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See detailThe patients’ perspective on access to and use of Personal Health Records
Paccoud, Ivana UL; Baumann, Michèle UL; Le Bihan, Etienne UL et al

Scientific Conference (2020, October 29)

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with ... [more ▼]

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with the access to and use of Personal Health Records. The findings come from the INTERREG APPS project that investigated preferences for and intention to use Personal Health Records in four cross-border regions, in Lorraine/France, Luxembourg, Rhineland-Palatinate and Saarland/Germany, and Wallonia/Belgium. [less ▲]

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See detailOrienter les soins vers le patient partenaire. Un livre blanc pour la Grande Région
Pétré Benoit, Consortium APPS Lux; Baumann, Michèle UL; Chauvel, Louis UL et al

Book published by INTERREG APPS (2020)

Les différents chapitres de ce livre proposent une approche holistique pour faire évoluer le système de santé vers le partenariat de soins. Résultat de trois années de recherche et de concertation, le ... [more ▼]

Les différents chapitres de ce livre proposent une approche holistique pour faire évoluer le système de santé vers le partenariat de soins. Résultat de trois années de recherche et de concertation, le Livre Blanc s’appuie sur des recherches documentaires (analyse de la littérature scientifique et de la législation spécifique de chaque pays), des entretiens et des enquêtes auprès de nombreux acteurs, le repérage et l’analyse d’initiatives en GR et la discussion orientée vers le consensus. Par ailleurs, les propositions de recommandations ont été élaborées et discutées lors d’un séminaire interrégional réalisé en décembre 2019. Le Livre Blanc est structuré en 5 parties qui s’adressent chacune à un public ciblé. La première partie situe le contexte dans lequel s’est réalisé le projet et décrit la méthodologie du programme. La seconde partie est consacrée aux aspects réglementaires de l’approche patient partenaire et à leurs conséquences sur les pratiques et les initiatives analysées sur le terrain. Elle est destinée de manière privilégiée aux mandataires politiques. La troisième partie propose une réflexion sur le développement de stratégies de partenariat au niveau des institutions de santé. Elle concerne les gestionnaires des établissements de santé. La quatrième partie vise à amener les professionnels à s’interroger sur ce que le partenariat de soins peut leur apporter dans leurs pratiques de soins. Elle s’adresse, en particulier, aux acteurs en contact direct avec les patients. La cinquième et dernière partie suggère différentes voies possibles de développement de l’APPS dans les domaines de l’enseignement et de la recherche. Toutes ces parties s’adressent bien évidemment au patient, qui est au coeur de l’APPS. Les prises de position proposées par ce Livre Blanc s’appuient sur les données collectées par le consortium de recherche de 2017 à 2020. Dès lors, ce document ne peut être exhaustif et est appelé à évoluer, basé davantage sur une fonction vectrice de normes que de règles. Pour davantage d’information et pour connaitre nos activités et nos publications, rendezvous sur le site web du projet APPS (https://www.patientpartner.org/). [less ▲]

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See detailHospital practices for the implementation of patient partnership in a multi-national European region
Scholtes, Beatrice; Breinbauer, Mareike; Voyen, Madeline et al

in European Journal of Public Health (2020)

The extent to which patients are involved in their care can be influenced by hospital policies and interventions. Nevertheless, the implementation of patient participation and involvement (PPI) at the ... [more ▼]

The extent to which patients are involved in their care can be influenced by hospital policies and interventions. Nevertheless, the implementation of patient participation and involvement (PPI) at the organisational (meso) level has rarely been assessed systematically. The aim of this study was to assess the occurrence of PPI practises in hospitals in Belgium, France, Germany and Luxembourg and to analyze if, and to what extent, the hospital vision and the presence of a patient committee influence the implementation of PPI practises. Methods: A cross-sectional study was carried out using an online questionnaire in hospitals in the border regions of the four countries. The data were analyzed for differences between regions and the maturity of PPI development. Results: Full responses were obtained from 64 hospitals. A wide range of practices were observed, the degree of maturity was mixed. A majority of hospitals promoted patient partnership in the hospital's philosophy of care statement. However, the implementation of specific interventions for PPI was not found uniformly and differences could be observed between the countries. Conclusions: Hospitals in the region seem to be motivated to include patients more fully, however, implementation of PPI interventions seems incomplete and only partially integrated into the general functioning of the hospitals. The implementation of the concept seems to be more mature in the francophone part of the region perhaps due, in part, to a more favourable political context. [less ▲]

