Les bases du développement de la psychologie communautaire en Europe

Community psychology was born in the USA during the sixties, in a context of poverty, social reforms and deinstitutionalisation. In Europe, because of government policies (dictatorships in Spain, Portugal…) and the orientation of Psychology Institutes, community psychology developed lately. On the other hand, there has been for a long time experiments of alternative care to the hospitalization which are based on the same principles (the experiment of Basaglia in Italy, the district policy in France…). Since the eighties, there are also much more courses in European universities. Finally, the creation of the European Network Community Psychology (ENCP) in 2005 illustrates the expansion of community psychology in Europe. In this article, we will reexamine the various medical and social policies in Italy, in France, in the United Kingdom, and in the other countries of Europe which supported the establishment of Community Psychology.     

Applications cliniques en psychologie de la santé

The aim of the present article is to present recent and validated clinical applications in the field of health psychology, in particular regarding pain and chronic disease management. Techniques such as acceptance and engagement therapy, mindfulness meditation and positive emotions enhancement have proved to be successful. Mindfulness is an attribute of consciousness long believed to promote well-being. It is commonly defined as the state of being attentive to and aware of what is taking place in the present. By this way, mindfulness meditation learns to patients with chronic pain to reduce their pain sensation. Moreover, encourage patients to have positive emotions, such as gratitude, is efficient in long term well-being. Prospective studies reveal that optimism, coping strategies such as positive reframing and acceptance, and social support yield less distress for patients with chronic disease. Similarly, psychosocial interventions that foster optimistic appraisals, build coping strategies, and bolster social support are benefit for patients. Other methods such as Cognitive Behavioral Stress Management (CBSM), enable to significantly enhance quality of life, adaptation to illness and chronic disease patient compliance. This 10-week group CBSM intervention that includes anxiety reduction (relaxation training), cognitive restructuring, and coping skills training is tested among women with breast cancer and HIV patients. The intervention reduces reports of thought intrusion, anxiety and emotional distress. Furthermore, biofeedback through Heart Rate Variability appears to be an important component of the development of patient potential in terms of cognitive and emotional resources enabling better coping with stressful situations and hence maintaining optimal health conditions. Biofeedback treatment intervention on pain and quality of life is helpful in the rehabilitation of patients with chronic pain. Limits of these applications are discussed as well as future research directions.     

Éléments de réflexion pour la mise en œuvre d’une démarche de prévention des risques psychosociaux au travail en France

Preventing social risks at work is an international concern. It has been demonstrated that the work in its all dimensions such as, organizational, technical, technological and relational, involves a multiplicity of constraints. They participate to the degradation of work health and to the organizational performance through to the complex and various mechanisms. The aim of this paper is to explain how a methodological consensus linking the European legislation, national agreements, scientifically theories and tools, and actual work has been gradually introducing in France. Based on theoretical and methodological considerations and on a Return Of Experience (ROE) we demonstrate the necessity to adopt an integrated approach to prevent social risks that focusing more on the work determinants than on individuals’ issues.     

Les foyers de protection judiciaire de la jeunesse et la prise en charge des jeunes auteurs de délit : représentations sociales et réflexions autour de groupes d’adolescents et d’éducateurs

The educators’ work in juvenile justice residential communities and their capacity of affective attunement to the adolescent's needs is essential for the creation of a protective and enriching context for the adolescent and his life trajectories. This article aims to explore the social representations of educators and young people in residential communities in Italy, through the analysis of their discourses gathered during focus groups. Our results reveal the need to compare these representations and work to narrow the gap between the caregivers and the users, in order to improve the relationship between the different protagonists of the interaction and, consequently, the possibilities of good success of interventions.     

Effet de la thérapie des schémas sur la dépression de la personne âgée institutionnalisée : 3 études de cas uniques de type AB en lignes de bases multiples

IntroductionSchema therapy has confirmed its effectiveness in caring for depression. However, few studies have evaluated its effectiveness of an institutionalized elderly population.ObjectiveThe aim of this pilot study is to evaluate the efficiency of this therapy for the treatment of depression in 3 elderly people, with no neurocognitive disease, living in a nursing home.MethodClinician conducted a single case experimental protocol AB with multiple baseline for 3 participants who were experiencing depressive symptoms. Participants were randomized in 3 baselines and performed respectively 8, 7, and 6 intervention sessions.ResultsThe results highlight progressive effectiveness for two of the three residents. From baseline to the end of the therapeutic sessions (11 weeks), the improvement was significant and clinically observable for the activation of the schemas (–1.4 and –2 points on average) as well as for the level of depression (–8 and –9 points to the GDS).ConclusionThis pilot study indicates the effectiveness and replicability of schema therapy as therapeutic intervention for depression in elderly people.     

