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.     

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.     

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

Sans résumé     

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

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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.     

Psychologie communautaire et psychologie de la santé : l’implication de la recherche psychosociale dans la promotion de la santé

This paper presents the issues and main principles of community psychology and community research as well as associated relationships and viewpoints in terms of health psychology and social psychology. In this perspective, the paper presents the context in which community psychology has emerged and its fundamental principles such as empowerment, community involvement and the ecological model. Using two examples of research in prevention of HIV infection, the paper leads to a greater comprehension of how a particular community-based approach to involve affected populations may be particularly relevant, not only to better understand their beliefs and behaviors but also to try to encourage them to change current behaviors or generate new ones. Research with adolescents involved in promoting condom use illustrates the use of psychosocial models of behavior change through a community approach. A second research focus on medical and psychosocial innovation through the use of non-routine, rapid screening tests for HIV - which are neither carried out nor supervised by medical personnel - aims to highlight the impact of the development of preventive action by directly concerned communities. The article aims to present the innovative methodological and epistemological issues which underpin community research.     

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.     

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.     

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.     

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.     

Représentations sociales de la personne obèse et de l’obésité : effets de la situation de contact

This paper introduces a study about social representations of obese people and obesity. Two hundred normal-weighted women divided in two groups (presence vs absence of contact with an obese person) completed a word association tasks with inductive words “obese people” and “obesity”. Two instructions were proposed: one in which they responded for themselves (standard instruction) and another in which they responded for someone else (substitution instruction). Results of the Correspondences Factor Analysis support the hypothesis of an intergroup contact effect on the explored social representations’ organization. Participants in contact with obese people seem to have a more empathetic representation than those who have no contact. Indeed, when participants did not respond for themselves, counter-normative representations were produced: stereotypical elements and a judgment on the physical characteristics were expressed. These results were discussed regarding theories of intergroup contact and of social representations.     

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.     

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.     

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.     

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.

     

Les conceptions hédoniques de la motivation

Hedonism is a psychological notion central to many conceptions of happiness and psychological well-being. Hedonism is also fundamental to motivation as a whole. The present article reviews four hedonic conceptions of motivation from a historical perspective: hedonism of instinct, hedonism as lack of arousal, hedonism as finding an optimum, hedonism as satisfaction to psychological needs. It appears that the first approach, linked to the instincts, is close to more modern conceptions such as satisfaction of psychological needs in a eudemonic perspective.     

Construction et validation de l’échelle de mesure des croyances relatives à la laïcité

Recently, social psychology has taken an interest in attitudes and beliefs about laïcité and their relations to other variables, such as expressions of prejudice. Laïcité can be defined as the separation of churches and State, the role of the State being to assure an equality and a freedom of religion. The aim of this study was to construct a measure of beliefs of laïcité, and then to compensate for the lack of reliable measures about the possible interpretations of laïcité. The exploratory (study 1) and confirmatory factor analyses (study 2) led to sixteen items being included in the scale and representing four laïcité dimensions: public expression of religious beliefs, religious neutrality of the State and its institutions, equality of different religious beliefs, and protection of religious groups. Correlations across different dimensions showed that the public expression of religious beliefs was positively correlated with equality of different religious beliefs and negatively to neutrality of the State and its institutions. Moreover, convergent and discriminant validity (studies 2 and 3) showed that dimensions of laïcité are differently correlated with prejudice, SDO, religiosity, or with the republican model's adhesion. t-tests showed that compared to Catholics, agnostics and atheistics want a stronger religious neutrality of the State, are more in favor of an equalitarian treatment of different religious beliefs, but are less in favor of a protection of religion by State. Concerning the attachment to laïcité, this variable is only very weakly correlated with the four dimensions. Statistical analysis conducted on attachment to laïcité and other psychosocial variables such as prejudice, social dominance orientation (SDO), religiosity, religious beliefs (atheistics and agnostics vs. catholics) and political orientation showed that only SDO is (negatively) related to attachment to laïcité. These results suggest different conceptions of laïcité depending on psychosocial variable such as religion, prejudice or SDO. Finally, a test-retest has been effected on the scale (study 4). The results shown that the adhesion to the laïcité’s dimensions is stable in the time.     

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 grands magasins de la médecine de Milton Friedman

The coronavirus pandemic has brought back the question in Western countries of the solidity of their health systems. This article discusses Friedman's 1962 piece of work, “Capitalism and Freedom”, and more specifically his presentation based on American occupational licensure. This research insists beyond the complexity of “de-licensing laws” passed for some U.S. health care facilities, on the consequences of a parasitic competition on health care ethics.