1
|
Pot E, Guenezan L, Pelen F, Facon G. [Evaluation of an experiment in ophthalmology telemedicine]. J Fr Ophtalmol 2024; 47:103986. [PMID: 38123443 DOI: 10.1016/j.jfo.2023.05.030] [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] [Received: 03/13/2023] [Revised: 05/02/2023] [Accepted: 05/22/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To meet the need for access to eye care in an area with a lack of physicians, a telemedicine workstation in ophthalmology was created. The main objective was to measure the improved access to eye care via telemedicine consultation. METHODS No criteria of age, sex or geographical location were defined. Depending on the cause for the consultation and the results of the examinations conducted by an ophthalmic technician physically present in the center, the patient might be given a telemedicine consultation with an ophthalmologist. Eleven indicators were defined to achieve the study objectives. Data were compared with a reference eye care center. RESULTS The quality, safety of care, and medical benefits of telemedicine consultation were not inferior to those of the reference center. The consultations screened 25 cases of age-related macular degeneration, 240 glaucoma, 229 cataracts and 27 diabetic retinopathy. 88.5% of patients were included in a cooperative ophthalmologist/technician protocol, compared with 27.3% in the reference center (P<0.0001). DISCUSSION The telemedicine workstation must be linked to a main center located at most a one-hour drive away. The equipment must be adapted to the use of telemedicine and to allow the technician to perform the necessary assessments and examinations. The number of emergency department visits after telemedicine consultation at the telemedicine workstation was higher than the reference center, which may lead to a subsequent study. CONCLUSION Telemedicine consultation improves access to eye care in a medically under-served area.
Collapse
Affiliation(s)
- E Pot
- Section santé publique, Epcare, 49, rue Molière, 92120 Montrouge, France
| | - L Guenezan
- Section santé publique, Epcare, 49, rue Molière, 92120 Montrouge, France.
| | - F Pelen
- Groupe Point Vision, 15, rue Pasquier, 75008 Paris, France
| | - G Facon
- Groupe Point Vision, 15, rue Pasquier, 75008 Paris, France
| |
Collapse
|
2
|
Willig TN, Dajon M, Assathiany R, Brun L, Fourneret P, Massé M, Monge A, Piollet A, Thiollier MC, Cortese S, Purper Ouakil D. Healthcare pathways and practitioners' knowledge about ADHD in children. Encephale 2023:S0013-7006(23)00144-6. [PMID: 37718197 DOI: 10.1016/j.encep.2023.07.005] [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] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/18/2023] [Accepted: 07/04/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Access to care for children and adolescents affected by ADHD in France remains below the levels attained in most industrialised countries. To contribute to improving ADHD care in France, we assessed existing ADHD knowledge among medical doctors (MDs) and described associated care pathways in two large French regions in 2021. We produced tools to evaluate the regional impact of implementing a stepped-care pathway for ADHD. METHODS A SurveyMonkey® study was sent to professionals from two regions in France accounting for 14 million inhabitants, allowing them to describe their role in child/adolescent ADHD, as well as their representations and knowledge about the disorder. RESULTS Around 9.4% of all MDs potentially involved with children took part in the study; 34.9% considered themselves untrained, 40.5% were involved in ADHD care at a first-tier level, and 19.6% at a second-tier level. Access to a second or third-tier service for ADHD was associated with mean waiting times of 5.7 and 8.5 months, respectively. Initiation of stimulant therapy remained mainly restricted to second or third-tier MDs, and adaptation of dosage or change in the galenic formulation was rarely performed by first-tier MDs (27.2% and 18%, respectively). Training in neurodevelopmental disorders and tier-level were the strongest determinants of knowledge, attitudes and self-assessed expertise about ADHD. CONCLUSIONS This study provides insight into training needs for MDs regarding healthcare pathways in ADHD and should support the implementation of health policies, such as a stepped healthcare access for ADHD. The study design and dissemination have been validated and will be available in France and other countries facing similar obstacles in care pathways for ADHD. Official recommendations on ADHD in children and adults are being updated in France, and our data and the survey design will be a starting point for their implementation.
