Résumé – Introduction : Différents facteurs ont été avancés pour expliquer les difficultés d’inté... more Résumé – Introduction : Différents facteurs ont été avancés pour expliquer les difficultés d’intégration des approches
éducatives dans les pratiques des professionnels de soins. Les représentations sociales peuvent offrir un nouvel éclairage.
Une recherche montre que différents concepts qui semblent faire consensus en éducation thérapeutique du patient
(ETP) recouvrent, en réalité, des représentations variées. Méthodologie : Une étude qualitative et inductive est menée
par entretiens semi-directifs auprès de 30 professionnels de soins. Résultats et discussion : Le concept d’ETP n’est
pas toujours compris et celui d’accompagnement se pose parfois en alternative. À côté des objectifs de santé globale,
la santé psychique subjective fait son apparition chez les soignants. Le flou caractérise la notion d’autonomie. Le Diagnostic
éducatif est tantôt inexistant, tantôt incomplet et confondu avec le bilan de santé (physique). Ces tendances sont
discutées : Quelle est leur diversité ? Comment l’interpréter ? Quel sens leur donner ? Conclusion : Des recherches sont
nécessaires afin de déterminer si les tendances observées sont présentes chez un public plus large de professionnels de
soins. La diversité des représentations invite à un travail sur ses propres représentations et à la méta communication
autour de celles-ci afin d’instaurer un véritable dialogue dans les équipes de soins et avec le patient.
Mots clés : éducation thérapeutique du patient / représentations sociales / santé globale / autonomie / diagnostic
Abstract – Various representations of concepts in therapeutic patient education among healthcare professionals:
Reflections and perspectives. Introduction: Numerous factors have been found to explain difficulties in integrating
educational approaches in health care practice. Social representations of healthcare professionals are factors
that may bring new light on the problem. Our research has shown that several concepts that seem to be consensual in
therapeutic patient education (TPE) actually cover various representations. Methods: This qualitative study has been
carried out by means of thirty semi-structured interviews with healthcare professionals. Results and discussion: The
concept of education is not always valued and sometimes healthcare professionals prefer the use of “support” (accompagnement).
About the objectives of TPE, beside the patient’s “global health” objective, another seems to emerge:
subjective mental health (well-being). Autonomy, usually the most cited value in TPE, seems to cover two contradictory
definitions. Educational diagnosis appears to be mistaken for health diagnosis. All these representations are explained
and discussed. Their meaning and influences are presented. Conclusion: If such wide differences are found among
healthcare professionals trained and active in TPE, more in-depth research is needed to understand if they may explain
practical problems in the implementation of TPE. The diversity of representations leads to recommend to undertake
real discussion and exchange on own perceptions and conceptions related to TPE, as part of any training programme.
Key words: therapeutic patient education / social representations / global health / autonomy / diagnosis
Buruli ulcer (BU) is an infectious skin disease caused by Mycobacterium ulcerans. It mainly affec... more Buruli ulcer (BU) is an infectious skin disease caused by Mycobacterium ulcerans. It mainly affects poor communities living close to bodies of water. In the absence of early treatment, this "neglected" disease can cause lasting deformities and may require limb amputation. It is reported in 34 countries and is the third most common mycobacterial disease in immunocompetent patients. Considerable progress has been made in treatment and prevention. The Cotonou Declaration (2009) describes the recommended control strategies. Although effective, current control strategies are limited because they do not take into account all the factors that influence emergence, prevention and cure of the disease. The control of Buruli ulcer mainly depends on intervention on social, cultural and psychosocial factors that influence preventive and self-care behaviour. The health promotion approach requires collaboration with populations in order to perform simultaneous actions on BU factors in the...
Health promotion and health education have often been limited to evaluation of the effectiveness ... more Health promotion and health education have often been limited to evaluation of the effectiveness of actions and programmes. However, since 1996 with the Third European Conference on Health Promotion and Education Effectiveness, many researchers have become interested in "quality assessment" and new ways of thinking have emerged. Quality assurance is a concept and activity developed in industry with the objective of increasing production efficiency. There are two distinct approaches: External Standard Inspection (ESI) and Continuous Quality Improvement (CQI). ESI involves establishing criteria of quality, evaluating them and improving whatever needs improvement. CQI views the activity or service as a process and includes the quality assessment as part of the process. This article attempts to answer the questions of whether these methods are sufficient and suitable for operationalising the concepts of evaluation, effectiveness and quality in health promotion and education, w...
This paper presents the rationale, theoretical developments and operationalization of the role of... more This paper presents the rationale, theoretical developments and operationalization of the role of contexts of care and education in practice, choice of methods and effects of patient education in chronic diseases. Starting from a review on the evolution of models of care, education and health education, and on the influence of characteristics of organization of care, it proposes an analysis model of contexts of care and education. A study carried out in 1993 in 10 Belgian and northern France hospitals, with 400 patients, is presented. Simultaneously, pre-post test evaluations of the effects of current patient education work on 40 compliance factors, and in-depth analyses of contexts of care and education were undertaken. The possible relationship between variety and number of effects of education and type of care and education is examined and discussed.
