L’annonce d’un décès en milieu hospitalier

Announcing a death is always a delicate moment for close familial members but also for caregivers. Law gives some precisions about how this information must be delivered. Recently the state council judged that the lack of empathy from caregivers and the late of the death announcement can create a damage. This judgement gives more precisions about how a death announcement must be in a hospital. This topic is pretty similar with the information which must be given to close familial members about organ donation. This latter is definitely more exceptional and the procedure is a way more regulated. There are much rules which explain how this information must be delivered.     

La contraception d’urgence chez les mineures. Une offre illimitée en manque d’évaluation

Avoiding the use of abortion by minors is the aim that has been pursued since 2000 through the facilitated access of young girls to emergency contraception : breaking numerous rules relative to health security and to Social Security, the dispensation is done anonymously and free of charge. However, the analysis shows that the three postulates from which this policy was built – satisfactory benefit/risk ratio of emergency contraception, safety of repeated medication and real efficiency to reduce numbers of unwanted pregnancies and abortion – are not validated. In addition, there are some indications that this policy is not devoid of adverse effects.     

Le travail coopératif d’équipes de projet d’ingénierie à l’épreuve de l’activité en réunion médiatisée et multi-localisée

Performing in worldwide competition compels companies to be innovative and this unyielding global pressure sparks engineering team projects on a far-reaching scale. The synergy of heterogeneous and dispersed skills supposes to overcome the geographical distance between teammates using sophisticated socio-technical devices. Based upon four grounds of empirical research, this article will examine the function of this media coverage technology with a comprehensive sight of phenomena underlying remote interactions between teammates. Face to the reality of their cooperative activity, experiencing multi-localized virtual meetings with synchronous co-presence, are considered the experience, the resources and the constraints introduced by these terms and working conditions.     

L’épuisement professionnel des enseignants en début de carrière

In the literature on the professional integration of teachers burnout is often invoked to at least partially explain the high percentage of those quitting the profession after a five-year practice or less. Teachers’ burnout implies emotional distress, viewing pupils as « things » (instead of as human beings), and being unsure of one’s teaching abilities. While this not always leads to quit teaching, victims of burnout can hardly escape pessimism and cynicism about their profession. This paper is made up of two parts: 1) a discussion of teachers’ burnout; 2) some suggestions for keeping teachers on the job.     

La construction de compétences d’étudiants en soins infirmiers lors d’un apprentissage par simulation : étude au cours d’un exercice de prise en charge d’un arrêt cardiorespiratoire

Our study focuses on the professionalization process in nursing students. More specifically, it aims to understand how each step of simulation in nursing education contributes to skills development in nursing students. In total, forty-seven students participated in this study. All the learners were first year students and answered anonymously, at the four stages of the research process, to a questionnaire consisting of six questions to measure their opinion on the acquisition of skills during a learning session based on simulation. Each question was built on one of the six forms of knowledge defined by Le Boterf, 1997, Le Boterf, 2007, Le Boterf, 2011 in his theoretical model of competence. The results show that each stage of the simulation training significantly modifies the students’ opinion on the different forms of knowledge they have acquired. Moreover, the debriefing, that is an essential part of simulation learning, proves to be the most complex stage given the multiple psycho-cognitive and emotional processes involved.     

Les autorisations d’équipements lourds d’imagerie médicale : un désordre organisé

Medical imaging is essential for all medical specialties and it is natural that the government wants to create a real healthcare provision policy in this area. Medical imaging and particularly the “heavy” equipment are subject to a regulatory and legal framework. This framework results in respect of administrative authorization mechanism. These authorizations are a major tool for development of medical imaging on French territory. This mechanism is an important instrument of economic regulation in controlling health costs. However, the access to this kind of equipment raises various issues in governance and administration but also in matter of economic regulation, distribution of healthcare supply in medical imaging in health territories and respect of public health issues. The authorization mechanism raises questionings, not only at national and regional level in terms of unequal access, but also at European and international level. Indeed, France is among the last countries in the ranking of CT (computed tomography) and MRI (magnetic resonance imaging) equipment rates in comparison with many OECD (Organization for Economic Cooperation and Development) countries. Now, these authorizations will integrate much more the concepts of accessibility and quality of patient care. The legal and regulatory framework of these authorizations will have to evolve and to adapt to new technologies and practices, which today should be a source of significant cost savings.     