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See detailLife Satisfaction and mobility: Their associations with career attitudes, and health-related factors among postgraduates having studied in universities intra EU and outside EU
Odero, Angela UL; Chauvel, Louis UL; Hartung, Anne UL et al

in BMC Public Health (2020), 20(3),

Background. University postgraduates’ mobility towards, and outside the EU is continuously increasing, creating a competitive context in which maintaining a high life satisfaction (LS) is a public health ... [more ▼]

Background. University postgraduates’ mobility towards, and outside the EU is continuously increasing, creating a competitive context in which maintaining a high life satisfaction (LS) is a public health challenge. However, the relationship between LS and its determinants among this population are under-documented. Our aims were to measure LS indicators of mobile postgraduates (Intra EU: Who pursue part of their studies in Europe; Outside EU: Who study outside of Europe) versus non-mobile (pursue their studies in Luxembourg), and to analyze the associations between LS and career attitudes, socioeconomic characteristics, and health-related factors for each group. Method. Six hundred and sixty-four (644) students obtained financial aid from the Luxembourgish government independent of their family’s socioeconomic situation. Contacted by post, they completed an online questionnaire. Analyses included a multiple linear regression model in which only significant relationships (p < 0.05) were used. Results.Three groups were created: Mobile intra EU (n = 381), mobile outside EU (n = 43) and non-mobile (n = 66) postgraduates. Health satisfaction was positively linked to LS, in all groups. Among the mobile outside EU group, majority (63.2%) were men and 57.9% did not live alone - health was the only determinant which contributed to their LS. Among the mobile intra EU, majority (57.8%) were women, and 64.3% not living alone. Autonomy and career adaptability attitudes were positively associated with their LS (b: 0.210 and 0.119, respectively), whereas the worry factor was negatively (b: − 0.153 and -0.159) associated. The non-mobile, were the oldest of the three groups. Majority (51.6%) were women, and 93.7% did not live alone. Career optimism and planning attitudes were positively correlated to their LS (regression parameter estimates (b: 0.400 and 0.212, respectively). Conclusions.Attention should be devoted to the LS of local and cosmopolitan students, as it seems to be a relevant health indicator. Overall, the farther the mobility was, the higher the postgraduates’ general LS (8.5/10) was; this indicator was higher than the LS indicator for the age group 25–34 years 7.53/10 (EU-28, in 2013). University’ services could promote the development of career projects and the promotion of health to enhance postgraduates’ LS. University policy makers need to ensure this for all students. [less ▲]

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See detailCore Values that Influence the Patient—Healthcare Professional Power Dynamic: Steering Interaction towards Partnership
Odero, Angela UL; Pongy, Manon UL; Chauvel, Louis UL et al

in International Journal of Environmental Research and Public Health (2020), 7(8458),

Healthcare has long been marked by the authoritative-physician–passive-patient interaction, with patients seeking help and physicians seeking to restore patients back to health. However, lobalisation ... [more ▼]

Healthcare has long been marked by the authoritative-physician–passive-patient interaction, with patients seeking help and physicians seeking to restore patients back to health. However, lobalisation, social movements, and technological advancements are transforming the nature of this relationship. We aim to identify core values that influence the power dynamic betweenpatients and healthcare professionals, and determine how to steer these interactions towards partnership, a more suitable approach to current healthcare needs. Patients with physical chronic diseases (10 men, 18 women) and healthcare professionals (11 men, 12 women) were interviewed, sessions transcribed, and the framework method used to thematically analyse the data. Validation was done through analyst triangulation and member check recheck. Core values identified as influencing the patient-healthcare professional power dynamic include: (A) values that empower patients (acceptance of diagnosis and autonomy); (B) values unique to healthcare professionals (HCPs) (acknowledging patients experiential knowledge and including patients in the therapeutic process); and (C) shared capitals related to their interactions (communication, information sharing and exchange, collaboration, and mutual commitment). These interdependent core values can be considered prerequisites to the implementation of the patient-as-partner approach in healthcare. Partnership would imply a paradigm shift such that stakeholders systematically examine each other’s perspective, motivations, capabilities, and goals, and then adapt their interactions in this accord, for optimal outcome. [less ▲]

