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.     

Les modèles de changements de comportements dans le domaine de la santé

Chronic diseases require both a medical treatment that a patient adherence to health recommendations. These include changes in lifestyle to adopt healthy behaviors. However, these changes are hardly adopted by patients. This article provides a review of theoretical models to explain resistance to change or factors motivating new behaviors. After presenting the steps by which a person gets through when changing an aspect of her lifestyle, we will discuss the factors involved in motivational and volitional phases of change. Thus, in the motivational phase, we will refer to classic sociocognitive models, illness representations model and the self-determination model. In the volitional phase, we discuss concepts related to action monitoring and action planning, self-control, and the anticipation of barriers to help maintain the action in time.     

De la prévention à la promotion de la santé : intérêt de l’approche communautaire

Psychological research and practice shows increasing interest for prevention and health promotion in France. Current-scientific literature recommends the implementation of targeted actions, directed towards populations expressing specific needs. The community-based approach offers a framework corresponding to the flexibility, which is necessary to the effectiveness of this type of intervention. It includes the mobilization and the participation of the citizens in the development of each unique project, in the renewal of the project according to the needs, in finding possible solutions, and in assessing the actions carried out. This article aims at presenting the importance of a community-based approach in the field of health promotion; a field which would benefit from being better known in France in order to develop intervention programs adapted to each population.     

Du secret médical aux dossiers de santé électroniques. Réflexions juridiques sur la protection des données de santé

Health data give rise to a plurality of qualifications. The exercise players are forced this not unusual for the legal system. In the case of health data, especially when these data are processed through folders to which several categories of actors need access, it may still be problematic. Electronic medical records, in which the authorities have in recent years invested a lot of hope and money, fail to cross the course of a generalization though it was presented as being beneficial for our public health system and financing of health spending. Without exaggerating the extent of social problems related to the interpretation and application of standards, it is reasonable to think that they are partly responsible for this fact. After presenting the two great bodies of norms which where initially protecting personal health data, this paper develops the analysis of their confrontation before highlighting the status of one of the most complex issues in this field, that is the people's consent to the various treatments that their data may be subject of.     

Travailler dans un réseau de santé : effets sur la santé psychique au travail

The new needs as regards care taking charge of patients have contributed to the creation of health networks. As they are growing fast, they are an integral part of the French sanitation system. The impact, on the health professionals, of networking is, today, the object of contrasted research and results, but has little been studied as far as Social Psychology, Work and Organizations are concerned. This article follows a research project which had the objective, on the one hand, to describe the effects of the participation to a health network mental health at work and, on the other hand, to examine the variables and process accounting for the variability of these effects. This research privileges an approach to the health network as a place of socialization and personalization (Malrieu, 1979). The research on the ground is carried out in collaboration with the health network town-hospital Prevention and Taking charge of Pediatric Obesity Network (RéPPOP) Midi-Pyrénées. We have carried out semi-guided interviews with 20 private professionals (8 doctors, 8 dieticians, 3 psychologists, 1 physiotherapist) members of the RePPOP Midi-Pyrénées network. The main results show that the perception of positive and/or negative effects of networking on mental health varies according to the age of membership of the network and the processes of transfer of experience (from professional practice within the network to professional practice off-network and vice versa). Proposals are deduced in terms of continuing education within the network.     

La santé à l’épreuve de la mobilité : les débuts de parcours de compagnons de l’aéronautique

In this article we relate a research, which has been carried out among workers in an aircraft-manufacturing site. The purpose of the research was to enlighten the links between health and professional mobility. Leaning on quantitative and qualitative analyzes of mobility inside a worksite, we put forward the complex network of itineraries of blue collars, at their beginning. These itineraries combine changes in workstations or in working conditions, and various individual, collective or organizational dimensions. The apprenticeship of mobility frameworks gets involved in wider series of professional norms, which might at the same time prevent from health disorders and make them less visible. Thus, the integration of these various temporal dimensions by blue collars themselves brings depending on organizational context, supports or damages for health.     

Effet du télétravail sur la santé psychologique et la performance des travailleurs durant la pandémie de la Covid-19

The aim of this study was to examine how the widespread use of telework during the COVID-19 pandemic may have created a specific work context influencing employees’ psychological health and performance. Results of analyses conducted on a sample of 3771 Canadian teleworkers revealed that telework created additional demands such as task interdependence and professional isolation. These demands had negative effects on telework performance by increasing the frequency of perceived stress. However, the presence of resources such as organizational support appeared to play a buffering role in moderating the direct effect of professional isolation on telecommuting performance.     

La protection des données personnelles des patients face à la modernisation de notre système de santé

With the Internet and the artificial intelligence, the collection of personal data is becoming a strategic element for the digital economy. The collection of information touching the health or the body must respect the patients’ rights. The GDPR came into effect on May 25th, 2018. The healthcare professionals who are established in a Member state, must be careful because they can base their exercise on clinical or biological elements of their patients.     

