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Bauquier C, Ginguené S, Leroy T, Doumergue M, Lebrun N, Della Vecchia C, Mabire-Yon R, Leveaux S, Sagaon-Teyssier L, Préau M. Measuring reconceptualization and reprioritization during France's first COVID-19-related lockdown in women with and without a history of cancer: an adaptation of the SeiQol-DW and PGI. Qual Life Res 2024; 33:1423-1431. [PMID: 38502415 DOI: 10.1007/s11136-024-03626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE This study aimed to provide a better understanding of the patient-perceived effects of France's first COVID-19-related lockdown on the quality of life (QoL) of women affected by cancer, and to test an ad hoc measurement scale for evaluating quasi-individualized QoL. QoL was measured for both during (i.e., current) and before (i.e., retrospectively) the lockdown. Respondents were women registered on the research platform Seintinelles. METHODS A tool for measuring quasi-individualized QoL was adapted from the SeiQol-DW and PGI. It was distributed as part of a larger online self-questionnaire to a sample of 1303 women with a history of cancer (i.e., former or current) and with no such history. RESULTS Current and retrospective QoL scores were not significantly different between the two respondent groups. An analysis of reconceptualization and reprioritization revealed a cancer-specific effect: women with a history of cancer reconceptualized more, while women with no such history reprioritized more. CONCLUSION Our novel ad hoc quasi-qualitative tool made it possible to assess the QoL of women with a history of cancer, a particularly vulnerable population in the context of the COVID-19 pandemic. Furthermore, it highlighted a difference in reconceptualization and reprioritization between this population and women with no such history.
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Affiliation(s)
- Charlotte Bauquier
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France.
| | - Stéphéline Ginguené
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France
| | - Tanguy Leroy
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France
| | - Marjolaine Doumergue
- Groupe de Recherche en Psychologie Sociale UR 4163, University Lumière Lyon 2, Lyon, France
| | - Natacha Lebrun
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France
| | - Claire Della Vecchia
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France
| | - Renaud Mabire-Yon
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France
| | - Sarah Leveaux
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France
| | - Luis Sagaon-Teyssier
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Aix Marseille University, 13005, Marseille, France
| | - Marie Préau
- Inserm U1296, Radiations: Santé, Défense, Environnement, University Lumière Lyon 2, Lyon, France
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Piton M, Della Vecchia C, Mabire R, Alain T, Salcedo Robledo M, Charpentier N, Puppo C, Petit AS, Carpentier C, Perray M, Mabire X, Michels D, Préau M. Facteurs associés à la crainte de l’infection par la COVID-19 chez des personnes vivant avec le VIH. Sante Publique 2023; 34:771-781. [PMID: 37019790 DOI: 10.3917/spub.226.0771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
INTRODUCTION People living with HIV (PLHIV) who may have experienced biographical disruptions in their life trajectory may have a vulnerability to risk that differs from the general population, particularly in the context of an infectious health crisis. This study aimed to understand the factors associated with concerns about being infected with COVID-19 among PLHIV during the first period of the health crisis. METHODS This was an online cross-sectional study using an online self-administered questionnaire in the context of the COVID-19 epidemic in France among a population of PLHIV. The recruitment was done via social networks and through various actors in the fight against HIV. The self-questionnaire was available from July 2020 to September 2020. RESULTS The ACOVIH study collected 249 responses, 202 men and 47 women, with a mean age of 46.6 ± 12.9 years. The most represented socio-professional categories were employees (n=73.29%), followed by managers, professionals and artists (n=59.24%). The PLHIV most worried about being infected by COVID-19 had a level of education lower than or equal to the baccalaureate, family difficulties related to HIV and a deterioration in the relationship of trust with the HIV medical team. CONCLUSION Feelings of anxiety can have a health and psychosocial impact on PLHIV. It is necessary to consider these negative factors by proposing adapted support and by carrying out preventive actions aiming in particular at improving the literacy of the PLHIV.