The objectives of this article are to: a) review litterature about physical, mental health and be... more The objectives of this article are to: a) review litterature about physical, mental health and behaviors of first generation immigrant adolescents and its evolution; b) compare first and second generations immigrant adolescents'health. Studies usually compare first generation and others adolescents groups: 1) first generation adolescents shows better physical health and behaviors than second generation; 2) first generation adolescents shows variable
Generalists occupy a strategic position in the area of prevention within the general population, ... more Generalists occupy a strategic position in the area of prevention within the general population, and among disadvantaged areas in particular. Yet, practice shows that this position is not a given, as the socio-cultural gap separating doctor and patient renders communication particularly difficult in this context. In order to analyse this situation, a review of the literature, surveys among generalists, and a European seminar were carried out. This article deals with the definition of "disadvantaged environments" by the practitioner, practices in prevention in disadvantaged environments and their related obstacles, and tracks for improving prevention in disadvantaged environments by visits with a generalist.
Au cours de l’année 2011, une recherche visant à suggérer des pistes en vue d’ « améliorer les ta... more Au cours de l’année 2011, une recherche visant à suggérer des pistes en vue d’ « améliorer les taux de participation aux dépistages organisés par la Communauté Française » a été commanditée par le Centre Communautaire de Référence pour le dépistage des cancers (CCR). La réalisation de cette recherche a été confiée à l’Equipe du RESO, Education pour la Santé, de l’Université Catholique de Louvain. Cette recherche qualitative vise à aller plus loin que les études antérieures et à obtenir des données actualisées pour la Fédération Wallonie-Bruxelles. Les objectifs poursuivis sont la mise en évidence des freins et surtout des moteurs à la participation au dépistage des cancers du sein et de l’intestin, en général et aux dépistages organisés, en particulier (soit au Mammotest et au test Hemoccult®). Il s’agissait également de mettre en évidence des suggestions permettant d’améliorer la participation au dispositif organisé.
Résumé – Introduction : Différents facteurs ont été avancés pour expliquer les difficultés d’inté... more Résumé – Introduction : Différents facteurs ont été avancés pour expliquer les difficultés d’intégration des approches
éducatives dans les pratiques des professionnels de soins. Les représentations sociales peuvent offrir un nouvel éclairage.
Une recherche montre que différents concepts qui semblent faire consensus en éducation thérapeutique du patient
(ETP) recouvrent, en réalité, des représentations variées. Méthodologie : Une étude qualitative et inductive est menée
par entretiens semi-directifs auprès de 30 professionnels de soins. Résultats et discussion : Le concept d’ETP n’est
pas toujours compris et celui d’accompagnement se pose parfois en alternative. À côté des objectifs de santé globale,
la santé psychique subjective fait son apparition chez les soignants. Le flou caractérise la notion d’autonomie. Le Diagnostic
éducatif est tantôt inexistant, tantôt incomplet et confondu avec le bilan de santé (physique). Ces tendances sont
discutées : Quelle est leur diversité ? Comment l’interpréter ? Quel sens leur donner ? Conclusion : Des recherches sont
nécessaires afin de déterminer si les tendances observées sont présentes chez un public plus large de professionnels de
soins. La diversité des représentations invite à un travail sur ses propres représentations et à la méta communication
autour de celles-ci afin d’instaurer un véritable dialogue dans les équipes de soins et avec le patient.
Mots clés : éducation thérapeutique du patient / représentations sociales / santé globale / autonomie / diagnostic
Abstract – Various representations of concepts in therapeutic patient education among healthcare professionals:
Reflections and perspectives. Introduction: Numerous factors have been found to explain difficulties in integrating
educational approaches in health care practice. Social representations of healthcare professionals are factors
that may bring new light on the problem. Our research has shown that several concepts that seem to be consensual in
therapeutic patient education (TPE) actually cover various representations. Methods: This qualitative study has been
carried out by means of thirty semi-structured interviews with healthcare professionals. Results and discussion: The
concept of education is not always valued and sometimes healthcare professionals prefer the use of “support” (accompagnement).
About the objectives of TPE, beside the patient’s “global health” objective, another seems to emerge:
subjective mental health (well-being). Autonomy, usually the most cited value in TPE, seems to cover two contradictory
definitions. Educational diagnosis appears to be mistaken for health diagnosis. All these representations are explained
and discussed. Their meaning and influences are presented. Conclusion: If such wide differences are found among
healthcare professionals trained and active in TPE, more in-depth research is needed to understand if they may explain
practical problems in the implementation of TPE. The diversity of representations leads to recommend to undertake
real discussion and exchange on own perceptions and conceptions related to TPE, as part of any training programme.