Développer des interventions de prévention et de promotion de la santé fondées sur les données probantes : la Démarche EValuation Action (DEVA)

While scientific knowledge informing how to prevent main public health problems builds up since decades, the gap between professional practice and scientific evidence remains important. Regarding disease prevention and health promotion, professionals – including psychologists – aim at enriching their practice by relying on scientific knowledge. However, barriers to knowledge transfer remain. Here we present the Evaluation-Action Approach (DEVA), which has been created to overcome such barriers and provide an operational tool to practitioners willing to use the best available data. This article describes this new project methodology, which is anchored in the evidence-based paradigm, and has been developed based on methodological tools in French, along with assessment practices from different academic disciplines. It has been pre-tested and improved in an academic context and then tested with practitioners (locally and nationally). The DEVA comprises three stages and twelve steps, four of which are evaluations. These evaluative steps aim at checking whether, at each stage, the best available data are used and that the (working and health) objectives are reached. The DEVA can contribute to the need of methodological innovation and the development of professional and practical skills. This project methodology provides an operating procedure to facilitate knowledge transfer and the development of evidence-based prevention and health promotion interventions.     

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.     

Les psychologues dans le champ de la santé mentale : les perspectives en promotion de la santé mentale positive

Literature findingsMental health promotion is still insufficiently known by psychologists and few of them work in this field, in part because it is based on public health concepts and data. Furthermore, its approach is focused on positive health – as opposed to deficit models – which proposes interventions consisting in developing human competencies and strengths as a means of preventing potential future mental illnesses.DiscussionThe present stake, in the field of mental health, thus requires a paradigmatic change in psychologists which would enable to move from mainly curative interventions to actions oriented towards individual and collectives’ potentialities. This article presents a synthesis of mental health determinants as well as national and international public policies aiming at developing health promotion.ConclusionIt concludes on how psychologist could become major actors in this field.     

L’abord de la sexualité par les professionnel·le·s de santé en oncologie : une revue de la littérature

The improvement in medical techniques has drastically modified the practice of care in oncology. Supportive care, geared towards supporting patients with chronic illnesses, now occupies a greater place alongside treatments aimed at survival. These changes have conducted some health care professionals to be more interested in patients’ quality of life and, in particular, to the impact of cancer on sexuality. Repercussions on sexuality are actually one of the most problematic aspects of patients’ quality of life post cancer. The aim of this paper is to draw up a review of the English and French literature on this “new” concern which still seems to raise many challenges in practice. Our review emphasizes that despite the recognition of the importance of addressing sexuality issues post cancer in oncology, in their practices, physicians as the nurses alike find it difficult to address. In addition, it underlines that the dominant social representations of sexuality – in terms of gender, sexual orientation and age – have permeated health care professionals’ subjectivities and, at the same time, influence how sexuality is address and interfere with a systematic discussion of these issues throughout the care process. Our discussion tackles the lack of psychologists, both in research and clinic, regarding these issues. Finally, our conclusion highlights the contributions of psychology facing issue posed by sexuality in oncology.     

Le droit à la protection de la santé dans la jurisprudence du Conseil constitutionnel

The establishment of constitutional review a posteriori did not fundamentally inflected jurisprudence of the Constitutional Council in the field of health protection. Decisions rendered in QPC material confirms that if the judge agrees to give priority to public health in the exercise of his office, he still refuses to recognize the subjective dimension of the right to individual health.     

Le droit à la protection de la santé dans l’alinéa 11 du Préambule de 1946 : les impacts en termes de solidarité

The right to health protection is recognized as a constitutional objective. This includes guaranteeing an equal access to health care without any discrimination. The implementation of this right is a difficult task due to geographical and socioeconomic inequalities. In many situations, the public health sector is experiencing financial crises. The problems concerning health access seem to be mounting and could jeopardise the principle of solidarity which is the foundation of the health system.     

La temporalitéy de la perception: A propos de l''Interprétation phénoménologique de la CRP de Kant

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Psychanalyse et existentialisme: A propos de la théorie lacanienne de la subjectivité

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Prévenir et agir sur les problèmes de santé au travail : les services de santé au travail à la croisée des chemins

This article presents an ongoing research regarding work-related health issues as they are perceived and identified by professionals practicing in occupational health services. The study is based on interviews with occupational doctors, nurses, technicians in prevention of occupational hazards and assistants, employed in two general services. The article starts with an overview of the recent changes in the workplace and in the practicing conditions of the professionals in the services. It then analyses the types of issues they identify among the employees they have in charge. Finally, the article examines the actions that can be done by the services, and the limitations of these actions. The professionals appear to be negotiating with various strains.