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Affiliation(s)
- Maëva Piton
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | | | - Renaud Mabire
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | - Tristan Alain
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. AIDES – Pantin – France
| | - Manuela Salcedo Robledo
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. AIDES – Pantin – France
| | - Nicolas Charpentier
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. Laboratoire de recherche communautaire Coalition – Pantin – France
| | - Costanza Puppo
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | - Anne Sophie Petit
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France. Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France
| | | | - Mathilde Perray
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | - Xavier Mabire
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France. Institut de recherches sociologiques (IRS) – Université de Genève – Genève – Suisse
| | - David Michels
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. AIDES – Pantin – France
| | - Marie Préau
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France. Laboratoire PHASE – Université de Lausanne – Lausanne – Suisse
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Della Vecchia C, Ebah JV, Tubiana S, Guimard T, Piroth L, Jaffuel S, Gorenne I, Mourvillier B, Hoen B, Duval X, Préau M. Mid-term health-related quality of life in community-acquired bacterial meningitis survivors; the COMBAT study. PLoS One 2023; 18:e0281544. [PMID: 36952472 PMCID: PMC10035867 DOI: 10.1371/journal.pone.0281544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/19/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Community Acute Bacterial Meningitis (CABM) is a rare infectious disease leading to important impairments. Our aim was to describe CABM survivors' quality of life (QOL) 12 months post-CABM and to assess its associations with CABM sequelae. METHODS Patients included in the CABM COMBAT cohort were evaluated one year after the CABM episode. Data were collected by questionnaire, via phone calls with the patients. The WHOQOL-BREF was used to measure CABM survivors' QOL. Hierarchical multivariate linear regressions were performed. RESULTS Study population was composed of 284 patients. At 12 months, 53.9% (153/284) reported at least incident headache/worsening headache intensity at 12 months post-CABM, and/or incident hearing impairment, and/or unfavourable disability outcome (GOS). Unfavourable disability outcome was associated with lower physical health QOL (B = -30.35, p<0.001), lower mental health QOL (B = -15.31, p<0.001), lower environmental QOL (B = -11.08, p<0.001) and lower social relationships QOL (B = -9.62, p<0.001). Incident headache/worsening headache since meningitis onset was associated with lower psychological health (B = -5.62, p = 0.010). Incident hearing impairment was associated with lower physical QOL (B = -5.34, p = 0.030). Hierarchical regressions showed that CABM impairments significantly increase explanatory power of multivariate models (for physical health R2 change = 0.42, p<0.001, for psychological health R2 change = 0.23, p<0.001, for social relationships R2 change = 0.06, p<0.001 and for environment domain R2 change was 0.15, p<0.001). CONCLUSIONS 12 month-CABM burden is heavy. Early detection and management of CABM impairments should be performed in clinical practice as early as possible to optimize patients' psychological and psychosocial functioning. CLINICALTRIAL. GOV IDENTIFICATION NUMBER NCT01730690.
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Affiliation(s)
| | - Josée Vicentia Ebah
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Nemesis team, Paris, France
| | - Sarah Tubiana
- IAME, INSERM, Paris University, Paris, France
- Inserm Clinical Investigation Centre 1425, Paris, France
| | - Thomas Guimard
- Infectious Diseases and Emergency Department, Centre Hospitalier de La Roche sur Yon, La Roche-sur-Yon, France
| | - Lionel Piroth
- INSERM CIC 1432, Infectious Diseases Department, CHU, University of Burgundy, Dijon, France
| | - Sylvain Jaffuel
- Department of Infectious Diseases, Brest University Hospital, Brest, France
| | - Isabelle Gorenne
- AP-HP, Department of Epidemiology, Biostatistic and Clinical Research, Inserm CIC-EC 1425, Bichat Hospital, Paris, France
| | - Bruno Mourvillier
- Medical and Infectious Diseases Intensive Care Unit, AP-HP, Bichat Hospital, Paris University, Paris, France
| | - Bruno Hoen
- CHU de Nancy, Hôpitaux de Brabois, Service de Maladies Infectieuses et Tropicales, Vandœuvre-lès-Nancy cedex, France
| | - Xavier Duval
- IAME, INSERM, Paris University, Paris, France
- Inserm Clinical Investigation Centre 1425, Paris, France
- INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Marie Préau
- INSERM, Unité U1296 « Radiations: Défense, Santé, Environnement », Lyon, France
