Réflexions d’un médecin expert et d’un juriste autour d’un exercice pratique de droit médical

We offer a reflection around a clinical case of nosocomial infection allowing us to address the difficulties faced by experts and lawyers and other jurists in matters of medical liability. This case is the result of an exercise proposed within the framework of the national DIU (interuniversity diploma) in medical accidents for which the two authors are responsible in Amiens and Bordeaux. The writing was enriched with the responses of the students. This clinical case makes it possible to approach the compensation for nosocomial infections, to compare the amicable procedure before the conciliation and compensation commission for medical accidents and the procedure before a judicial or administrative jurisdiction. Finally, the reflection focuses on patient information, especially protected adult, and access to the medical file. It is not a question here of detailing the medical care but of discussing medical responsibility and the rights of the patients.     

Défaut d’information préalable : présomption de la souffrance morale et préjudice d’impréparation

The Conseil d’État, relatively to the ruling dated the 16th of June 2016, keeps defining the legal regime of the harm of unpreparedness which consists in a violation of the health professionals’ duty to inform their patients, based on article L. 1111-2 of Code de la santé publique. Moreover, it can be highlighted a shared understanding between the judicial and administrative jurisprudences. Yet, the Conseil d’État is likely withholding the patients’ right to information that the Cour de cassation may have headed toward.     

Refuser sans dire non : étude d’un jeu de langage dans une transaction entre un patron et un employé

The aim of this paper is to go on with the articulation between the notions of form of life and language game started by Agnoletti (2006). In this way, we want to show the links between language game and activity through the study of pieces of verbal interaction coming from a professional transaction between a chief and his employee. By using the hierarchical and functional analysis (Roulet et al., 1985), we show regularities, both at the level of the structure of the interaction and in that of the sentences and vocabulary. We make then a relationship between the linguistic forms and the context in which they appear and we consider that we have to deal with a language game which has two modalities: appeal to the rule and the charge. These forms are related to power and authority.     

Parcours : développement d’une stratégie de prévention de la récidive adaptée aux milieux ouverts

Experiments show that applying RNR principles “in the real world” within the context of probation can reduce recidivism, provided that evidence-based intervention models are used. In Quebec, probation officers agreed to take part in a pilot project whereby the Parcours program (Pathways) was transposed into a series of interview outlines to be used in a community setting. The experiment took place over a one-year period, the management of convicted offenders consisting in around 10 30 to 90-minute interviews. These interviews addressed: motivation for change, beliefs, values and cognitive distortions, as well as the adoption of relapse prevention strategies. Results were positive enough to authorize the deployment of Parcours en milieu ouvert (Pathways in community settings) in all sectors. This approach could be implemented in France, where at the instigation of the Council of Europe, new European probation rules recommend the establishment of interventions based on evidence-based models.     

De l’opportunité d’une nouvelle loi sur la fin de vie ?

This paper deals with the end of life issue. It advocates for putting the legislation about end of life a part from bioethics laws and addresses some legal problems.     

L’équipe paramédicale à l’hôpital psychiatrique : Retentissement actuel d’une évolution de deux décennies Analyse d’un entretien de supervision

At the advent of the reform of nursing education in France, this study attempts to give an overview of changes in the work practices of nurses and the employment of nurse’s aides in psychiatric wards of hospitals. Based on the assumption that interaction acts as an interface between the individual on one side and collective systems on the other, the authors approach this issue by analyzing a supervisory meeting of a caregiving team in a psychiatric hospital.     

Les stratégies de coping : une revue de la littérature dans les domaines du sport et de l’éducation

IntroductionCoping is a central concept in sport and educational settings, given the stress caused by the involvement of skills, the uncertainty of the result, the failure and/or the obstacles during learning efforts. Understanding why and how individuals adopt or do not adaptive behaviors in these contexts is a major issue not only in terms of health and well-being but also in terms of performance optimization.Literature findingsThis literature review is based specifically on the studies in the fields of sport and education psychology.DiscussionThe specific features and common points of these contexts, the specific coping strategies, their antecedents and their outcomes as well as the methodological limitations and existing designs are highlighted.ConclusionPromising research perspectives are discussed to study coping in sport and academic contexts.     

Le TASC200, une épreuve d’attention et de saillance visuelle : fidélité, validité et normes préliminaires

In the clinical setting, attention is classically assessed by tasks that do not take into account theoretically important aspects, such as the salience-based guidance of visual search. The aim of this study was to develop a paced paper-and-pencil task for clinical use based on strong theoretical accounts that would assess salience-based visual search and that would meet the psychometric requirements for the assessment of attention. Participants were required to search and cancel targets of varying visual saliences as quickly and as accurately as possible during a predefined short period of time. The targets were intermixed with distractors. In agreement with theories of salience-based visual search, the results showed that the most salient targets were detected more easily than less salient targets. The task exhibited a quite acceptable test-retest reliability, and two construct validity studies showed that different scores involve different processes. This new task fully complies with the major theories of salience-based guidance of attention during visual search. It also meets the requirements of a plausible clinical task since its psychometric qualities are quite good. Preliminary normative data (n = 863) are presented for clinical use.     

La compréhension d’un scénario médical à partir d’images sans texte : l’apport des représentations sociales

In this study, participants (n = 125) were shown a sequence of four images illustrating the medication scenario. Depending on the results of a pre-test (n = 384), the sequence is composed of typical images, non-typical images or mixed. Depending on the case, the instructions given to the participants are neutral, or it induces the representation of the drug. Participants must identify the scenario described in the sequence of images proposed to them. The sequence of typical images gives rise to the better identification. The mixed sequence gives rise to comparable scores following non-typical images when the instruction is neutral and to comparable scores following typical images when the instruction induces the representation of the drug.     

