by Sabrina Lessard, Annie Bernatchez, Houda Garrach, Mélanie Couture, Claire Godard-Sebillotte, Sarita Israel, Rym Zakaria
ObjectiveThis project aims to gain a thoroughly understanding of the characteristics and experiences of psychological mistreatment among older adults, acknowledging the diversity within this population. It also seeks to identify clinical tools and practices for its detection and intervention. While there is extensive literature on mistreatment of older adults, specific studies focusing on psychological aspects and intersecting social and identity dimensions are scarce. The findings will provide valuable insights for policymakers and healthcare professionals, helping to shape interventions and policies aimed at countering mistreatment in the ageing population.
IntroductionPsychological mistreatment involves a range of behaviors, expressions, and gestures—or the lack of appropriate actions—that negatively impact an individual's health and dignity. Often subtle and difficult to detect, this type of mistreatment is prevalent and can coexist with other types of abuse. Examination of psychological mistreatment, shaped by various social and identity dimensions, is lacking in current research, particularly regarding how it is experienced by older adults. This scoping review seeks to map the current knowledge on psychological mistreatment of older adults, while highlighting gaps and future directions for research.
Inclusion criteriaThis scoping review will encompass studies that explore the characteristics and experiences of psychological mistreatment among older adults, including their experiences and those of perpetrators and witnesses. It will also identify clinical tools and practices for the detection and intervention of psychological mistreatment in this population.
MethodA scoping review will be undertaken by a multidisciplinary team, examining studies from post-2010, sourced from both bibliographic databases and grey literature, available in English or French. Employing an intersectional framework, the review will use Gender-Based Analysis Plus (GBA+) to examine how different forms of discrimination intersect and shape experiences of mistreatment. That is, this approach will help explore how social and identity dimensions—including gender, age, sexual orientation, ethnicity, socioeconomic status, and health conditions—shape the experiences and manifestations of psychological mistreatment.
Cardiac surgical procedures are associated with a high incidence of postoperative infection, a risk attributed to their inherently invasive nature and extended duration. The goal of this study is to evaluate the efficacy of negative pressure wound therapy (NPWT) compared with standard dressings in preventing sternal scar dehiscence in patients undergoing cardiac surgery via complete vertical midline sternotomy, comparing a 3 day change system (NPWT 3/7 d) versus a 7 day wear system (NPWT 7d) versus standard dressings.
The PRISTER study is a prospective open-label multicentre, randomised, controlled, three-arm trial. Patients aged ≥18 years and meeting all the following inclusion criteria: patients undergoing scheduled or semiurgent cardiac surgery, with or without extracorporeal circulation, and patients managed by complete vertical median sternotomy will be recruited. Total sample size will consist of 660 patients. The primary outcome, surgical wound dehiscence after complete median sternotomy, expressed as occurrence or non-occurrence during the first 30 postoperative days, will be assessed by tablet calibrated photos analysed by an independent blinded staff. The secondary outcomes will be the number of dressing repairs between D7 (excluding initial protocol) and D90, length of initial hospital stay, occurrence of surgical site infection and its classification collected on day 90 (D90), use of an anti-infectious treatment and its duration, incidence of postoperative mediastinitis defined by dehiscence of the sternum with positive sternal samples, incidence of surgical revision for dehiscence of the surgical wound at D90 and collection of all operations involving surgical revision of the sternotomy wound, number of rehospitalisations (including hospital consultations) and their duration (evaluated at D90). Medicoeconomic assessment will be assessed by evaluation of hospital and extrahospital costs (number of days in hospital, consultations, rehospitalisations, imaging, biology and drugs), dressing costs and patient quality of life by EQ-5D-5L.
The study was approved by the French Agency for the Safety of Health Products (ANSM, Agence National de Sécurité du Médicament) as well as by the Ethics Committee (CPP Ile de France VIII) N°ID-RCB: 2023-A01782-43. Recruitment began in April 2024 and ended on 26 May 2025.
clinicaltrials.gov NCT06207630.