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Della Vecchia C, Préau M, Haesebaert J, Viprey M, Rode G, Termoz A, Dima A, Schott AM. Factors associated with post-stroke social participation: A quantitative study based on the ICF framework. Ann Phys Rehabil Med 2022; 66:101686. [PMID: 35779831 DOI: 10.1016/j.rehab.2022.101686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Post-stroke social participation is a major determinant of quality of life and life satisfaction. However, few data relating to participation determinants are available, especially the influence of psychological factors and factors related to the living environment. OBJECTIVES This study investigated determinants of post-stroke social participation within the International Classification of Functioning, Disability and Health framework. METHODS We contacted people with stroke who had been hospitalized in the Rhône County, included in a previous cohort study, were aged ≥18 years and were not institutionalized. The primary outcome was social participation measured with the Stroke Impact Scale (SIS) 2.0. We performed multiple hierarchical linear regressions to test the following predictors: clinical factors (stroke-related variables, limitations in Activities of Daily Living [ADL]/Instrumental ADL), personal factors (sociodemographic factors, coping strategies) and environmental factors (satisfaction with social relationships and living environment). RESULTS Among the 352 participants, 63% were men, and mean age was 68.7(SD 14.5) years. In the last multivariate model, variables associated with higher levels of social participation were the use of the positive thinking coping strategy (B (SD)=1.17(0.52), p = 0.03), higher perceived satisfaction with the living environment (B (SD)=0.17(0.07), p = 0.03) and fewer perceived activity limitations (B (SD)=0.55 (0.06), p < 0.001). Conversely, the seeking social support coping style (B (SD)= -1.98 (0.60), p = 0.001), and a higher number of stroke-related sequelae (B (SD)= -1.93(0.53), p = 0.001) were associated with lower social participation. CONCLUSIONS The identification of potentially modifiable personal and environmental factors that influence social participation provides elements to strengthen existing rehabilitation programs and opens the way for possible psychosocial interventions.
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Affiliation(s)
- Claire Della Vecchia
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France.
| | - Marie Préau
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Julie Haesebaert
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
| | - Marie Viprey
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
| | - Gilles Rode
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon (CRNL), Equipe ImpAct, Bron, France; Service de Médecine Physique et Réadaptation, Hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Anne Termoz
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
| | - Alexandra Dima
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Anne-Marie Schott
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
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Della Vecchia C, Girodet M, Ginguené S, Carpentier C, Leroy T, Siméone A, Vayre E, Mabire X, Ferraz D, Morin-Messabel C, Préau M. At the heart of the COVID-19 crisis: Perceived concerns of changes in long-term cancer care in French women with cancer. Eur J Cancer Care (Engl) 2022; 31:e13599. [PMID: 35523418 PMCID: PMC9349365 DOI: 10.1111/ecc.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 12/15/2022]
Abstract
Objective In the COVID‐19 crisis context, the main objective of the study is to investigate factors associated with perceived concerns of change in long‐term cancer care in patients currently under treatment. Methods A French population‐based cross‐sectional study was performed using an online questionnaire in April 2020. All persons currently receiving cancer treatment and belonging to the Seintinelles Association (https://www.seintinelles.com) were included in this present analysis. Individual sociodemographic characteristics, medical status and information regarding cancer care were collected. Multivariate binomial logistic regression analysis was performed. Results We included 298 women in the analysis. Younger participants (OR = 0.96 [0.94–0.99]), the need to visit healthcare facilities to receive treatment (OR = 2.93 [1.16–8.52]), deterioration in the quality of communication with the medical team since the beginning of the COVID‐19 crisis (OR = 3.24 [1.61–7.02]) and being cared for by a university hospital or a public hospital (OR = 2.19 [1.16–4.23] versus comprehensive cancer centre) were associated with a perceived fear of change in long‐term cancer care. Conclusion To address patients' concerns regarding changes in their long‐term cancer care, medical teams should consider the patients' own perceptions of the situation and provide clear, appropriate, precise information on cancer care, especially in the centres mostly affected by the COVID‐19 crisis.