Collapse
Affiliation(s)
- Thiébaut-Noël Willig
- Occitadys, 24, impasse de la Flambère, 31300 Toulouse, France; Consultation de pédiatrie, clinique Ambroise Paré, ELSAN, and Eventail31, Toulouse, France; Association française de pédiatrie ambulatoire (AFPA), zone de la Fouquetière, 155, rue Edouard-Branly, 44150 Ancenis Saint-Géron, France.
| | - Marie Dajon
- PhD in Psychology, Research engineer, GIS BECO, University of Toulouse, France
| | - Rémy Assathiany
- Association française de pédiatrie ambulatoire (AFPA), zone de la Fouquetière, 155, rue Edouard-Branly, 44150 Ancenis Saint-Géron, France
| | - Louise Brun
- General medicine resident of the University of Montpellier, France
| | - Pierre Fourneret
- Child psychiatrist, professor at the University of Lyon. Deputy Head of the Child and Adolescent Developmental Psychopathology Department, Marc Jeannerod Institute of Cognitive Sciences UMR 5229 CNRS, 59 Bd Pinel, 69677 Bron, France
| | - Magali Massé
- Head of "Réseau Dys42", and of "SESSAD Dys", "APF France handicap", Saint Étienne, France
| | - Anne Monge
- Head of "CMPP" and "PCO-OVE", Givors, France
| | - Anne Piollet
- Association française de pédiatrie ambulatoire (AFPA), zone de la Fouquetière, 155, rue Edouard-Branly, 44150 Ancenis Saint-Géron, France; PCO PICOPAP 63", Chamalières, CHEM and AFPA
| | - Marie Claire Thiollier
- Head and co-founder of the health network DYS/10, and the Dispositif TSA, coordinator of the PCO, Lyon, France
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Diane Purper Ouakil
- CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Unit of Child and Adolescent Psychiatry (MPEA1), INSERM U 1018, CESP University Paris Saclay, Team Psychiatry, Development and Trajectories, 80, avenue Augustin-Fliche, 34000 Montpellier, France
| |
Collapse
|
3
|
Pougnet R, Lucas D, Pougnet L, Chapalain D, Fortin C, Loddé B, Dewitte JD, Eniafe-Eveillard MB, Le Denmat V. [Smoking, vaping among hospital staff during the Covid-19 pandemic: Appraisal of the "tobacco-free hospital, campus" campaign in Brest]. Rev Mal Respir 2022; 39:413-419. [PMID: 35597726 PMCID: PMC8847087 DOI: 10.1016/j.rmr.2022.01.020] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/19/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In the framework of a "tobacco-free hospital and campus" campaign, we conducted a study on the prevalence of smoking and vaping among a university hospital (CHRU) staff. The study took place in late 2020 (from 1 September to 15 December), and involved self-assessment of the impact of the covid-19 pandemic on smoking. MATERIAL AND METHOD A cross-sectional study was carried out using an online questionnaire, which was distributed by email and QR code posting and included socio-professional details as well as data on participants' smoking and vaping. RESULTS There were 782 responses, representing a participation rate of 13.5%. The sample included 73.3% women and 22.7% men; 28.9% nurses, 24.9% medical staff, 3.6% nursing assistants and 42.6% other professional categories. The overall smoking rate was 13%. Sixty-two (7.9%) participants vaped; 37 (5%) vaped exclusively, 25 (3.2%) combined smoking and vaping. Men smoked more than women: 23.7% vs. 9.4% (P < 0.01). Medical staff smoked and vaped less than other categories; 6.2% vs 14.8% (P < 0.01) and 4.1% vs 9.1% respectively (P=0.02). Doctors were more often non-smokers: OR=2.71 (95% CI: 1.14-6.46). Among smokers, 25% said they had increased their cigarette consumption during the covid-19 pandemic, frequently as a means of combating stress or fatigue. CONCLUSION This study showed a lower smoking rate than in the literature, possibly due to the high participation of physicians. Ours were the initial estimates of vaping among hospital staff.