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See detailAdolescent Body Dissatisfaction in ContrastingSocioeconomic Milieus, Coming from a French andLuxembourgish Context
Regnier, Faustine; Le Bihan, Etienne UL; Tichit, Christine et al

in International Journal of Environmental Research and Public Health (2020), 17(61),

: To analyze the relationships between body mass index (BMI), ideal body,current declared body shape, and gap between ideal and declared body shape, and the associationsthat these have with social and ... [more ▼]

: To analyze the relationships between body mass index (BMI), ideal body,current declared body shape, and gap between ideal and declared body shape, and the associationsthat these have with social and cultural factors among 329 adolescents (11 to 15 years i.e., at two stagesof adolescence, the early and late adolescence), attending an international school in Luxembourg,and 281 from Paris.Methods:A cross-sectional survey was conducted using an online questionnaire.Missing data were addressed using the data augmentation method in a Bayesian framework.Results: For both sets, higher the BMI and bigger their current body shape (CBS), the slimmertheir ideal body shape, especially for those who perceive a link between body shape and beauty.For girls, slimness is a shared ideal; for boys, older they are, more they want a muscular body shape.Most students want slimmer bodies, but in affluent or intermediate social milieu students in relationsto identification to personalities such as celebrities, while students from modest milieus, this isexpressed in relation to success in love. In addition, they declared that their “talk diet with friends”were associated with large gap between ideal and declared body shape.Conclusions:A social controlnorm was revealed involving a displacement of values affecting body weight and health in the latestage of adolescence to early adolescence, especially for boys. [less ▲]

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See detailResources and Competences required at the Institutional Level for a Patient – Healthcare Professional Partnership
Odero, Angela UL; Baumann, Michèle UL

in Conference Handbook EHPS : Individuals and Professionals Cooperation to health (2019)

Societal changes have catalyzed the perception of health as a personal responsibility, with social studies showing a behavioral trend where patients are increasingly seeking health information. This has ... [more ▼]

Societal changes have catalyzed the perception of health as a personal responsibility, with social studies showing a behavioral trend where patients are increasingly seeking health information. This has given rise to patients who are active players in their care, and participate in decision-making. Central to these changes, are patients and healthcare professionals’, whose backgrounds and experiences reflect both cultural factors that influence health decisions, and a power shift from professional dominance to a more equitable partnership style. Our study aims to determine resources and competences required at the institutional level to implementing a partnership Semi-structured focus groups with 20 chronic disease patients and interviews with 15 healthcare professionals were conducted. Thematic content analysis was performed with NVivo 12 to categorize verbatim. Items were grouped into dimensions, and themes common to both parties were grouped together. Three major areas emerged: 1) Training to develop a partnership culture - Training healthcare professionals in patient psychology, developing therapeutic education programs for patients and enriching available information with patients’ experiential knowledge. 2) Creation of information / support centers for: Interdisciplinary meetings, facilitating the provision of structured, verified and pertinent information and providing administrative aid to patients. 3) Development of e-health solutions to: Provide information 24/7; facilitate collaborative content creation by healthcare professionals, patients and researchers, and for sharing and updating patient files among professionals. Our findings will help design, implement, monitor and evaluate suitable actions, and help promote sustainable forms of expertise – inclusion of experiential knowledge and resource patients within the healthcare team [less ▲]

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See detailOptimisation de la prise en charge médicale des patients sortant de prison au Luxembourg
Battista, Jorge; Stein, Romain; Baumann, Michèle UL

Poster (2019)

Le passage en prison peut être un gain de chance pour la santé de la population carcérale qui a généralement un faible accès au système de soins. L’élargissement de prison peut devenir une période de ... [more ▼]