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Affiliation(s)
- Claire Della Vecchia
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Magali Girodet
- Human and Social Sciences Department/Medical Evaluation and Sarcomas Team, Comprehensive Cancer Care Centre Léon Bérard, Lyon, France.,Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphéline Ginguené
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Camille Carpentier
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Tanguy Leroy
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Arnaud Siméone
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Emilie Vayre
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Xavier Mabire
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Dulce Ferraz
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France.,PHASE (Psychology of Health, Aging and Sport Examination), University of Lausanne Faculty of Social and Political Science, Lausanne, Switzerland
| | - Christine Morin-Messabel
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Marie Préau
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
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Della Vecchia C, Leroy T, Bauquier C, Pannard M, Sarradon-Eck A, Darmon D, Dufour JC, Preau M. Willingness of French General Practitioners to Prescribe mHealth Apps and Devices: Quantitative Study. JMIR Mhealth Uhealth 2022; 10:e28372. [PMID: 35147508 PMCID: PMC9491832 DOI: 10.2196/28372] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/25/2021] [Accepted: 08/27/2021] [Indexed: 12/21/2022] Open
Abstract
Background The field of mobile health (mHealth) is constantly expanding. Integrating mHealth apps and devices in clinical practice is a major and complex challenge. General practitioners (GPs) are an essential link in a patient’s care pathway. As they are patients’ preferred health care intermediaries, GPs play an important role in supporting patients’ transition to mHealth. Objective This study aims to identify the factors associated with the willingness of French GPs to prescribe mHealth apps and devices to their patients. Methods This study was part of the ApiAppS project whose overall objective was to help remove barriers GPs face when prescribing mHealth apps and devices by developing a custom-built platform to aid them. The study included GPs recruited from the general practice department of several medical faculties in France (Lyon, Nice, and Rouen) and mailing lists of academic GPs, health care professional associations, and social and professional networks. Participants were asked to complete a web-based questionnaire that collected data on various sociodemographic variables, indicators of their involvement in continued education programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, and indicators characterizing their patient population. Data on their perceptions of mHealth apps and devices were also collected. Finally, the questionnaire included items to measure GPs’ acceptability of prescribing mHealth apps and devices for several health-related dimensions. Results Of the 174 GPs, 129 (74.1%) declared their willingness to prescribe mHealth apps and devices to their patients. In multivariate analysis, involvement in continued education programs (odds ratio [OR] 6.17, 95% CI 1.52-28.72), a better patient base command of the French language (OR 1.45, 95% CI 1.13-1.88), GP-perceived benefits of mHealth apps and devices for both patients and their medical practice and GP-perceived drivers for mHealth apps and device implementation in their medical practice (OR 1.04, 95% CI 1.01-1.07), and validation of mHealth apps and devices through randomized clinical trials (OR 1.02, 95% CI 1.00-1.04) were all associated with GPs’ willingness to prescribe mHealth apps and devices. In contrast, older GPs (OR 0.95, 95% CI 0.91-0.98), female GPs (OR 0.26, 95% CI 0.09-0.69), and those who perceived risks for the patient or their medical practice (OR 0.96, 95% CI 0.94-0.99) were less inclined to prescribe mHealth apps and devices. Conclusions mHealth apps and devices were generally seen by GPs as useful in general medicine and were, for the most part, favorable to prescribing them. Their full integration in general medicine will be conditioned by the need for conclusive certification, transparency (reliable and precise data concerning mHealth app and device methods of construction and clinical validation), software aids to assist GPs prescribe them, and dedicated training programs.