Collapse
Affiliation(s)
- R Pougnet
- Service de santé au travail du personnel hospitalier, CHRU Morvan, 2, avenue Foch, 29200 Brest, France; Laboratoires d'études et de recherches en sociologie (LABERS), EA 3149, université de Bretagne Occidentale, Brest, France.
| | - D Lucas
- Service de santé au travail du personnel hospitalier, CHRU Morvan, 2, avenue Foch, 29200 Brest, France; Optimisation des régulations physiologiques (ORPHY), EA 4324, université de Bretagne Occidentale, Brest, France
| | - L Pougnet
- Laboratoire médicale, hôpital d'instruction des Armées, Clermont-Tonnerre, Brest, France
| | - D Chapalain
- Consultation hospitalière de tabacologie, CHRU Morvan, Brest, France
| | - C Fortin
- Consultation hospitalière de tabacologie, CHRU Morvan, Brest, France
| | - B Loddé
- Service de santé au travail du personnel hospitalier, CHRU Morvan, 2, avenue Foch, 29200 Brest, France; Optimisation des régulations physiologiques (ORPHY), EA 4324, université de Bretagne Occidentale, Brest, France; Consultation hospitalière de tabacologie, CHRU Morvan, Brest, France
| | - J D Dewitte
- Service de santé au travail du personnel hospitalier, CHRU Morvan, 2, avenue Foch, 29200 Brest, France; Laboratoires d'études et de recherches en sociologie (LABERS), EA 3149, université de Bretagne Occidentale, Brest, France; Consultation hospitalière de tabacologie, CHRU Morvan, Brest, France
| | - M B Eniafe-Eveillard
- Service de santé au travail du personnel hospitalier, CHRU Morvan, 2, avenue Foch, 29200 Brest, France
| | - V Le Denmat
- Consultation hospitalière de tabacologie, CHRU Morvan, Brest, France
| |
Collapse
|
4
|
Lucas G, Colson S, Boyer L, Inthavong K, Haller PH, Lancon C, Auquier P, Gentile S, Fond G. Risk factors for burnout and depression in healthcare workers: The national AMADEUS study protocol. Encephale 2021:S0013-7006(21)00159-7. [PMID: 34666893 DOI: 10.1016/j.encep.2021.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/23/2021] [Accepted: 06/04/2021] [Indexed: 11/21/2022]
Abstract
CONTEXT Burnout is an international phenomenon defined as a state of professional exhaustion. It can lead to depression and have major economic and organizational impacts. Previous studies of healthcare professionals in France have focused on physicians, but none to date have explored other healthcare professions. OBJECTIVES The main objective of our study is to determine the prevalence of burnout among healthcare workers. The secondary objectives are to explore the associations of burnout with professional and psycho-social factors and the risk of depression, professional harassment, sexual harassment, sexual-orientation based discrimination, consumption of antidepressants, anxiolytics and also the lifestyle of the individual: smoking, alcohol consumption, coffee consumption, physical activity and sleep quality. MATERIALS AND METHODS The survey will take the form of a voluntary and anonymous online questionnaire carried out on the FramaForm1® platform and will be disseminated via social networks, professional networks and mailings. STUDY POPULATION Senior doctors, interns, directors of care, nurses, head nurses and senior head nurses, physiotherapists and occupational therapists, dieticians, radiology technicians, laboratory technicians, psychologists, nurses' aides, auxiliary nurses and midwives will be included. COLLECTED DATA Burnout will be measured with the Maslach Inventory burnout (MBI) questionnaire, work environment with the Karasek questionnaire and anxiety, depression risk with the Center for Epidemiologic Studies- Depression (CES-D), physical activity with the Global Physical Activity Questionnaire (GPAQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). ETHICS This protocol has been accepted by the ethical committee (IRB n°C08/21.01.06.93911, CNIL). EXPECTED RESULTS Based on international studies, we expect a high rate of burnout with disparities according to profession, socio-demographic data, seniority and type of service. We also expect a significant rate of untreated depression. This study will provide evidence for policy makers to implement collective strategies to reduce burnout and depression in the different populations studied.