Les déterminants de la charge de travail perçue dans deux services d’urgence hospitaliers en France

This article gives an account of research carried out the workload of healthcare providers in hospital emergency wards, by focusing on several factors that are both related to the patients and to their activity. Based on 121 observations conducted in two hospitals, coupled with the NASA-TLX scale and an ad hoc questionnaire, this research indicates that the elements which contribute the most to perceived workload are the agitated behavior of patients and communication difficulties linked to handicap. However, variations in the number of tasks do not seem to have an influence on the workload perceived by health care providers which tends to highlight that the relations to patients contribute more to the perception of workload than the number of tasks. In the situation observed, the regulation of workload is made possible by the management of relational factors (physical demand, frustration and effort) which determine, in part, workload perception. In order to reduce or adapt this load, this article suggests basing interventions on the way to deal with difficult patients and not on the regulation of the number of tasks.     

De la question de l’évaluation psychologique et de la psychométrie en douleur chronique

The practice of psychological assessment is an important step in the evaluation of the complex problems presented by patients dealing with chronic pain. We want to discuss here the framework of intervention of the psychologist in the context, but also shed light on the contributions of this practice to the pain clinic. This will include discussing a joint assessment, combining a psychological assessment referred to as classic with a psychological evaluation specific pain.     

Pierre de La Ramée et le déclin de la rhétorique

This article provides a basic general introduction to Ramus, and evaluates his role in the history of logic and rhetoric, especially with relation to the study of argumentation. The author agrees with Ong and other historians of logic that Ramus is not to be taken seriously as a logician, and that his undoubted importance in the history of ideas is to be found elsewhere.Ramus advocates a belief in nature, experience and reason, and rejects the reliance on the authority of ancient philosophers, above all Aristotle, though experience does not mean scientific experiment and, paradoxically, includes the example of great philosophers and writers. In the end Ramus is seen as responsible for substituting for ancient classical rhetoric an entirely ornamental rhetoric of figures which was to take over education (with the exception of the Jesuit schools) almost until our own day. This curtailing and diminishing of rhetoric is seen as a degeneration. Ancient five-part rhetoric had been concerned with convincing and persuading: Aristotle distinguished the analytic, scientific reasoning of logic, from dialectic which was based on opinion and probability and had close links with rhetoric; by the time of Cicero and Quintilian, who addressed themselves to jurists and politicians, logic has given way to dialectic. In the Middle Ages and the Renaissance the two become assimilated; the evolution of this is traced here through the thirteenth-century Summulae logicales of Peter of Spain to the fifteenth-century German humanist logician Rudolph Agricola, who influenced Ramus partly through the intermediary of Johann Sturm. Ramus took over their topical theories but restricted them to logic/dialectic, and left rhetoric with little more than tropes and figures. He believed that there was only one method for teaching all the arts, and one dialectic common to them all. The distinction between analytical and dialectical has disappeared, with far-reaching consequences for the study of argumentation. Over the centuries logic has lost its connection with controversy and persuasion. With the development of the post-Cartesian, post-Baconian emphasis on the clarity of scientific discourse, and the mid-nineteenth-century interest in mathematical and formal logic, the process was complete. Argumentation, or the new rhetoric, aims to fill the gap thus created.

     

Adaptation et validation de la version française de l’échelle d’évaluation de la relation

IntroductionRelationship satisfaction is one of the most studied constructs in the field of relationship evaluation because of its impact on various aspects of daily life. It is therefore important to have an instrument in French.ObjectivesThis study aims to adapt the Relationship Assessment Scale (RAS) and validate its psychometric properties in French from its original version in English.MethodTwo studies were carried out. In the first study, 200 participants responded to the French version of the Relationship Assessment Scale (EER), the Dyadic Adjustment Scale (DAS), and the Hospital Anxiety Depression Scale (HADS) to assess the factor structure and psychometric properties of the French version (reliability, convergent validity, incremental validity). In the second study confirmatory factor analysis was used to validate the factor structure and to examine the gender invariance of the EER through a multi-factorial analysis in a population of 114 adults.ResultsThe results show that the psychometric properties of the EER are acceptable and comparable to the original version of the instrument. The EER presents a one dimensional factor structure. The positive correlations between the EER and the different scales tested support good external validity. The multi-group analysis showed that both women and men similarly understand the items and attribute the same meaning to the questions, confirming gender invariance of the EER.ConclusionThe French version of the EER is a valid and reliable assessment instrument of relationship satisfaction. The clinical and research implications of this scale are discussed.     