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Affiliation(s)
- Claire Della Vecchia
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Tanguy Leroy
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Charlotte Bauquier
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Myriam Pannard
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
| | - Aline Sarradon-Eck
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut de Recherche pour le Développement, Aix-Marseille Université, Marseille, France.,Institut Paoli-Calmettes, CanBios, Marseille, France
| | - David Darmon
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut de Recherche pour le Développement, Aix-Marseille Université, Marseille, France.,Département d'Enseignement et de Recherche en Médecine Générale, Université Côte d'Azur, Nice, France
| | - Jean-Charles Dufour
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Institut de Recherche pour le Développement, Aix-Marseille Université, Marseille, France.,Service Biostatistique et Technologies de l'Information et de la Communication, Assistance Publique Hôpitaux de Marseille, Hôpital de la Timone, Marseille, France
| | - Marie Preau
- Institut de Psychologie, Université Lyon 2, Bron, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1296, "Radiations: Defense, Health and Environment" Centre Léon-Bérard, Lyon, France
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Chammem R, Domi S, Della Vecchia C, Gilbert T, Schott AM. Experience and Perceptions of Changes in the Living Environment by Older People Losing Their Autonomy: A Qualitative Study in the Caribbean. Risk Manag Healthc Policy 2021; 14:743-756. [PMID: 33654442 PMCID: PMC7910078 DOI: 10.2147/rmhp.s287382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/23/2020] [Indexed: 11/23/2022] Open
Abstract
Rationale Although the literature recognizes the importance of older individuals’ subjective perceptions about their living environments, past studies on the subject have been primarily restricted to nursing home settings. Objective This study aimed to better understand the experiences, perceptions, coping mechanisms, and needs of older people living in Martinique who had to modify their living environment because of a decline of autonomy. Design Qualitative study using content analysis. Methods Semi-structured one-on-one interviews were conducted with older people living in three different types of environment i) at home with professional support, ii) in a foster care family, iii) in a nursing home. Interviews were conducted until data saturation was reached. A conventional content analysis approach was used. Results Thirty-four participants were interviewed. Subjects perceived ageing as a factor leading to changes in their living environment. However, they did not spontaneously evoke their functional/structural impairments nor their activity limitations as if the change of living environment could reduce the perceived loss of autonomy by maintaining an acceptable participation. Participants mostly experienced change as both inevitable and as a relief as it took them out of isolation and domestic hardship. This reaction was somewhat facilitated by spiritual beliefs as the changes were interpreted as the will of spiritual forces. Family and social relationships appeared to be more important determinants of participants’ perception of changes in living environment than was health status. We found differences between the three groups regarding familial relationship, fear of death, acceptance of change, and unmet needs. Unmet needs were particularly expressed by those living in foster care. The concept of “feeling at home”, which emerged as essential for all participants, was lacking in foster care families. Conclusion Perceived autonomy, including not only functional/structural impairments, but also, social interactions, should be carefully considered when developing support services for older individuals.
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Affiliation(s)
- Rita Chammem
- University of Claude Bernard Lyon 1, HESPER Laboratory, Lyon, EA 7425, France.,CRIFONDO, Caribbean Renaissance Initiative, Département de Gérontologie, Martinique, France
| | - Serge Domi
- CRIFONDO, Caribbean Renaissance Initiative, Département de Gérontologie, Martinique, France
| | | | - Thomas Gilbert
- University of Claude Bernard Lyon 1, HESPER Laboratory, Lyon, EA 7425, France.,Hospices Civils De Lyon, Pôle De Santé Publique, Public Health, Lyon, France
| | - Anne-Marie Schott
- University of Claude Bernard Lyon 1, HESPER Laboratory, Lyon, EA 7425, France.,Hospices Civils De Lyon, Pôle De Santé Publique, Public Health, Lyon, France
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Viprey M, Gouillet M, Puppo C, Termoz A, Della Vecchia C, Derex L, Haesebaert J, Schott AM, Préau M. A Qualitative Study of Barriers and Facilitators to Adherence to Secondary Prevention Medications Among French Patients Suffering from Stroke and Transient Ischemic Attack. Patient Prefer Adherence 2020; 14:1213-1223. [PMID: 32801652 PMCID: PMC7382755 DOI: 10.2147/ppa.s257323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/23/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Secondary prevention medications (SPM) reduce the risk of ischemic stroke (IS) and transient ischemic attack (TIA) recurrence. However, approximately one-third of patients are estimated to be non-adherent. This qualitative study aimed to explore barriers and facilitators to adherence to SPM after IS or TIA. PATIENTS AND METHODS Thirty-six face-to-face semi-structured interviews were conducted with 14 TIA patients and 22 IS patients who self-administered their treatment 12 months after IS/TIA. A thematic analysis was performed. RESULTS Major facilitators to good adherence to SPM were the fear of stroke recurrence and the high level of trust in the prescribing physician. Barriers included a perceived lack and/or inappropriate timing of information about SPM, practical difficulties of taking some SPM (eg, inadequate packaging) and of implementing routines into their daily life. CONCLUSION Information on SPM is inadequate in terms of quantity and timing both during the acute IS/TIA period and over the long term. Providing more tailor-made information at an opportune moment, in particular by promoting discussion with their general practitioner (GP) throughout the course of illness and recovery, is essential to ensure that patients are not left alone in the decision-making process regarding adherence to SPM.