Le passage en prison peut être un gain de chance pour la santé de la population carcérale qui a généralement un faible accès au système de soins. L’élargissement de prison peut devenir une période de vulnérabilité où ce gain potentiellement acquis s’annule si la transition vers la société civile n’est pas anticipée. L’objectif principal était l’identification et l’analyse des facteurs qui favorisent et s’opposent à une pratique de soins primaires chez les patients sortant du milieu carcéral au Luxembourg. L’objectif secondaire était l’élaboration de recommandations à l’égard des principaux résultats en s’appuyant sur une revue de la littérature. Méthodes : Une enquête qualitative à l’aide d’entretiens semi-dirigés a été menée auprès de médecins généralistes et de patients-détenus. Les questions des deux guides d’entretien étaient semblables afin que l’analyse permette une mise en miroir des résultats. Un recueil des caractéristiques sociodémographiques a également été effectué. A l’aide de la transcription des entretiens, une analyse de contenu thématique catégorielle de ces derniers a été réalisée au regard des objectifs. Sur base des verbatim, des items ont été formulés et regroupés en dimensions puis en thèmes. Résultats : Notre analyse a mis en lumière le manque de relais entre la prison et l’extérieur à chaque étape de la prise en charge médico-psycho-sociale du point de vue des soins et des aides proposées en prison jusqu’à l’élargissement. Des recommandations concernant des améliorations possibles ont pu être proposées, comme la création d’un réseau de médecins généralistes prenant le relais ainsi qu’une véritable coopération avec des organisations prenant en charge des toxicomanes. Conclusion : Des reformes concernant les soins en prison devraient être envisagées entre le système de l’élargissement, la création de relais socio-médicaux et des alternatives à l’incarcération, en analogie aux transitions clinics retrouvés aux États-Unis. [less ▲]

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See detailGeneration of Patients-as-Partner Items Through a Qualitative Data Analysis : Initial Item Reduction
Odero, Angela UL; Baumann, Michèle UL

in Conference Handbook EHPS : Individuals and Professionals Cooperation to health (2019)

Health psychology aspires to find ways for evaluating the Patient as a Partner. The Montréal model, proposes a verbal and conceptual interpretation. Developed by a University of Montréal research team ... [more ▼]

Health psychology aspires to find ways for evaluating the Patient as a Partner. The Montréal model, proposes a verbal and conceptual interpretation. Developed by a University of Montréal research team, this approach advances that patients should play an active role in the healthcare process. Quantitative assessments employing a methodological framework involving a qualitative approach do not exist. Our study aimed at analyzing a procedure for generating patient as a partner related items and to elaborate their classification. Five semi-structured focus groups with 20 chronic disease patients and 15 professionals (doctors, nurses) were conducted. A qualitative analysis, combining inductive (data abstraction was conducted from specific to general), and deductive (guided by a predefined protocol) methods was employed to create a flexible framework of analysis. A thematic categorical content analysis of the transcriptions was conducted. Verbatim were extracted and classified into categories. Cluster analysis using Sorensen’s coeffient was performed with the software N’Vivo 12. Sorensen’s similarity analysis helped to structure a conceptual framework for the assessment of patient as partner at the doctor patient interaction level. The content of each category was verfied through consensus by multidisciplinary experts, who formulated items to capture the overall patient as partner experience. Our list of items constituted fundamental dimensions of partnership, constituting a first classification and a basis for the development of a routine clinical assessment tool. This process should guarantee that the items are acceptable, comprehensive and relevant (reflecting the lived experience of the participants) ensuring a validity of the future questionnaire. [less ▲]

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See detailEmotional and social repercussions of stroke on patient-family caregiver dyads: Analysis of diverging attitudes and profiles of the differing dyads
Bucki, Barbara; Spitz, Elisabeth; Baumann, Michèle UL

in PLoS ONE (2019), 14(4), 0215425

For patients, the social and emotional repercussions of stroke include shame, personality changes, and upheavals experienced by the couple (i.e. patient and main family caregiver). These impacts on the ... [more ▼]

