L’éducation pour la santé : une activité intégrée aux programmes du projet Equal-Reset.

in Institut National de la Promotion, et de l'Education pour la Santé (Ed.) Les journées de la prévention (2008)

Les déterminants majeurs de la non-réinsertion et de la récidive sont la mauvaise santé mentale, une faible estime de soi, mais surtout le manque d’attitudes positives envers le travail telles que la ... [more ▼]

Les déterminants majeurs de la non-réinsertion et de la récidive sont la mauvaise santé mentale, une faible estime de soi, mais surtout le manque d’attitudes positives envers le travail telles que la motivation à avoir un emploi, la responsabilité à l’égard des résultats professionnels. Dans le cadre du projet Equal-reset (Réinsertion Économique et Sociale par l’Éducation et le Travail des détenus), nous avons tenté de montrer qu’il existait un lien entre santé mentale et valeur accordée au travail. Méthodes Parmi les 62 détenus présents au Centre Pénitentiaire de Givenich au moment de l’enquête, 52 ont été volontaires. Variables mesurées à l’aide d’un questionnaire : (1) la santé mentale à l’aide du General Health Questionnaire (GHQ-12 items) (Goldberg 1972), (2) la valeur attribuée au travail avec l’échelle de centralité du rôle professionnel (Meyers & Houssemand 2007) ; plus le score est élevé plus l’investissement accordé au travail dans la vie est important. Résultats Les détenus représentent une population jeune avec une surreprésentation des 25-34 ans. Une majorité d’entre eux a déjà eu une expérience professionnelle de plus de 24 mois, mais a un niveau d’éducation scolaire inférieur. Plus les détenus attribuent de l’importance au travail, moins ils ont de détresse psychique. Par rapport à un niveau d’instruction scolaire supérieur, un niveau inférieur favorise la dépression. Discussion Plus les détenus accordent de l’importance au travail, moins ils paraissent en souffrance psychologique ; les moins instruits étant les plus concernés. Développer des habitudes positives envers le travail dans le sens d'une motivation accrue pour la tâche est un moyen pour favoriser leur réadaptation et leur insertion dans la société, mais cela représente aussi des activités structurantes qui permettent aux détenus pendant le temps de la détention de garder ou de se reconstruire un équilibre mental. L’innovation du projet EQUAL-RESET a été de concevoir un dispositif comportant : • un accompagnement personnalisé assuré par un case manager du Service Psycho-Socio-Educatif selon la méthodologie de l’Empowerment Case Management ; • trois programmes d’accompagnement : Emploi & Employabilité, Enseignement & Formation, Développement Personnel (activités d’éducation pour la santé). Un parcours individualisé et un soutien psychologique sont recommandés pour aider les détenus à mieux exploiter leur potentiel dans les programmes d’accompagnement proposés. [less ▲]

Social inequalities and correlates of alcohol abuse among young adults.

in Psychology and Health (2008), 23(suppl. 1), 242

is a public health problem. This study assessed social disparities in alcohol abuse among young adults and whether they were mediated by psychological and social characteristics. Methods: 1,905 people ... [more ▼]

is a public health problem. This study assessed social disparities in alcohol abuse among young adults and whether they were mediated by psychological and social characteristics. Methods: 1,905 people aged 18-34, randomly selected in north-eastern France completed a post-mailed questionnaire. The data were analyzed via logistic models. Findings: Alcohol abuse was common: 18.7%. Compared with upper/intermediate professionals, significant OR adjusted for sex were found for manual workers (159, 95%CI 1.05-2.42) and employees (1.55, 1.02-2.37) but not for other professionals, students, housewives, and unemployed people. Adjusting for all confounders did not reduce the OR for manual workers (1.48) and employees (1.56). The significant confounders were: sex, living alone, poor health, hearing/cognitive disabilities, being not-sociable, aggressive, and low income (1.28≤OR≤4.25). Discussion: There are social disparities in alcohol abuse among young adults, but they are slightly mediated by individual confounders. [less ▲]

How patients perceive the therapeutic communications skills of their general practitioners, and how that perception affects adherence: use of the TCom-skill GP scale in a specific geographical area

in BMC Health Services Research (2008), 8

To study: (1) the structure and test-retest reliability of a measure of how patients perceive the therapeutic communications skills of their general practitioners (TCom-skill GP), and (2) the associations ... [more ▼]