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Affiliation(s)
- Marie Viprey
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER EA 7425, University of Lyon, University Claude Bernard Lyon 1, Lyon, France
| | | | | | - Anne Termoz
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER EA 7425, University of Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - Claire Della Vecchia
- HESPER EA 7425, University of Lyon, University Claude Bernard Lyon 1, Lyon, France
- GRePS, Lyon 2 University, Lyon, France
| | - Laurent Derex
- HESPER EA 7425, University of Lyon, University Claude Bernard Lyon 1, Lyon, France
- Comprehensive Stroke Center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Bron, France
| | - Julie Haesebaert
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER EA 7425, University of Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - Anne-Marie Schott
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER EA 7425, University of Lyon, University Claude Bernard Lyon 1, Lyon, France
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Xue Y, Haesebaert J, Derex L, Viprey M, Termoz A, Della Vecchia C, Tassa O, Kerd H, Cakmak S, Meyran S, Ducreux B, Pidoux C, Du Besset M, Bony T, Gueugniaud PY, Douplat M, Potinet V, Jacob X, Sigal A, Tazarourte K, Lablanche C, Melaine R, Nighoghossian N, Schott AM. Choice of Initial Brain Imaging in Patients with Suspected Acute Stroke: STROKE69, a Population-Based Study. Cerebrovasc Dis 2020; 49:110-118. [PMID: 32097908 DOI: 10.1159/000505960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/16/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In patients with suspected stroke, brain imaging is recommended in the acute phase for appropriate management and treatment. Both computed tomography (CT) and magnetic resonance imaging (MRI) are considered reasonable choices for initial brain imaging. When both techniques are available, choosing one or the other might be associated with specific factors related either to patients, stroke symptoms, and severity or management organization. METHODS The study was performed within the STROKE 69 database, a population-based cohort of all adult patients with suspected stroke admitted in one of the emergency departments (ED), primary stroke center, or stroke center of the Rhône County, from November 2015 to December 2016. Patients were included if they were admitted within 24 h following either symptom onset or last known normal. To identify factors potentially associated with the choice of initial brain imaging, a multivariate logistic regression was performed. RESULTS Among the 3,244 patients with suspected stroke enrolled in the STROKE69 cohort, 3,107 (95.8%) underwent brain imaging within the first 24 h after admission. Among those 74.6% underwent CT as initial imaging while 25.4% had an MRI. In multivariate analyses, several factors were associated with a lower probability of having an MRI as initial brain imaging versus CT. These were either patient characteristics: older age (>80 years old, OR 0.39 [95% CI 0.28-0.54]), preexisting disability (OR 0.55 [95% CI 0.36-0.84]), use of anticoagulants (OR 0.52 [95% CI 0.33-0.81]), stroke characteristics: stroke of unknown onset (OR 0.42 [95% CI 0.31-0.58]) or factors associated with overall management: onset-to-door time (>6 h, OR 0.38 [95% CI 0.23-0.60]), initial admission to ED (OR 0.02 [95% CI 0.02-0.04]) or intensive care unit (OR 0.01 [95% CI 0.001-0.08]), personal transport (OR 0.66 [95% CI 0.45-0.96]), and admission during working hours (OR 0.65 [95% CI 0.51-0.84]). CONCLUSIONS Besides CT or MRI availability, a number of other parameters could influence the choice of first imaging in case of stroke suspicion. These are related to patient characteristics, type of stroke symptoms, and type of organization.