Développement des collectifs de travail et développement de la sécurité : une étude sur les décisions à risque en anesthésie

This article highlights the collective dimensions of risk management for patients before an anesthesia. After a phase of observation of real activity, interviews were conducted with 20 anesthetists from two French hospitals. The analysis reveals interindividual diversity in practices. This diversity is explained by the inclusion, in decisions, of knowledge about “distributed” skills in the team and about local “shared practice”. The results establish a link between the site where the anesthetists are working and the choice of an anesthetic technique. They also show that the positioning of anesthetist vis-à-vis the “shared practice” is significantly related to their seniority in the profession. These results open perspectives for research and intervention for the joint development of collective work and safety.     

La portée normative des avis d’expert dans l’élaboration de la décision administrative en matière de sécurité sanitaire

The development of scientific knowledge and the complexity of the issues of health safety have led to increase the use of expertise. The need for transparency following the “scandals” at the end of the last century has led the state to outsource its assessment procedures in health safety, by creating independent agencies. These agencies turn to outside experts because their own staff does not have all the necessary competence. So, the question is: what is the role of these experts in the elaboration of the standards made by the decisions of the agencies? The link between the decision and the expert advice may be almost considered as subordination: the administrative decision becomes stuck by the advice, due to the technical incompetence of the agency. But the circumstances of the administrative decision, especially the situation of scientific uncertainty, can impose a degree of autonomy. If the scope of expert advice seems considerable in certain aspects, it should not hide the full responsibility of policy makers.     

Risques de la régulation médicale en médecine d’urgence. Analyse des dossiers de plaintes de la permanence des soins ambulatoire au SAMU du Var

Introduction

The non-urgent care requests depending on the continuity of care system have to be regulated by a regulating doctor of a medical emergency service call center. We aim to determine the risk factor of litigations about the regulation of the continuity of care system. So, the cases with friendly complaint and those with litigation have been compared.

Perception de la gêne environnementale en fonction de différents types d’unités urbaines françaises

This paper follows the analysis of a survey conducted on a broad sample of French urban residents. The aim of this secondary analysis was to identify the different dimensions of the perceived urban annoyances. The objective of this secondary analysies is to compare the perception of urban nuisances by city size and their geographical location within the metropolitan area: downtown Paris/provincial France, inner Paris/Parisian suburbs. Responses from 986 urban residents highlight (1) an effect related to the size of the urban unit since in provincial France, the six larger cities stand out against the others in terms of the greatest intensity of discomfort perceived by the residents; (2) a “capital” effect, since in Paris, in spite of the gigantic scale of the space and the very strong density of population involving hard environmental nuisances, the residents have a positive perception of their city compared to the residents of the other big French cities; (3) a heterogeneity of the responses from the residents of the Parisian suburbs according to their department. The results are discussed on the one hand in the light of the logic of sociospatial segregation of the urban territories, and on the other hand by suggesting that affective-cognitive processes could be mediators between the objective characteristics of the urban nuisances and their subjective perception by the residents.     

Amélioration de la qualité de vie au travail dans les unités de soins : la démarche ORSOSA

Improve the quality of working conditions is a major issue for healthcare workers who have to deal with productivity obligations and multiple procedures. Based on the magnet hospital concept, the ORSOSA study (prospective cohort study of 4000 helthcare workers) helped develop and validate a methodolody that allows to quickly diagnose the levels of psychological and organizational constraints (CPO) from the staff’s point of view / of the staff. The ORSOSA method relies on an organisational psychologist who launches a dynamic during the diagnostic feedback phase. He gets the team to appropriate the strengths and weaknesses and to rank their recommendations. This article presents an overview of the method and it the first stages of its evaluations.     

Composer avec la diversité culturelle en classe de maternelle: résultats d’une analyse de récits de pratique enseignante

This article offers an analysis of teachers’ narrative within which kindergarten teachers have rebuilt their intercultural experience in the classroom, through a situation featuring a child "from another culture". The progressive scheduling in, oriented towards the ideal type of commitment to the child "of another culture", which led the analysis, will be presented and interpreted from two angles, therefore providing a definition of what we named the "otherness in act ", referring to some "enactment" of the paradigm of otherness (Abdallah Pretceille, 1996, 1999, 2003).