches and Bas-Saint-Laurent to improve services. “Our research must be collaborative and participatory, if we want it to make sense in the region,” notes Mme Lessard.
Reweaving the social net
Another important area of research of the chair is the influence of the social environment and networks on the health of rural populations. It is in this context that the MOSAIC living laboratory was set up, which focuses on “aging well” in a rural context. By involving stakeholders around seniors, but also aging people themselves, the laboratory wishes to better understand their needs and explore innovative solutions. “The idea is to provide a space to think, innovate, develop and experiment,” summarizes Mme Lessard.
The laboratory explores various questions. Ariane Plaisance, postdoctoral fellow involved in the MOSAIC project, takes an anthropological look at the place of death in the health and social services network. “We are all going to die, but no one talks about end of life and end of life planning. It has to be done,” she says. If previously rural communities mobilized to take charge of end-of-life care and rites (reducing symptoms, supporting a person at the end of life or a person in mourning) and birth, the establishment of the provincial health system in the 1970s changed the situation. “It’s as if we had forgotten all that and, when the health and social services system fails or when the need is not covered by it, we are taken completely by surprise,” says M.me Plaisance. “We forgot that we can help each other. We broke the steps of the church at the same time as the church,” she continues.
Through meetings and interviews, MOSAIC probes the needs surrounding end-of-life care, connecting organizations that would not otherwise speak to each other. “People are sorely lacking in information and space to speak,” notes M.me Plaisance. These links formed, the researchers hope, will last beyond the end of the project’s funding.
Virtual unity, real results
What if innovations from small communities radiated throughout the world? This is the wish of Daniel Milhomme, professor of critical care at the Lévis campus of UQAR.
This is interested in the cognitive and behavioral process of clinical monitoring in the context of critical care. “Concretely, this is how nurses monitor patients in intensive care units to avoid complications,” he explains. After observing that, during internships, students had difficulty acquiring this knowledge, something clicked while he was trying out a virtual reality headset at a family gathering. “I said to myself: “I want to develop an intensive care unit in virtual reality!” » he remembers.
In collaboration with his colleague Frédéric Banville, Mr. Milhomme first designed a scenario to introduce nurses to work in an intensive unit. “There are several issues: multiple technologies, unstable patients, risks of complications,” lists Mr. Milhomme. Faced with the interest aroused by his idea, a complete care and work environment was deployed: scenarios for obstetrics, gerontology, oncology, palliative care, and general care units. are or will be added.
“The care unit project is a societal project, to which the university clinic community can contribute,” he hopes. The initiative has generated such enthusiasm that collaborations have been established with France, Luxembourg and Switzerland. “We have developed a disaster scenario, in particular,” underlines Mr. Milhomme, who would like the scenarios developed to be offered throughout the French-speaking world.
Behind the technology is a deep concern to improve the training of nurses to improve their clinical judgment and, thereby, patient safety. “I have always worked on this angle: making knowledge accessible to all nurses, regardless of their experience,” he concludes.
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