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Affiliation(s)
- Yufeng Xue
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France.,Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Julie Haesebaert
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France.,Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Laurent Derex
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France.,Hospices Civils de Lyon, Comprehensive Stroke Center, Hôpital Pierre Wertheimer, Bron, France
| | - Marie Viprey
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France.,Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Anne Termoz
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France.,Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Claire Della Vecchia
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France
| | - Ouazna Tassa
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Hela Kerd
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Serkan Cakmak
- Hôpital Nord Ouest, Primary Stroke Center, Villefranche-sur-Saône, France
| | - Sylvie Meyran
- Department of Emergency, Hôpital St Joseph St Luc, Lyon, France
| | - Bruno Ducreux
- Department of Emergency, Hôpital Nord Ouest, Villefranche-sur-Saône, France
| | - Christelle Pidoux
- Department of Emergency, Hôpital Nord Ouest, Villefranche-sur-Saône, France
| | - Marc Du Besset
- Department of Emergency, Hôpital Nord Ouest, Villefranche-sur-Saône, France
| | - Thomas Bony
- Department of Emergency, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France
| | | | - Marion Douplat
- Department of Emergency, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Veronique Potinet
- Department of Emergency, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Xavier Jacob
- Department of Emergency, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Alain Sigal
- Department of Emergency, Hospices Civils de Lyon, Hôpital Croix Rousse, Lyon, France
| | - Karim Tazarourte
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France.,Department of Emergency, Hospices Civils de Lyon, HEH, Lyon, France
| | | | - Regis Melaine
- Department of Emergency, Hôpital Desgenettes, Lyon, France
| | - Norbert Nighoghossian
- Hospices Civils de Lyon, Comprehensive Stroke Center, Hôpital Pierre Wertheimer, Bron, France
| | - Anne-Marie Schott
- Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, Lyon, France, .,Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France,
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Della Vecchia C, Viprey M, Haesebaert J, Termoz A, Giroudon C, Dima A, Rode G, Préau M, Schott AM. Contextual determinants of participation after stroke: a systematic review of quantitative and qualitative studies. Disabil Rehabil 2019; 43:1786-1798. [PMID: 31646906 DOI: 10.1080/09638288.2019.1679897] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE From a patient's perspective, participation is a major determinant of quality of life. We aimed to review contextual factors, both personal and environmental, potentially associated with post-stroke participation. METHODS PubMed, PsycINFO, and Web of Science were searched for original quantitative and qualitative studies that investigated contextual factors of post-stroke participation, measured participation as the primary outcome, and met inclusion criteria. RESULTS Socio-demographic determinants were mostly unrelated with participation or showed discordant and inconclusive results. Although less investigated, psychosocial/psychological factors, particularly self-esteem and acceptance, were associated with participation in most studies. Motivation was found in qualitative studies, but discordant in quantitative ones. Environmental factors were even less investigated and mainly in qualitative studies among patients with communication disabilities. Among these, social support and attitude of others appeared to be major determinants of participation as well as physical environment and societal environment (services and polices). CONCLUSIONS Personal factors, particularly psychological and psychosocial factors, were identified as positively associated with post-stroke participation. Environmental factors such as support, relationships, and positive attitudes towards patients were major facilitators of participation as well as physical environment and accessibility to appropriate services. Most of these factors are modifiable and should be addressed to improve patient participation.Implications for RehabilitationPsychosocial factors (motivational aspects, acceptance of a new condition, self-esteem) and environmental factors (social support, attitudes towards the patient, physical environment, access to health, social services and policies) were identified as determinants of post-stroke participation.A structured evaluation of determinants of participation may be used in clinical practice to propose appropriate support and then improve patients' recoveryPrograms to improve patients' psychosocial skills such as self-esteem, acceptance, motivation should be tested and implemented, and policies to develop appropriate services accessibility should be encouraged.
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Affiliation(s)
- Claire Della Vecchia
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Social Psychology Research Group (EA 4163 GRePS), Lyon 2 University, Bron, France
| | - Marie Viprey
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Julie Haesebaert
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Anne Termoz
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Caroline Giroudon
- Central Documentation Department, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Dima
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Gilles Rode
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon (CRNL), Equipe ImpAct, Bron, France.,Service de Médecine Physique et Réadaptation, Hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Marie Préau
- Social Psychology Research Group (EA 4163 GRePS), Lyon 2 University, Bron, France.,INSERM UMR 912 SESSTIM, Aix-Marseille Université, Marseille, France
| | - Anne-Marie Schott
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
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