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.     

Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.     

Déontologie et santé publique en droit constitutionnel

Ethics, even if there is a renewed interest today, has long been important in the public health domain, keeping constitutional law at a distance for the benefit of a relative autonomy of the medical field. However, the indifference between sanitary ethics and constitutional law tends to become less marked because of the appearance of a double opposite movement, consisting on the one hand of a public “déontologisation” of health law, including constitutional law and, on the other hand, in a constitutionalisation of ethics regarding public health. This evolution sets up as an arbitrator of State interventionism a Constitutional Council originally reluctant to check the intervention of public authorities in the field of health.     

Les interventions préventives en santé mentale du jeune enfant vues par leurs bénéficiaires : l’exemple du projet CAPEDP

ObjectiveHome-visiting programs have become one of the most popular early childhood interventions, though their impact on parents and children remain uncertain. Outcomes measures often rely on experimental quantitative design and little space is offered for the voices of those served by these interventions. This paper presents the results of a qualitative protocol performed by the research team with participants in the CAPEDP project which took place in France from 2005 to 2011.MethodAll 184 women who had accepted at least one home visit in the CAPEDP programme were contacted and invited to participate. Individual and group interviews were conducted with the first 16 who accepted to participate. The semi-structured interview schedule addressed their overall appreciation of the project, their initial concerns, the quality of their relationship with their home visiting psychologist, positive and negative aspects of the intervention and any recommendations they might have for future interventions. Interviews were recorded, transcribed and anonymised. An inductive categorical thematic analysis was performed by the research team.ResultsParticipants expressed overall satisfaction with the CAPEDP intervention, underlining the quality of the relationships with the home visitors, usefulness of parental guidance, the fact that the intervention could be adapted to suit their own personal agenda, routine and needs, the importance of learning how to accept help and give help to others. Less positive aspects included the fact that the home visitors were not mothers themselves and that they lacked technical experience, the difficulty ending the relationship at the end of the 27-month project, insufficient integration of fathers, the difficult and time-consuming evaluation protocol and the lack of interaction with other parents during the intervention.ConclusionAlthough mothers who accepted to participate in the qualitative interview schedule may have had a more positive overall experience of the CAPEDP project than those who declined to participate, participants’ points of view provide potentially useful indications for adapting future home-visiting programs to the French context.     

Valorisation de la recherche en santé humaine et protection des données à l’ère du numérique

Medical research collects a huge number of medical data sheltered in Data Centers. An European regulation rule (GDRP) or General Data Protection Regulation aims to give an ethic frame to protect personal data and delegate responsability to citizens.     

Recherche en santé et protection des données personnelles à l’heure du Règlement général relatif à la protection des données

France has a very rich legal framework, which defines the conditions of access and use of health data for scientific research purposes and ensures their protection. Currently, this legal framework is undergoing revision. The European regulation of April 27th 2016 on protection of natural persons in relation to the processing of personal data came into effect in EU member states since 25th May 2018 and substitute a rationale of administrative process for a rationale that empowers the researchers to document and prove compliance with the regulation (“accountability”). This regulation must be coordinated with the other regulation applicable to research in UE and with national law.     

Où en est t’on du Big Data en médecine ?

Opening of medical datas and files is nowadays an important challenge. French Government increments new rules to allow access to these data files.     

L’accueil en santé mentale,si on en parlait ! Une revue de littérature

ObjectiveThis narrative literature review aims to present the studies on the concept of welcome in the field of health. The concept of reception remains difficult to define by healthcare professionals and their beneficiaries. This is a fruitful concept but whose outlines are still poorly defined. This paper aims to identify the intrinsic dimensions of reception?MethodA narrative synthesizes systematic reviews was conducted using 4 search engines: PubMed, PsychINFO, Cairn and Science Direct. A total of 17 publications was selected.ResultsSeven dimensions of the welcome have emerged: (1) relational approach; (2) singular and iterative process; (3) conditions of the reception; (4) risks of the encounter; (5) personal qualities of healthcare professionals; (6) gestures at the reception; (7) needs of people welcomed. These results highlight the importance of integrating these dimensions within an integrative model.ConclusionIt appears that reception must be perceived as a complex iterative process enroll in a relational approach. The major issues to the establishment of a sufficiently good welcome are to be perceive in a reflexive attitude for all the protagonists.     

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.     

Organisation du travail,stress et conséquences en milieu universitaire

The objective of this study is to show that the organization of work, appearing in a cultural context marked by inequity, and raising the symptoms of stress, has an adverse impact on the functioning of Cameroonian universities. From a random probability sample of 287 university teachers were selected. Relative to the French version of the organizational factors Karasek and Siegrist questionnaire and inventory-based stress symptoms questionnaire were administered to them. The analysis method was statistical results and hypotheses were tested with multiple regression. All hypotheses are confirmed.This research raises awareness of mental health, if it is not supported, can further contribute to weaken higher education in Cameroon.     

Du modèle transactionnel à une approche dyadique en psychologie de la santé

In the context of chronic disease, models and studies in health psychology have first focused on the patients’ adjustment. Research conducted with the Transactional Model of Stress and Coping (Lazarus and Folkman, 1984) and the Transactional Integrative and Multifactorial Model (Bruchon-Schweitzer, 2002) have shown that individuals’ social relations, and especially family support, are associated to patients’ outcomes. Recently, studies have taken more attention to the “significant others”, most often the partners. In fact, relatives are also affected indirectly by the disease and its changes on daily life. Moreover, they often play a crucial role by helping the patient to face the disease. These models are focused on the individual and are not relevant to study dyads. An evolution of these models can be proposed by integrating a systemic and dyadic approach. In fact, the way the patient and the relative face the disease, the quality of their relation but also the way they face the disease together, as a dyad, have to be considered. The first part of this article presents the Transactional Model of Stress and Coping and the Transactional Integrative and Multifactorial Model and their evolutions. The second part shows how it is possible to develop a dyadic approach based on these models. It presents the Family System-Illness Model (Rolland, 1987), the Developmental-Contextual Model of couples coping with chronic illness across the adult life span (Berg and Upchurch, 2007) and a Systemic and Transactional Model of Dyads, which help to take more completely into account the adjustment processes of patients and relatives to a chronic illness.     

Fidélité inter juge d’une mesure du stress par échelle visuelle analogique

The use of a visual analogue scale (VAS) for the assessment of stress during occupational health examination could be an useful tool. However, psychometrics features of the VAS have to be assessed. The aim of this study is to test the inter judge reliability of the VAS in a psychological dimension assessment. Two occupational physician have used the VAS in a worker group. There is no significant difference in the distribution of VAS values. This result supports the hypothesis of a satisfactory inter judge reliability of the VAS in stress measurement.