Intérêts et limites de l’utilisation d’une méthodologie mixte : à propos d’une recherche en psychologie de la santé

Recently, the health social sciences, like some fields of psychology, have progressively adopted qualitative methods, particularly in English-speaking countries. When they come in addition to quantitative methods, they are called “mixed methodologies”. Among other reasons, these approaches suffer nonetheless of a lack of acknowledgement because of a still topical debate opposing the positivist-objectivist and the constructivist paradigms. Another reason to this lack of acknowledgement is due to the fact that several authors explain the use of a mixed methodology according to pragmatic arguments. The authors of this paper briefly present these debates and their pertinence in health psychology research and try to overcome them by showing that it is possible to make mixed methodologies fall within a constructivist approach. Their proposal is exemplified through a research work about organ donation decision led in Switzerland. Actually, this research embed multiple and complex factors that offer an appropriated ground for the use of a mixed methodology, qualitative and quantitative.     

Vérification de la structure factorielle et de la fiabilité des preqis en France et test d’un modèle de prédiction de l’attachement au quartier : une étude sur un échantillon parisien

This paper has two aims: testing the Perceived Residential Environment Quality Indicators (PREQIs’, Bonaiuto et al., 2003) factorial structure and reliability in the French context and testing a three-level model where more specific PREQIs cover the first level, more molar PREQIs about pace of life (i.e., the attribution of qualities such as stimulating vs. boring and relaxing vs. distressing) cover the second level, and neighbourhood attachment represents the final outcome variable. Participants (n = 383) were residents of Paris who filled in a questionnaire including the French version of the extended PREQIs and Neighbourhood Attachment (NA) scales (Bonaiuto et al., 2006). PREQIs are validated in France with 139 items and 19 indicators (plus one indicator composed of 8 items for place attachment). The path analysis model presents an indirect connection between some PREQIs and NA via pace of life indicators, which are influenced by PREQIs and are directly associated to NA. More specifically, different PREQIs affect different pace of life dimensions: the perception of a more relaxed neighbourhood is associated to a high quality of design features, environmental health, and safety, whereas the perception of a more stimulating neighbourhood is connected to the presence of human activities and services.     

Les principes d’une prévention de la récidive efficace : le modèle Risque-Besoins-Réceptivité

Recidivism prevention remains a crucial issue in France. While meta-analyses clearly indicated the effectiveness of the Risk-Need-Responsivity (R-N-R) model for assessment and rehabilitation, this model is not used in French probation services. The aim of this article is to introduce the R-N-R model, through an emphasis on its three main principles. A necessary continuity from assessment to intervention is highlighted. The article concludes by stressing the need to empirically evaluate the effectiveness of intervention to prevent recidivism.     

Les compétences mobilisées par le psychologue dans la pratique de l’éducation thérapeutique : exemple d’une prise en charge d’un patient obèse

The Therapeutic Education is a tool allowing the patient to find its own strategies of change by confronting with the point of view of others, by approaching new knowledge and recapturing some skills. The change involves a multitude of psychological processes, which we rarely question. What place do we grant to these psychological processes? What is the role of the psychologist of the health in the ET. We shall approach these notions by discussing a clinical case of a patient obese having participated in a therapeutic patient education “for a long-lasting loss of weight” (Medical Unit of the Nutrition, CHU de Toulouse).     

Les techniques biomédicales en matière d’assistance médicale à la procréation conçues dans l’objectif de pallier l’infertilité médicale peuvent-elles évoluer de manière à être utilisées pour remédier à l’infertilité sociale ?

Medically assisted procreation includes techniques that may allow infertile couples to procreate. However, the application of 2011 bioethics law reveals lots of paradox and high-risk behaviors which arouse the question of the relevance and advisable aspect of its opening to all women.     

Insertion des femmes dans un métier « masculin » : transfert d’acquis d’expériences et stratégies identitaires

Entering a male-dominated occupation is favorable to the study of identity strategies. Based on a research among thirty female bus drivers, this article aims to demonstrate that the transfer – in the professional sphere – of knowledge, abilities, attitudes and values acquired in other spheres and times of socialization, is an important component of such strategies. Referred to the model of an active and plural socialization (Baubion-Broye & Hajjar, 1998 ; Almudever & al, 1999) and to Dubar’s distinction (2000) of a biographical and a relational transaction, the content analysis of the female bus drivers interviews allowed : a) to emphasize the relevance of using transfer of experiences acquisitions as an indicator of biographical transaction; b) to establish the links between transfer processes and gender positioning (as an indicator of relational transaction); c) to define three types of identity strategies distinguished by their level of transfer activation.     

La dynamique identitaire de stagiaires immigrants : Stratégies d’acculturation et insertion dans un collectif de travail

The aim of this research was to explore reciprocal relations between acculturative strategies of immigrant trainees and their “strategies” of integration into a workgroup. The investigation of each participant’s identity dynamics served as a basis to this qualitative and exploratory study, using the IMIS (multistage social identity investigator), created by Zavalloni and Louis-Guérin (1984, 2007). In both the cases presented here, work environments echoed back to some of the main obstacles opposing to the social integration of immigrants. Therefore, part of the results revealed spontaneous emergence of adaptative strategies simultaneously linking to cultures and the profession.     

Facteurs d’invention,de dissémination et de diffusion d’une innovation : leçons d’une triple étude de cas

The aim of this article is to identify the factors facilitating the invention, dissemination and diffusion phases of the innovation process. An action-research was conducted in a hospital setting using mixed methods (participant observation, interviews and questionnaires). A triple case study illustrated the invention of a change management methodology, its dissemination using an interactive learning strategy and its diffusion within and outside the organization. Ten factors from various research traditions emerged. No model was able to explain all factors facilitating one phase. Phases of the innovation process were carried out dynamically, as a continuously reactivated process.