Key words: therapeutic patient education / social representations / global health / autonomy / diagnosis
Buruli ulcer (BU) is an infectious skin disease caused by Mycobacterium ulcerans. It mainly affec... more Buruli ulcer (BU) is an infectious skin disease caused by Mycobacterium ulcerans. It mainly affects poor communities living close to bodies of water. In the absence of early treatment, this "neglected" disease can cause lasting deformities and may require limb amputation. It is reported in 34 countries and is the third most common mycobacterial disease in immunocompetent patients. Considerable progress has been made in treatment and prevention. The Cotonou Declaration (2009) describes the recommended control strategies. Although effective, current control strategies are limited because they do not take into account all the factors that influence emergence, prevention and cure of the disease. The control of Buruli ulcer mainly depends on intervention on social, cultural and psychosocial factors that influence preventive and self-care behaviour. The health promotion approach requires collaboration with populations in order to perform simultaneous actions on BU factors in the...
Health promotion and health education have often been limited to evaluation of the effectiveness ... more Health promotion and health education have often been limited to evaluation of the effectiveness of actions and programmes. However, since 1996 with the Third European Conference on Health Promotion and Education Effectiveness, many researchers have become interested in "quality assessment" and new ways of thinking have emerged. Quality assurance is a concept and activity developed in industry with the objective of increasing production efficiency. There are two distinct approaches: External Standard Inspection (ESI) and Continuous Quality Improvement (CQI). ESI involves establishing criteria of quality, evaluating them and improving whatever needs improvement. CQI views the activity or service as a process and includes the quality assessment as part of the process. This article attempts to answer the questions of whether these methods are sufficient and suitable for operationalising the concepts of evaluation, effectiveness and quality in health promotion and education, w...
This paper presents the rationale, theoretical developments and operationalization of the role of... more This paper presents the rationale, theoretical developments and operationalization of the role of contexts of care and education in practice, choice of methods and effects of patient education in chronic diseases. Starting from a review on the evolution of models of care, education and health education, and on the influence of characteristics of organization of care, it proposes an analysis model of contexts of care and education. A study carried out in 1993 in 10 Belgian and northern France hospitals, with 400 patients, is presented. Simultaneously, pre-post test evaluations of the effects of current patient education work on 40 compliance factors, and in-depth analyses of contexts of care and education were undertaken. The possible relationship between variety and number of effects of education and type of care and education is examined and discussed.
The objectives of this article are to: a) review litterature about physical, mental health and be... more The objectives of this article are to: a) review litterature about physical, mental health and behaviors of first generation immigrant adolescents and its evolution; b) compare first and second generations immigrant adolescents'health. Studies usually compare first generation and others adolescents groups: 1) first generation adolescents shows better physical health and behaviors than second generation; 2) first generation adolescents shows variable
Generalists occupy a strategic position in the area of prevention within the general population, ... more Generalists occupy a strategic position in the area of prevention within the general population, and among disadvantaged areas in particular. Yet, practice shows that this position is not a given, as the socio-cultural gap separating doctor and patient renders communication particularly difficult in this context. In order to analyse this situation, a review of the literature, surveys among generalists, and a European seminar were carried out. This article deals with the definition of "disadvantaged environments" by the practitioner, practices in prevention in disadvantaged environments and their related obstacles, and tracks for improving prevention in disadvantaged environments by visits with a generalist.
Au cours de l’année 2011, une recherche visant à suggérer des pistes en vue d’ « améliorer les ta... more Au cours de l’année 2011, une recherche visant à suggérer des pistes en vue d’ « améliorer les taux de participation aux dépistages organisés par la Communauté Française » a été commanditée par le Centre Communautaire de Référence pour le dépistage des cancers (CCR). La réalisation de cette recherche a été confiée à l’Equipe du RESO, Education pour la Santé, de l’Université Catholique de Louvain. Cette recherche qualitative vise à aller plus loin que les études antérieures et à obtenir des données actualisées pour la Fédération Wallonie-Bruxelles. Les objectifs poursuivis sont la mise en évidence des freins et surtout des moteurs à la participation au dépistage des cancers du sein et de l’intestin, en général et aux dépistages organisés, en particulier (soit au Mammotest et au test Hemoccult®). Il s’agissait également de mettre en évidence des suggestions permettant d’améliorer la participation au dispositif organisé.
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éducatives dans les pratiques des professionnels de soins. Les représentations sociales peuvent offrir un nouvel éclairage.