Collapse
|
5
|
Bemba ELP, Ouedraogo AR, Ngouoni GC, Bopaka RG, Koumeka PP, Ossale Abacka KB, Mboussa J. [Overview of the knowledge and attitudes of physicians in Brazzaville on obstructive sleep apnea syndrome]. Rev Pneumol Clin 2018; 74:1-8. [PMID: 29329966 DOI: 10.1016/j.pneumo.2017.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 11/07/2017] [Accepted: 12/17/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is the leading sleep-related breathing disorder. Its complications and its repercussions on the quality of life of patients make the OSAS a real public health problem. The objective of this study is to both asses physicians knowledge of OSAS and describe their attitudes towards suspect subjects in Brazzaville. MATERIAL AND METHOD This was a cross-sectional study of 230 doctors practicing in various hospitals in the city of Brazzaville. The data collection was done by a self-questionnaire developed after a bibliographic analysis on the OSAS. The questionnaire was completed without recourse to a source of information. RESULTS Our sample consisted of 141 (70.50%) general practitioners and 59 (29.50%) specialist physicians. The average of the knowledge score was 9.34 points±3.03 points. The general level of physician knowledge about SAS was good in 2% of cases, average in 44% of cases and low in 54% of cases. The level of knowledge was related to the number of times the OSAS diagnosis was mentioned by the physician in his practice (P<0.001), to the doctor's grade (P=0.003); to his university of origin and to the quantity of sources of information. When faced with suspects OSAS subjects, the doctor, the doctor directed the patient in 62% of the cases in ENT and in 49% in the pulmonology. CONCLUSION The knowledge of the doctors on the OSAS are weak; this results in poor management of this pathology in the Congo.
Collapse
Affiliation(s)
- E L P Bemba
- Service de pneumologie, CHU de Brazzaville, B.P. 32, Brazzaville, Congo; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo.
| | - A R Ouedraogo
- Service de pneumologie, CHU Yalgado-Ouédraogo, Ouagadougou, Burkina Faso
| | - G C Ngouoni
- Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo; Service d'ORL, CHU de Brazzaville, B.P. 32, Brazzaville, Congo
| | - R G Bopaka
- Service de pneumologie, CHU de Brazzaville, B.P. 32, Brazzaville, Congo
| | - P P Koumeka
- Service de pneumologie, CHU de Brazzaville, B.P. 32, Brazzaville, Congo
| | - K B Ossale Abacka
- Service de pneumologie, CHU de Brazzaville, B.P. 32, Brazzaville, Congo
| | - J Mboussa
- Service de pneumologie, CHU de Brazzaville, B.P. 32, Brazzaville, Congo; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo
| |
Collapse
|
6
|
Vié le Sage F, Gaudelus J, Lert F, Dufour V, Texier N, Pouriel M, Schück S, Tehard B, Bréart G. Public health impact of Infanrix hexa™ (DTPa-HBV-IPV/Hib) reimbursement: A study programme in France. Part 2: Evolution of the acceptability of infants' vaccination against hepatitis B in general and pediatric practices - the PRALINE study. Rev Epidemiol Sante Publique 2016; 64:185-94. [PMID: 27238163 DOI: 10.1016/j.respe.2015.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 11/30/2015] [Accepted: 04/13/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The reimbursement of the hexavalent vaccine (Infanrix hexa™), comprising the DTPa-IPV-Hib components and the hepatitis B recombinant in a single vaccine, was approved in France in March of 2008. The impact of its reimbursement on physicians' decisions to vaccinate infants against hepatitis B was assessed in a study conducted with general practitioners and pediatricians. METHODS The PRALINE study (NCT01777074) was a national, cross-sectional, repeated study with two measurement periods (T1 and T2) that measured the changes in physicians' acceptance of hepatitis B vaccination of infants before and for the 3 years after the approval of the hexavalent vaccine reimbursement. Two patient registers were created for each measurement period to enroll the first 15 12- to 15-month-old infants and the first 15 24- to 27-month-old children seen by the practitioners. The proportion of eligible children receiving a hepatitis B vaccine