To study: (1) the structure and test-retest reliability of a measure of how patients perceive the therapeutic communications skills of their general practitioners (TCom-skill GP), and (2) the associations of that scale with socio-demographic and health-related characteristics, and adherence. Methods: A total of 393 people who lived in the same geographic area and invited to attend a preventive medical centre for a check up were asked to complete a self-administered questionnaire concerning TCom-skill GP (15 items), socio-demographic and health-related characteristics, and to answer two questions on perceived adherence. Results: The average age of respondents was 46.8 years (SD 14), and 50.4% were men. The TCom-skill GP score was one-dimensional, had high internal coherence (Cronbach α 0.92), and good test-retest reliability (intra-class correlation coefficient 0.74). The overall score was positively related to increasing age. Respondents aged 60+ were more likely to be adherent. The higher the score, the higher the probability of adherence. Multivariate analysis showed that the TCom-skill score was associated with advancing age and the number of consultations with the GP during the previous 3 months, but not with gender, living alone, being employed, job category or educational level. Multivariate analysis also showed that adherence was associated with TCom-skill GP score which concealed the association between adherence and advancing age observed in univariate analysis. Conclusion: The TCom-skill GP scale probably has value in assessing the quality of doctor-patient relationships and therapeutic communications. The psychometric properties of the TCom-skill GP scale were appropriate for its use in this context. Adherence related to the TCom-skill GP and the latter related to the age of patients and the number of their previous consultations. The TCom-skill GP scale may be a useful way to assess, in a specific geographical location, the impact of medical professional training on therapeutic communication. [less ▲]

Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender differentials: a population-based study

in International Journal of Health Geographics (2007), 2

The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge ... [more ▼]

The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse. Methods: The sample comprised 6,216 people aged ≥ 15 years randomly selected from the population in northeastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia). A deprivation score (D) was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa) computed with logistic models. Results: Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D ≥ 3. More men than women reported tobacco use (30.2% vs. 21.9%) and alcohol abuse (12.5% vs. 3.3%), whereas psychotropic drug use was more common among women (23.8% vs. 41.0%). Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D ≥ 3), alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D ≥ 3) and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D ≥ 3). These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women). Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men. Conclusion: Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial measures. [less ▲]

Health status among French, Polish and Romanian students

in Health Psychology and Society. Congressboock (2007)

Research question. Students face many school and living difficulties which alter health status and favour substance use which were assessed in this study among university students from France, Poland and ... [more ▼]

Research question. Students face many school and living difficulties which alter health status and favour substance use which were assessed in this study among university students from France, Poland and Romania. Methods. In total 934 French, 480 Polish, and 195 Romanian students from the Universities of Metz, Iaşi, and Silésie, completed a self-administred questionnaire. The data were analyzed using adjusted odds ratios (OR) and variance analysis taking age and sex into account, vs. French. Results. Mean age 20 (SD = 2) years. Female represented 58% French and 80% Polish/Romanian. Although most students were satisfied with their university integration (81-97%), many students had deteriorated heath status compared with the period before the university (13-22%), suffered from tiredness (11-85%), nervousness (42-56%), sleep disorders (19-48%), financial difficulty (15-39%), and being alone (8-23%). Were also common increasing tobacco use (15-32%), alcohol use every day (15-40%), tranquilizer pill use (1-6%), hashish/marijuana use (2-42%), suicide thinking (15-19%), and frequent consultation of health professionals (7-30%). Bad heath status was more frequent among French and Romanian overall, and suicide thinking among Polish. Higher PSS-14 and GHQ-12 scores among Polish compared with their French counterparts who used more hashish/marijuana. Satisfied social support was similar between the three groups. Conclusion. A better guidance for those who are in need of adapted mental health care seem nevertheless recommended to support them through their university success. [less ▲]

Content of quality-of-life instruments is affected by item-generation methods

in International Journal for Quality in Health Care (2007), 19(6), 390-398

Methods used to generate items for complex measurement scales are heterogeneous and probably produce heterogeneous data, yet nothing is known about the advantages of one method over another. Objective. We ... [more ▼]

Methods used to generate items for complex measurement scales are heterogeneous and probably produce heterogeneous data, yet nothing is known about the advantages of one method over another. Objective. We aimed to compare methods of generating items for tools designed to measure quality-of-life for patients. Methods. We used five methods to develop a quality-of-life instrument for patients with lower-limb osteoarthritis: individual interviews with patients involving two different techniques (semi-structured and cognitive), individual interviews with health professionals, and focus groups of patients and health professionals. The process generated 80 items, of which 37 were excluded after content and psychometric analysis. With the final 43-item scale used as a ‘reference standard’, we estimated the contribution of each method. Results. For health professionals, the focus group and individual interviews produced 35 and 81% of the items, respectively. For patients, the focus groups produced 74% of the items and both interview techniques 100% of the items. Health professionals provided a narrower picture of the effects of the disease on quality-of-life. Focus groups contributed less to social domains than did individual interviews. The two patient interview techniques highlighted different themes. Conclusion. In developing a complex measurement scale for patients, we found individual interviews with patients the best method for formulating items; other methods such as physician interviews and focus groups contributed no additional information. Reports of instrument generation should include details of the item-generation step, the methods used to develop items and the number of people involved. [less ▲]

Utilisation d'un modèle de réponse à l'item pour la validation d'une échelle des attitudes professionnelles des médecins généralistes

in Journal of Educational Measurement and Applied Cognitive Sciences (2007)

Nous avons développé une échelle des attitudes professionnelles des médecins généralistes destinée à évaluer le niveau de communication thérapeutique dispensé durant les consultations. La construction de ... [more ▼]