For patients, the social and emotional repercussions of stroke include shame, personality changes, and upheavals experienced by the couple (i.e. patient and main family caregiver). These impacts on the couple ‘patient/family caregiver’ are scarcely documented. Focusing on the perceptions of the patients and the family caregivers living at home, two years after a stroke occurrence, the aims of the study were to analyse the concordance of attitudes towards the emotional and social repercussions of stroke and to determine the profiles of the differing dyads. Two researchers conducted separate face-to-face structured interviews with stroke survivors and their family caregivers. Eleven items, identified through a content analysis of interviews and after a qualitative process of generating questionnaire items, assessed the commonly experienced impact of stroke on the family, the social repercussions of stroke, and its emotional effects on the stroke survivors. The kappa concordance coefficient was used to determine the response convergence between patients and family caregivers. Four items, selected by a panel of experts, were included in logistic regressions (i.e., demographic characteristics and patients’ impaired functions) to identify the differing dyadic profiles. Family caregivers’ and patients’ attitudes towards the social repercussions of stroke were similar. Patients with motor deficiencies tended to underestimate the upheaval brought to their couple by stroke, whereas caregivers of language-impaired patients tended to underestimate their feelings of shame and demeaning. Communication disturbances, but also residual physical disabilities in stroke survivors, may affect the understanding of each other’s attitudes within dyads. In order to avoid dysfunctional relationships between family caregivers and patients, healthcare professionals need to pay special attention to this issue, especially in cases of aphasia and motor deficiencies. [less ▲]

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See detail“Patient participation” and related concepts: A scoping review on their dimensional
Ortiz Halabi, Iness; Scholtes, Beatrice; Voz, Berarrd et al

in Patient Education and Counseling (2019)

Several concepts on collaboration between patients and healthcare systems have emerged in the literature but there is little consensus on their meanings and differences. In this study, “patient ... [more ▼]

Several concepts on collaboration between patients and healthcare systems have emerged in the literature but there is little consensus on their meanings and differences. In this study, “patient participation” and related concepts were studied by focusing on the dimensions that compose them. This review follows two objectives: (1) to produce a detailed and comprehensive overview of the “patient participation” dimensions; (2) to identify differences and similarities between the related concepts. Methods; A scoping review was performed to synthesize knowledge into a conceptual framework. An electronic protocol driven search was conducted in two bibliographic databases and a thematic analysis was used to analyse the data. Results. The search process returned 39 articles after exclusion for full data extraction and analysis. Through the thematic analysis, the dimensions, influencing factors and expected outcomes of “patient participation” were determined. Finally, differences between the included concepts were identified. Conclusion. This global vision of “patient participation” allows us to go beyond the distinctions between the existing concepts and reveals their common goal to include the patient in the healthcare system. Practice implications. This scoping review provides useful information to propose a conceptual model of “patient participation”, which could impact clinical practice and medical training programs. [less ▲]

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See detailOptimising patients’ medical care after prison in Luxembourg
Batista, Jorge; Stein, Romain; Baumann, Michèle UL

in General Practice : The human side of medicine (2019)

Introduction : Passing through prison can be a health gain for the incarcerated population and release from prison can become a period of vulnerability where this potentially acquired gain is lost if the ... [more ▼]

Introduction : Passing through prison can be a health gain for the incarcerated population and release from prison can become a period of vulnerability where this potentially acquired gain is lost if the transition back to civil society in not anticipated. The main objective was the identification and analysis of the factors favor and oppose primary care practice for patients leaving prison in Luxembourg. The secondary objective was to develop recommendations based on the key findings through a literature’s review. Methods : A qualitative study using semi-structured interviews was conducted with general practitioners and patient-inmates. The questions from the two interview guides were similar so that the analysis allowed the results to be mirrored. Using the interviews’ transcripts, a categorical thematic content analysis of those was conducted based on the objectives. On the basis of verbatim, items were formulated and grouped into dimensions and then themes. Results : Our analysis has highlighted the lack of links between the prison and the outside world at each stage of medical and psychosocial care from the point of view of care and support proposed in prison until prison release. Recommendations for doable improvements have been proposed, such as the creation of a general practitioners’ network continuing the medical care as well as genuine cooperation with organisations dealing with drug addicts. Conclusion : Reforms concerning prison care should be considered between the system of prison release, the creation of socio-medical relays and alternatives to incarceration, in analogy to the transitions clinics found in the United States [less ▲]

