| Le partenariat de soin avec le patient : analyses |  |
3 | 2e semestre 2021
Ce numéro comprend des articles qui prolongent des communications en congrès sur le partenariat de soin avec le ou les patients, ici le 2e Colloque international sur le partenariat de soin avec les patients organisé en février 2021 à Toulouse, tout en restant ouvert à un article issu d’un autre univers.
1. La contribution des patients au développement des connaissances professionnelles sur les réseaux sociaux
As part of a doctoral research work questioning the contribution of social networks in the dissemination and development of professional nursing praxeologies, we questioned the role that patients play in professional exchanges on these devices. The place of patients in the medical landscape has changed since the 1980s thanks to their contribution to the development of knowledge about AIDS. The recognition oftheir skills is linked to this know-how to act developed in life situations where the disease prevails, unique and singular situations that question and bring out new knowledge. We rely on two theoretical frameworks: the anthropological theory of didactics (TAD) by Yves Chevallard, which takes both a didactic and anthropological perspective on the construction and dissemination of knowledge in society and the theory of communities of practice in Lave and Wenger. We therefore assume that by participating in the discussions, patients contribute to the development of nurses' knowledge. The research device is based on a mixed method: quantitative analysis by questionnaires, descriptive analysis on a corpus of texts extracted from exchanges on professional discussion groups, and qualitative analysis using content analysis. The results show that under certain conditions, the expression of patients in communications on social networks participate in the praxeological dynamic and therefore in an enrichment and development of knowledge in nursing and medical sciences, this […]
2. Parcours de soin disparate et complexe : évaluations et impacts sur la qualité de vie des patientes endométriosiques
Endometriosis is a complex, multifactorial disease with differential symptomatology, resulting in a long and tedious course of treatment where diagnostic erraticism reaches seven years. The often insufficiently coordinated management leads to a heterogeneous and non-optimal care pathway with a plurality of management and real therapeutic relationships. What about the reality of patients facing their doctor? Psychological processes that can explain quality of life and emotional experience will be examined in the light of Bruchon-Schweitzer's multifactorial integrative transactional model. For this purpose, a sample of 635 women aged 18 to 56 years completed a self-administered questionnaire assessing anxietydepressive symptomatology (HAD), shared decision making inherent in their care (SDM-Q9), body image (BIS) and quality of life (SF-36). Sociodemographic and biomedical questions were also asked. The results show that the participants took an average of 9.5 years to be diagnosed (SD = 6.8), and before that, 86.2% of them considered that their symptoms were of little or no importance to doctors. Today, 26.7% of them consider that they are not included in treatment decisions. This last variable is central since it is linked to levels of physical and mental quality of life and satisfaction with care. These findings lead us to think about a partnership between patients and doctors, with the aim of improving care.
3. Implémentation du Dossier Médical Partagé dans l’accès aux soins et l’accompagnement des migrants en médecine générale : représentations des principaux acteurs
Context. The use of the Electronic health record (EHR) could facilitate the support of migrants but its implementation in France is laborious.Objective. Explore the representations on the use of the EHR among migrants, with migrants and general practitioners. Method. Exploratory qualitative study by semi-structured individual interviews and focus group, carried out between April and July 2020 with sampling in maximum variation. The two populations were recruited and analyzed independently until data saturation. An inductive analysis was performed with double blind coding. Results. Twelve participants were recruited from each population. The use of the EHR among migrants was considered by both populations as beneficial but difficult according to the specificities of migrant life. The EHR appears to be a practical solution to access migrant health data but the access should be simplified. Thus, the facilitating elements were the involvement of socialworkers and the interest in accessing the EHR upon the arrival of the migrants on the French territory. Opinions differed on the impact that the EHR would have on the doctor-patient relationship, which is specificamong migrants. Conclusion. The implementation of the EHR among migrants will not take place without the main actors. Their opinion is essential to avoid multiplying tools that are not adapted to the patients who need them the most. Involving healthcare users and primary care professionals is the only way to develop a […]