Le droit de recours en matière d’autopsies médico-légales

The decision to carry out forensic autopsies is frequently made to determine the reasons of the death, especially in cases of non-natural death. In Switzerland, the judge strictly controls the authorisation to conduct forensic autopsies and the possibility to appeal against such a decision remains limited. This article aims to analyse the legal framework that enables appeals against a decision to conduct a forensic autopsy, taking into account the jurisprudence from the High Court of Switzerland (Tribunal Fédéral) and the European Court of Human Rights.     

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.     

L’appropriation de l’espace chez les personnes âgées dépendantes résidants en EHPAD

IntroductionThe present study focuses on space acquisition process in dependant elderly people living in institution.ObjectiveOur aim was to assess the role of the type of space and level of control on the quality of life in dependant elderly people living in institution.MethodThree variables were examined. The type of space (private versus collective, evaluated with two scales), the level of control (Levenson's IPC and EHIPA) and the quality of life (SF-36 and Geriatric Depression Scale). Our sample consisted of 30 elderly people living in institution.ResultsOur results showed that: (1) subjects appropriate more the private space than the collective space; (2) the level of control influences the acquisition process of collective space but not private space; and (3) the more subjects appropriate the collective space, the better is their quality of life.ConclusionThe results propose that potential applications should be developed in institution.     

Développer l’apprentissage,la coopération et l’identité organisationnelle en milieu hospitalier Evaluation de l’impact d’un Dispositif d’Immersion Structuré

In this article we analyse the effects of an innovative approach adopted in a hospital institution. Using a specific framework, this approach consists of placing staff into a department other than their own. The objectives of this approach relate to cognition, identity and organisational behaviour. Based on thematic and structural analysis of 25 interviews, this evaluation shows that the effects of the intervention are consistent with the anticipated objectives on several levels: (1) learning about ways of functioning and working in the host department, (2) growth of co-operation between departments, (3) the development of a feeling of organisational belonging.     

Le rôle de la stigmatisation dans la symptomatologie dépressive de femmes françaises en surpoids ou en situation d’obésité

IntroductionDespite the high prevalence of depressive symptoms among women being overweight or having obesity, the role of stigma and causal attributions in the expression of these symptoms in French women has been largely under-explored to date.ObjectiveThe aim of this research is to study the role of internalized stigmatization, stigmatizing experiences and causal attribution in the intensity of depressive symptoms in overweight and obese French women.MethodThese four variables were measured in 160 French women being overweight or having obesity.ResultsOur analyses highlight positive correlations between stigmatizing experiences, internalized stigmatization and depressive symptomatology. It is important to note that stigmatizing experiences seem to play a more preponderant role than internalized stigmatization in the expression of depressive symptoms.ConclusionFor women with significant depressive symptoms, it appears essential to integrate interventions aimed at reducing their level of stigma. Moreover, from a preventive perspective, it also seems essential to promote campaigns in France aimed at reducing the stigmatization in this population.     

Le collectif de travail : une protection pour la santé psychologique d’éducateurs d’ateliers industriels en milieu carcéral

Using data from a survey conducted in Psychodynamic of Work in a maximum security penitentiary with monitors of industrial workshops, this paper proposes an understanding of the impact of organizational constraints on the psychological health. This qualitative study shows that the situation faced by these workers produces significant sources of suffering for example, work prevented, oppositions between different groups of workers, rough social relationships, fears and dangers). Few sources of pleasure, based on the team relationship, the challenge of rehabilitation of prisoners and the satisfaction of making quality products. The study identified various defensive strategies to counter the suffering at work. Finally, the discussion focuses on the importance of collective work as a means of protecting psychological health.     

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.     

Effets comportementaux et attitudinaux d’une procédure de Pied-dans-la-porte en entreprise

The present research investigates attitudinal and behavioral effects of a Foot-in-the-door paradigm (Freedman & Fraser, 1966), adapted to a company world. Moreover, it measures the impact of a variable whose integration to the paradigm has been discussed (Joule and Beauvois, 1998; Joule, Py & Bernard, 2004) although its effect has not been experimentally demonstrated: Action Identification (Vallacher and Wegner, 1985). Results show a response rate to the target request and a mean of affective commitment to the organization (Allen & Meyer, 1990) higher in the F.I.T.D. condition, particularly when the level of action identification is taking into account. Results are discussed in terms of commitment theory and action identification theory.     