Nous avons développé une échelle des attitudes professionnelles des médecins généralistes destinée à évaluer le niveau de communication thérapeutique dispensé durant les consultations. La construction de l'échelle a abouti à un questionnaire constitué de 15 items à 10 modalités de réponse allant de "Jamais" à "Toujours". Après avoir étudié les propriétés métriques de l’échelle selon une méthodologie classique, nous avons employé un modèle de réponse à l’item (le Generalized Partial Credit Model, GPCM) pour explorer un éventuel fonctionnement différentiel d’item (FDI) selon le genre des individus. Le modèle a été construit dans un cadre bayésien en utilisant un algorithme MCMC. La détection du FDI est basée sur le test de rapport de vraisemblance, en comparant le modèle de référence où tous les paramètres associés aux items sont communs aux hommes et aux femmes, à un modèle incluant deux ensembles de paramètres distincts selon le genre des individus pour un item particulier. La démarche a été appliquée aux 338 observations de l'échantillon de validation ne comportant pas de données manquantes. Parmi les 15 items de l'échelle, seul l'item 6 ("Mon médecin m’informe sur les effets secondaires des médicaments") présente un FDI significatif au niveau de signification de 5% (p = 0.016). Cet item est plus discriminant chez les hommes. De plus, il semble que, à un niveau de communication thérapeutique égal, les hommes ont une probabilité supérieure aux femmes de répondre aux catégories les plus élevées. Finalement, nous avons décidé de ne pas écarter cet item car 1) le FDI est modéré (si nous ajustons le test pour les comparaisons multiples, celui-ci n'est plus significatif au niveau 5%) et 2) nous n'avons aucune interprétation qualitative de cette différence. [less ▲]

Associations of deprivation with musculoskeletal, cardiovascular, respiratory diseases and disabilities

in Psychology and Health (2007)

L'aphasie, principal facteur aggravant du vécu d'un AVC par l’entourage

Presentation (2007)

La survenue d’AVC est un événement majeur dans la vie de la victime et de son entourage, amenant des bouleversements considérables tant sociaux que psychoaffectifs. Notre étude a porté sur les ... [more ▼]

La survenue d’AVC est un événement majeur dans la vie de la victime et de son entourage, amenant des bouleversements considérables tant sociaux que psychoaffectifs. Notre étude a porté sur les conséquences de cet évènement sur la famille proche, notamment le conjoint, du malade qui en a été victime. L’hypothèse posée est que parmi les différentes gravités, les AVC qui ont entraîné une aphasie grave, voire totale, sont plus dramatiques que celles où les déficiences étaient seulement physiques. La question de la stigmatisation est ainsi posée : elle semble en grande partie liée à certaines représentations sociales du handicap physique et mental et à leur intériorisation par le malade et par son entourage proche. L’objectif de l’enquête quantitative était de comparer le retentissement familial et social, en particulier chez les conjoints, en fonction de la nature de l’atteinte (ici présence ou non d’une aphasie) Parmi les variables de différenciation, le fait d’être aphasique ou non à la suite de l’AVC est celle qui est la plus discriminante. [less ▲]

Associations between multiple deprivation and tobacco, alcohol, and psychotropic drug use

in Proceedings of 10th European Congress
of Psychology (2007)

Objectives. To assess the relationships of multiple deprivation and gender differences towards tobacco, alcohol and psychotropic drug use. Design and methods. The sample included 6,216 subjects, aged 15 ... [more ▼]

Objectives. To assess the relationships of multiple deprivation and gender differences towards tobacco, alcohol and psychotropic drug use. Design and methods. The sample included 6,216 subjects, aged 15 years, randomly selected in north-eastern France who completed a mailed questionnaire. Data were analyzed with the logistic model. Results. Multiple deprivation (noted MD, defined by the cumulative number of: low educational level, manual worker, unemployment, living alone, nationality (other than Western Europe), low income, and non-home-ownership) concerned many people: 37.4% for MD1, 21.2% for MD2, 10.0% for MD≥3. Tobacco and excess alcohol use was more frequent in men than in women (30.2% vs. 21.9%, 12.5% vs. 3.3%, p<0.001) contrarily to frequent psychotropic drug use (for headache, tiredness, nervousness/anxiety, insomnia, 23.8% vs. 41.0%, p<0.001). The MD was strongly related to tobacco use (odds ratio 1.16, 95%CI 1.00-1.34 for MD1; 1.49, 1.27-1.74 for MD2; 1.93, 1.59-2.35 for MD≥3; vs. MD0) as well as to excess alcohol use (1.19, 0.94-1.52 for MD1; 1.32, 1.01-1.73 for MD2; 1.80, 1.32-2.46 for MD≥3; vs. MD0) and to frequent psychotropic drug use (1.26, 1.11-1.44 for MD1; 1.51, 1.30-1.75 for MD2; 1.91, 1.58-2.30 for MD≥3; vs. MD0). Marked relationships were observed between the MD and the use of those substances in active/non-retired inactive men and women (except for excess alcohol use in female). In retired people, the MD was associated with tobacco and psychotropic use in men only. Conclusion. Multiple deprivation may favour tobacco, alcohol and psychotropic drug use. The psychologists may find gender differences remedial measures. [less ▲]