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See detailLes malades chroniques veulent avoir des rapports nouveaux « plus jeunes » avec les professionnels de santé….
Baumann, Michèle UL

Article for general public (2018)

« S’appuyer sur Nos expériences liées à notre maladie, aux soins reçus, c’est faire entendre Notre vécu et reconnaitre Notre savoir à Nous ». L’équipe du Pr Michèle BAUMANN est allée à la rencontre de ... [more ▼]

« S’appuyer sur Nos expériences liées à notre maladie, aux soins reçus, c’est faire entendre Notre vécu et reconnaitre Notre savoir à Nous ». L’équipe du Pr Michèle BAUMANN est allée à la rencontre de personnes (dyalisées, victimes d’un Accident Vasculaire Cérébral, de cancer du sein, de maladies rares, …) pour qu’elles nous parlent des relations qu’elles ont avec les professionnels et les équipes (infirmiers, médecins, spécialistes, etc.). Dans le cadre d’un projet INTERREG (cofinancé FEDER) concernant le Luxembourg, mais aussi les pays frontaliers de la Grande-Région, les membres d’associations ont exprimé leurs attentes sur la façon dont ils souhaiteraient avoir des relations de PARTENAIRES. « S’intéresser à mes questions car pour moi c’est survivre… m’impliquer dans les soins pour que j’apprenne … partager et échanger les informations qui me concernent… et surtout m’investir dans le processus …pour que je me sente partie prenante dans les décisions qui doivent être prises… » sont des demandes d’une époque nouvelle. Les discours de ces personnes en cours d’analyses, avec l’appui d’Angela ODERO doctorante, permettront de comprendre les points forts à discuter pour mettre en œuvre des réseaux de porte-parole, des formations pour les patients et professionnels, etc. Les personnes des associations qui veulent aussi s’exprimer en groupe, doivent nous contacter. Michèle Baumann, professeure en sociologie médicale et santé publique à l’IRSEI, à l’Université du Luxembourg, a été nommée en octobre 2018 par la Commission Européenne, experte indépendante pour le Luxembourg sur les soins de santé de longue durée et membre de l’European Social Policy Network (ESPN). [less ▲]

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See detailDer Patient-als-Partner-Ansatz in der Gesundheitsversorgung (APPS -Approche Patient Partenaire de Soins): ein interregionales Forschungsprogramm, um zu verstehen, wie man von der Theorie zur Praxis übergehen kann
Baumann, Michèle UL

Article for general public (2018)

Das Projekt „ Der Ansatz vom Patienten als Partner im Gesundheitswesen“ (APPS INTERREG) möchte die Qualität der Krankenpflege in Nachsorge und Vorbeugung durch den Aufbau einer Kultur der Partnerschaft ... [more ▼]

Das Projekt „ Der Ansatz vom Patienten als Partner im Gesundheitswesen“ (APPS INTERREG) möchte die Qualität der Krankenpflege in Nachsorge und Vorbeugung durch den Aufbau einer Kultur der Partnerschaft zwischen Patienten und Fachkräften aus dem Gesundheitswesen in der Großregion verbessern. Das Projekt hat sich also zum Ziel gesetzt den„Ansatze vom Patienten als Partner im Gesundheitswesen“ zu hinterfragen und zu fördern. Hierbei sollen Lösungen entwickelt werden, die insbesondere sozio-kulturelle Aspekte, die Organisationen und die jeweiligen Regeln der verschiedenen Ebenen (micro, meso, macro) des Gesundheitssystems berücksichtigen. Konkret bedeutet dies, dass die Gruppenleiter der vier Territorien (Luxemburg, Belgien, Frankreich) wissenschaftliche Forschung betreiben, Verbände und Patientenkomitees mobilisieren, Fachkräfte aus dem Gesundheitswesen sensibilisieren und die Anwendung neuer Technologien bei den Praktiken des APPS bewerten werden. Das Projekt wird folgendes hervorbringen: • Eine Definition der Funktionsweise, sowie ein gemeinsamer konzeptueller Rahmen des APPS in der Großregion. • Empfehlungen, um die Einführung des APPS möglich zu machen. • Eine Analyse der Aktivitäten des APPS, sowie der bereits existierenden Maßnahmen in der Großregion. • Ein grenzüberschreitendes Netzwerk der Patientenkomitees. • Innovative Lösungen, die neue Technologien nutzen (z.B. E-Gesundheit, M-Gesundheit), um die Einführung der Praktiken des APPS zu erleichtern. • Ein berufliches Weiterbildungsprogramm, um die Fachkräfte aus dem Gesundheitswesen für den APPS zu sensibilisieren. [less ▲]