Une recherche montre que différents concepts qui semblent faire consensus en éducation thérapeutique du patient
(ETP) recouvrent, en réalité, des représentations variées. Méthodologie : Une étude qualitative et inductive est menée
par entretiens semi-directifs auprès de 30 professionnels de soins. Résultats et discussion : Le concept d’ETP n’est
pas toujours compris et celui d’accompagnement se pose parfois en alternative. À côté des objectifs de santé globale,
la santé psychique subjective fait son apparition chez les soignants. Le flou caractérise la notion d’autonomie. Le Diagnostic
éducatif est tantôt inexistant, tantôt incomplet et confondu avec le bilan de santé (physique). Ces tendances sont
discutées : Quelle est leur diversité ? Comment l’interpréter ? Quel sens leur donner ? Conclusion : Des recherches sont
nécessaires afin de déterminer si les tendances observées sont présentes chez un public plus large de professionnels de
soins. La diversité des représentations invite à un travail sur ses propres représentations et à la méta communication
autour de celles-ci afin d’instaurer un véritable dialogue dans les équipes de soins et avec le patient.
Mots clés : éducation thérapeutique du patient / représentations sociales / santé globale / autonomie / diagnostic
Abstract – Various representations of concepts in therapeutic patient education among healthcare professionals:
Reflections and perspectives. Introduction: Numerous factors have been found to explain difficulties in integrating
educational approaches in health care practice. Social representations of healthcare professionals are factors
that may bring new light on the problem. Our research has shown that several concepts that seem to be consensual in
therapeutic patient education (TPE) actually cover various representations. Methods: This qualitative study has been
carried out by means of thirty semi-structured interviews with healthcare professionals. Results and discussion: The
concept of education is not always valued and sometimes healthcare professionals prefer the use of “support” (accompagnement).
About the objectives of TPE, beside the patient’s “global health” objective, another seems to emerge:
subjective mental health (well-being). Autonomy, usually the most cited value in TPE, seems to cover two contradictory
definitions. Educational diagnosis appears to be mistaken for health diagnosis. All these representations are explained
and discussed. Their meaning and influences are presented. Conclusion: If such wide differences are found among
healthcare professionals trained and active in TPE, more in-depth research is needed to understand if they may explain
practical problems in the implementation of TPE. The diversity of representations leads to recommend to undertake
real discussion and exchange on own perceptions and conceptions related to TPE, as part of any training programme.
Key words: therapeutic patient education / social representations / global health / autonomy / diagnosis
éducatives dans les pratiques des professionnels de soins. Les représentations sociales peuvent offrir un nouvel éclairage.
Une recherche montre que différents concepts qui semblent faire consensus en éducation thérapeutique du patient
(ETP) recouvrent, en réalité, des représentations variées. Méthodologie : Une étude qualitative et inductive est menée
par entretiens semi-directifs auprès de 30 professionnels de soins. Résultats et discussion : Le concept d’ETP n’est
pas toujours compris et celui d’accompagnement se pose parfois en alternative. À côté des objectifs de santé globale,
la santé psychique subjective fait son apparition chez les soignants. Le flou caractérise la notion d’autonomie. Le Diagnostic
éducatif est tantôt inexistant, tantôt incomplet et confondu avec le bilan de santé (physique). Ces tendances sont
discutées : Quelle est leur diversité ? Comment l’interpréter ? Quel sens leur donner ? Conclusion : Des recherches sont
nécessaires afin de déterminer si les tendances observées sont présentes chez un public plus large de professionnels de
soins. La diversité des représentations invite à un travail sur ses propres représentations et à la méta communication
autour de celles-ci afin d’instaurer un véritable dialogue dans les équipes de soins et avec le patient.
Mots clés : éducation thérapeutique du patient / représentations sociales / santé globale / autonomie / diagnostic
Abstract – Various representations of concepts in therapeutic patient education among healthcare professionals:
Reflections and perspectives. Introduction: Numerous factors have been found to explain difficulties in integrating
educational approaches in health care practice. Social representations of healthcare professionals are factors
that may bring new light on the problem. Our research has shown that several concepts that seem to be consensual in
therapeutic patient education (TPE) actually cover various representations. Methods: This qualitative study has been
carried out by means of thirty semi-structured interviews with healthcare professionals. Results and discussion: The
concept of education is not always valued and sometimes healthcare professionals prefer the use of “support” (accompagnement).
About the objectives of TPE, beside the patient’s “global health” objective, another seems to emerge:
subjective mental health (well-being). Autonomy, usually the most cited value in TPE, seems to cover two contradictory
definitions. Educational diagnosis appears to be mistaken for health diagnosis. All these representations are explained
and discussed. Their meaning and influences are presented. Conclusion: If such wide differences are found among
healthcare professionals trained and active in TPE, more in-depth research is needed to understand if they may explain
practical problems in the implementation of TPE. The diversity of representations leads to recommend to undertake
real discussion and exchange on own perceptions and conceptions related to TPE, as part of any training programme.
Key words: therapeutic patient education / social representations / global health / autonomy / diagnosis