for each physician's practice was calculated. Practitioners also answered a vaccination practice questionnaire via telephone interviews. RESULTS Across the two study periods, 418 general practitioners and 463 pediatricians were recruited and responded to the telephone interview on their vaccination practices. The overall number of children included in the study in both study periods reached almost 20,000. In the general practitioners group, there was a significant increase in the proportion of physicians "practicing hepatitis B vaccination" (i.e., at least 50% of eligible children receiving the initial hepatitis B vaccination) in children 24-27 months old (79% T2 versus 47% T1, P-value [P]<0.001). Similarly, the proportion of pediatricians initiating hepatitis B vaccination increased from 51% (T1) to 94% (T2) (P<0.0001). General practitioners offered hepatitis B vaccination to infants more systematically in the second study period (87% T2 versus 73% T1, P<0.001) and also suggested the use of the hexavalent vaccine to more patients after reimbursement (92% T2 versus 78% T1, P<0.0001). The proportion of pediatricians offering vaccination to every infant was high at T1 (94%) and remained steady (97%) with a high use of the hexavalent vaccine (94% T1 and 96% T2). CONCLUSION The PRALINE study shows a significant and immediate change in the hepatitis B vaccination practices of general practitioners and pediatricians following hexavalent vaccine reimbursement with a significant increase in hepatitis B vaccine coverage in infants.
Collapse
|
7
|
Marchand C, Salhi L, Le Rhun A, Ravilly S, Danner-Boucher I, Gagnayre R, David V. [Perceptions of cystic fibrosis patients, patient relatives and physicians: barriers or motivations to lung transplantation]. Rev Mal Respir 2014; 31:237-47. [PMID: 24680115 DOI: 10.1016/j.rmr.2013.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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] [Received: 02/26/2013] [Accepted: 06/11/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aims of this study are to describe qualitatively the perceptions of three groups involved in the cystic fibrosis transplant decision, looking for similarities and differences between groups, and to identify those that act as motivations or barriers to transplantation. METHODS Thirty patients, 26 patient relatives and 27 physicians were interviewed, and concept maps were constructed from those interviews. Their degree of transplant acceptance at the time of the interview was measured. RESULTS There were motivations and barriers in the pre-, peri- and post-transplant period. Analysis revealed similar perceptions regarding the risks and benefits of transplantation, but also different perceptions in the specific concerns of each group. Patients and patient relatives expressed many questions and fears in their concept maps, and physicians expressed difficulties. CONCLUSIONS This study highlights the value of better understanding the perceptions of patients, relatives and physicians, in order to remove some of the barriers to transplantation. It also demonstrates the benefits of education and support activities for patients and patient relatives prior to transplantation, and continuing education and supervision for physicians.
Collapse
Affiliation(s)
- C Marchand
- EA-3412, laboratoire de pédagogie de la santé, université Paris-13, Sorbonne Paris-Cité, 74, rue Marcel-Cachin, 93019 Bobigny cedex, France.
| | - L Salhi
- EA-3412, laboratoire de pédagogie de la santé, université Paris-13, Sorbonne Paris-Cité, 74, rue Marcel-Cachin, 93019 Bobigny cedex, France
| | - A Le Rhun
- Unité d'éducation thérapeutique du patient, CHU de Nantes, 44093 Nantes, France
| | - S Ravilly
- Vaincre La Mucoviscidose, 75013 Paris, France
| | - I Danner-Boucher
- Centre de ressources et de compétences de la mucoviscidose, CHU de Nantes, 44093 Nantes, France
| | - R Gagnayre
- EA-3412, laboratoire de pédagogie de la santé, université Paris-13, Sorbonne Paris-Cité, 74, rue Marcel-Cachin, 93019 Bobigny cedex, France
| | - V David
- Centre de ressources et de compétences de la mucoviscidose, CHU de Nantes, 44093 Nantes, France
| |
Collapse
|