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See detailApproche Patient Partenaire de Soins (APPS) : un programme de recherche interrégional pour comprendre comment passer de la théorique à la pratique
Baumann, Michèle UL

Article for general public (2018)

Le projet « Approche Patient Partenaire de Soins » (APPS INTEEREG) vise à améliorer la qualité des soins dans le suivi et la prévention de la maladie par la mise en place d’une culture de partenariat ... [more ▼]

Le projet « Approche Patient Partenaire de Soins » (APPS INTEEREG) vise à améliorer la qualité des soins dans le suivi et la prévention de la maladie par la mise en place d’une culture de partenariat patients-professionnels de santé dans la Grande Région. Il a pour but de questionner et de promouvoir l’Approche du Patient Partenaire de Soins en développant des solutions qui intègrent, notamment les aspects socioculturels, les organisations et les réglementations respectives des différents niveaux (micro, meso, macro) du système de santé. Concrètement, les responsables des équipes des quatre territoires (Luxembourg, Belgique, France) procéderont à des recherches scientifiques, mobiliseront les associations et les comités de patients, sensibiliseront les professionnels de santé et évalueront la place des nouvelles technologies dans les pratiques d’APPS. Le projet produira : • Une définition des principes de fonctionnement ainsi qu’un cadre conceptuel de l’APPS communs aux pays de la Grande Région. • Des recommandations pour rendre possible l’implémentation de l’APPS. • Une analyse des activités d’APPS ainsi que des interventions existantes dans la Grande Région. • Un réseau-transfrontalier des associations et des comités de patients. • Des solutions innovantes, utilisant les nouvelles technologies (ex : e-santé, m-santé), pour faciliter le développement durable des pratiques de l’APPS. • Un programme d’études et de formations professionnels pour sensibiliser les professionnels de santé à l’APPS. [less ▲]

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See detailLe changement de rôle des patients atteints de maladie chronique dans l'organisation des soins
Odero, Angela UL; Bucki, Barbara; Baumann, Michèle UL

in Pratiques et interventions en santé (2018)

Introduction: Les patients sont de plus en plus impliqués dans les soins qui exigent leur engagement dans la surveillance, la prévention des risques, l'auto-éducation et l'auto-traitement. Les ... [more ▼]

Introduction: Les patients sont de plus en plus impliqués dans les soins qui exigent leur engagement dans la surveillance, la prévention des risques, l'auto-éducation et l'auto-traitement. Les professionnels, quant à eux, ils sont plus enclins à adopter avec leurs patients des modèles d'interaction équitable. Sur le plan théorique, une Approche Patient Partenaire de Soins (APPS) a été proposée par des chercheurs canadiens. Pour clarifier ce que représente l’APPS, une étude qualitative a tenté d’analyser les facteurs culturels et psychosociaux qui interviennent dans la mise en place d’une APPS. Méthode : Avec l’appui des associations luxembourgeoises, six focus groupes ont été organisés avec 30 patients. A partir des retranscriptions, une analyse de contenu thématique catégorielle a été réalisée avec l’aide de N’Vivo 12 Résultats: Parmi les obstacles qui freinent une APPS, des divergences culturelles entre patients et professionnels de santé sont évoqués. Des patients préfèrent en effet rester en harmonie avec leurs valeurs et refusent de partager les prises de décision, pour eux seuls les professionnels doivent les prendre. Les échanges avec les professionnels restent compliqués car des positions dominantes et autoritaires demeurent. Parmi les facteurs favorisants APPS, on peut retenir le fait que les patients estiment avoir une connaissance de leur corps, et qu’ils ressentent l’impact que peut avoir les effets secondaires des traitements ; ceci à condition qu’ils soient capables de les verbaliser. Enfin l'accent est mis sur une confiance réciproque. Conclusion: Une éducation des patients devrait être développée pour leur permettre d’acquérir un «Capital Culturel en Santé» ; une connaissance de base favorisant la compréhension des soins et facilitant les relations avec les professionnels de santé. De même, une formation médicale et une pratique infirmière plus soutenues par des «Compétences Culturelles» permettaient aux professionnels de mieux reconnaître l'impact socioculturel que peut avoir leur identité lors de leurs relations avec les patients. [less ▲]