Environnement lumineux et anxiété des patients en service d’IRM

BackgroundMagnetic Resonance Imaging (MRI) is a medical imagery exam, which is considered stressful/worrying for patients. This anxiety is related to several factors: negative beliefs linked to the lack of knowledge about the procedure of the exam, duration, noise of the MRI, etc. Several interventions, before and during the MRI were proposed and evaluated with the aim of reducing anxiety for patients (information given to patients, psychological preparation before the exam and hypnosis, aromatherapy, sedation, environment and positioning of the patient). While the health service is more and more centered on cost-efficiency and pressure for greater patient throughput, it is important to find appropriate interventions to improve patient tolerance of MRIs.ObjectiveThe objective of this study was to compare anxiety of patients based on the MRI luminous environment.Methods208 patients aged 18–70 years participated in the study. Four subgroups were created according to the presence or absence of luminous environment, screen and music: G1 (60 participants, with luminous environment, without screen, music with fast tempo); G2 (60 participants, with luminous environment, with screen, music with slow tempo); G3 (27 participants, without luminous environment, without music); G4 (61 participants, without luminous environment, music with fast tempo). All participants completed a questionnaire to evaluate their anxiety regarding the exam (anxiety-state, AE) and in everyday life (anxiety-trait, AT): STAI-Y. Open questions were also asked to participants in order to gain an understanding of their experience of the exam (positive points and suggestions for improvements).ResultsThe results showed a significant difference between the groups of the AE: patients of group G1 showed more AE than patients in group G2 (p = 0.037), patients of group G2 showed less AE than those of group G3 (p = 0.001), and patients of group G3 showed more AE than patients in group G4 (p = 0.019). No significative difference was found between the 3 groups in the AT. The participants who underwent exams in a room with a luminous environment equipped with a screen with slow tempo music reported more satisfaction and offered fewer suggestions for improvement compared with the two other groups.ConclusionThis study has revealed that the environment in which patients undergo their exam affects their level of anxiety during the exam. A luminous environment equipped with a screen led to a considerable decrease in patient anxiety during the MRI exam. Technological innovations are allowing the patient to be the center of radiographers focus more and more. Trying to priorities improvement of patient well-being consequently facilitates their work. Taking into account the cost and increasing number of medical imagery exams, prevention of anxiety and its undesirable side-effects is not only important for patients, but also avoids wastage of staff and of time. The results of this study should encourage health centers to invest in these new installations, keeping in mind that new technologies can never replace information and support offered before the exam by radiologists and radiographers.     

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.     

Les figures temporelles de l’adulte en reconversion vers la création d’entreprise

IntroductionMore and more vocational retraining in France lead the adults to break with his former career for engaging in a new occupation. This entrepreneurial project is at the crossroads of several temporalities, which this paper has investigated.ObjectiveWe study mainly the processes of retraining to start up a company. The goal is to know if the devices of accompaniment to the construction of the entrepreneurial project come to support or interfere the temporalities of the adult in retraining to creation of company. We want to know how these adults in retraining seize these temporalities of the entrepreneurial process (beliefs, feelings, representations) and these temporalities of the assistance and counseling devices (in a structuring way, to gradually build this new professional identity of entrepreneur, or limiting way, like a form of subjugation).MethodNine adults were interviewed in semi-structured interviews about their experience of retraining to start a new business. This research provides a key to seeing the plural temporalities arising from the relationship between the desire for autonomy and the normative framework of the devices.ResultsA thematic content analysis was carried out, to identify the phases of the transition, the temporalities of the processes of retraining and creation, the logics of actions and the forms of relationships.ConclusionThe actor strives to make the limiting and emancipatory temporalities coexist through a personal work of appropriation. This allowed to construct four figures of adulthood in retraining towards entrepreneurship: the author of his artwork, the decision maker of his future, the coin adult of his actions and his time, and the runner.     

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.     

Un cadre psychosocial d’intervention pour accompagner le développement et le déploiement d’une technologie nouvelle

This article presents a psychosocial intervention framework to support the development and deployment of a new technology. This methodology articulates the three phases necessary for the study of the representation of the use and its evolutions (i.e., the usual trajectory): acceptability, acceptance and appropriation. After an argumentative presentation of the methodological choices made, the article continues with the presentation of an example of accompaniment carried out within the framework of the IDViandes project aimed at the development of a traceability device for meat containers Of slaughter within the company SVA Jean-Rozé, subsidiary of the Intermarché group. This example argues in favor of the idea that the use of such a method makes it possible to optimize the successful accompaniment of the development of a technology and thus ensure its future diffusion.