Le climat d’entropie et le stress dans les organismes de sant

In recent years, many research and reporting of findings highlight the deteriorating work conditions in our hospitals, describing a climate of disorder in the arrangement of this system components (Masclet 2010). The study presented here examines the relationship between the entropy climate and stress of health personnel. The study was conducted in two hospitals in the Picardie region using a self-administered questionnaire answered by 161 workers in six trades. A transactional perspective has been used to clarify the role of organizational stressors through the mediation of psychological stress. The results confirm the mediating effect of psychological stress among the organizational social climate and perceived stress.     

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.     

Le contentieux de la régularité externe des décisions rendues par les juridictions ordinales des médecins

In the event of irregular composition of the ordinal jurisdiction or omission of certain compulsory particulars in the decision rendered, the parties may challenge the external regularity of the decision. The pleas based on the contested decisions are formal and procedural defects. If successful, these means result in the annulment of the decision ordering the doctor to be disciplined. These means constitute a separated legal cause and can only be invoked within the time limit for appeal, unless they are of public order.     

La représentation des causes de l’état de santé par les infirmiers et les points de vue envisagés des patients et des aidants naturels : une approche socionormative

This study examines the representation of the determining factors of patients’ states of health in therapeutic care situations. We describe the average representation of experienced hospital nurses (n=44) and the differences which they consider to exist between their own and their patients’ points of view. Taking as our starting point the purpose of the care provided and the asymmetry of the carer/patient relationship, we hypothesize, on the one hand, that nurses will have a representation of their patients’ state of health which is based on the care to be provided, with the factors determining the state of health being necessarily perceived as having a general impact on patients’ lives while still being remediable, i.e. capable of changing and being controlled by the provided care. On the other hand, we expect them to attribute a passive position and attitude to their patients, with the factors determining their state of health being necessarily perceived as being out of their own control. The results and the analysis of the representations reported as being those of the patients and their families seem to justify this perception and role of carer: the supposed representations of the latter would appear to be convergent but less focused on health problems and would tend to minimize the patient’s involvement, in particular when the state of health declines. The results are discussed with reference to the Health Belief Model and the social norm of internality as well as the professional practices observed in hospital environments.     

L’évolution des normes face au développement des objets de santé connectés

A lot of connected objects can be sold on the Internet and in some general stores. These products can be used in a health environment; they can help to promote a healthy lifestyle. But they do not always have a well determined legal status, that is established to protect the patients or the healthcare professionals. The connected objects can support innovation. They can become an essential help for the patients and the healthcare professionals, nevertheless they can be at the origin of physical injuries, if they are badly used.     

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.     

L’accès aux médicaments : quelles contributions des règles sur les brevets de l’Accord de partenariat transpacifique global et progressiste ?

Enhanced protection for patents in free trade agreements would undermine access to medicines and show difficulties for developing countries with respect to public health issue. In the context of the Comprehensive and Progressive Trans-Pacific Partnership Agreement, however, after the withdrawal of the United States, the legal regime applicable to patents seems less rigid and, therefore, more favorable to access to medicines. This results, on the one hand, from certain flexibilities contained in this agreement itself; and on the other hand, the suspension of some material and procedural obligations. This article aims to analyze these two sides to justify the contribution of this agreement to ensure access to medicines.     

Interactions entre règles sociales de santé publique : étude des liens entre le port du masque et les règles routières en temps de crise sanitaire

IntroductionThe health crisis that France has experienced since the beginning of 2020 has justified the introduction of new health rules requiring changes in behaviour. The context of the implementation of these health rules, instituted very recently and for a limited period of time, raises the question of their perception and respect among the population.ObjectiveMobilising the social developmental psychology, the objective of this article is to explore inter-individual differences in the perception of these health rules measured through the wearing of masks. It aims also at studying the links between these perceptions with the experience of the health context and the perception of other legal public health rules, apprehended through some road safety rules.MethodThe questionnaire survey, carried out during the second confinement with a representative sample of 4999 people, made it possible to measure the experience of the health context, the internalisation of the rules and their justifications, the usefulness of the rules and the perception of the legal system.ResultsThe results show the links between internalisation, the type of arguments used to justify it for wearing a mask and for road rules respectively, as well as the links between internalisation and the perception of the legal system. They also show that women use moral and prudential arguments more to justify their internalisation of rules and that they have internalised the traffic rules (but not the wearing of masks) more than men.ConclusionThese results show that the perception of the rule of wearing a mask is more related to the general perception that individuals have of the legal system and other legal public health rules involving the relationship with others than to the context in which these rules were put in place.     

Contentieux des professionnels de santé avec les caisses d’assurance maladie

This article examines current case law, emanating from the Cassation Court and the Courts of Appeal, and extending over the period from September 2018 to March 2019.