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See detailNew cultural competences needed for healthcare teams as a priority in treatment of chronic diseases
Odero, Angela UL; Baumann, Michèle UL

in "Health Psychology across the Lifespan: Uniting Research, Practice and Policy” (2018)

Technological changes and higher prevalence of chronic diseases require changing patients’ and healthcare professionals’ position with more participation in healthcare organization, and more implication ... [more ▼]

Technological changes and higher prevalence of chronic diseases require changing patients’ and healthcare professionals’ position with more participation in healthcare organization, and more implication in their relationships. Based on the Canadian ‘patient-as-partner in healthcare’ approach, our aims were to identify and categorize cultural values underlying this term in Luxembourg, and to characterize a set of cultural competencies needed for its practical application. Method: A qualitative study using a semi-directive guide developed within an INTERREG project was conducted among 30 healthcare professionals. A categorical thematic content analysis was realized using N'Vivo software. Results: For some professionals, the word ‘partner’ is not appropriate in Luxembourgish, but they defined it as a companion who engages in a mutual cooperation, structured collaboration and sharing of information with a common goal: Quality of healthcare. For others, a ‘partner’ is an associate who takes part in decision making, discussions, negotiations and evaluations. This partner approach would allow processes of change, bringing autonomy (surveillance, self-education, and monitoring treatment) to the patients, provided that professionals partly cede their traditional power. Trust and respect would be the main start of this process. Difficulties in communication and relationships would arise when helping the patients understand their disease, adhering to instructions, and giving a balanced place to the information found on Internet. Conclusion: This ‘collaborative accompaniment’ appears to allow decisional balance, an interdisciplinary method which requires training for all partners (physicians GP or specialists, patients and psychologist) and not only case-managers to help patients acquire self-efficacy for behavioral changes. [less ▲]

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See detailReversing social gradient: Impact of patients’ communication with their practitioners on adherence to preventive behaviours
Baumann, Michèle UL; Bucki, Barbara; Tchicaya, Anastase et al

in "Health Psychology across the Lifespan: Uniting Research, Practice and Policy” (2018)

Good communication with a physician has positive effects on the patients’ adopting preventive behaviours. Knowing social inequalities in health, we aimed at analysing in what extent financial situation ... [more ▼]

Good communication with a physician has positive effects on the patients’ adopting preventive behaviours. Knowing social inequalities in health, we aimed at analysing in what extent financial situation influences the associations between quality of communication and improved secondary preventive behaviours and limited risk factors - in cardiovascular diseases: hypertension, overweight, obesity, hypercholesterolemia, diabetes. Methods: 1,289 patients who underwent a coronary angiography in Luxembourg completed a self-administered questionnaire in 2008/09 and 2013/14. The association between improving each preventive eating behaviour (decrease of salt, sugar, fat consumption; increase of fruits/vegetables) and the quality of physician-patient communication (5-items scale) was evaluated using logistic regression models. Perceived financial situation (difficult, easy, and very easy) was introduced in interaction with the communication score. Findings: Patients declared in a difficult or easy financial situation had a higher probability of decreasing their salt intake when physician-patient communication quality was higher (OR [95% CI] respectively: 1.139 [1.045; 1.240], 1.105 [1.032; 1.182]). The pattern was similar for increased consumption of fruits/vegetables in patients with hypertension, diabetes, overweight and hypercholesterolemia. Reduced sugar consumption was associated with communication quality in hypercholesterolemia patients in financial difficulty (OR [95% CI]: 1.095 [1.009; 1.189]). Discussion: The quality of communication has a higher impact on adopting healthy behaviours in patients declaring themselves in financial difficulty. These findings raise awareness on the importance, in patients with perceived financial difficulties, of physician-patient quality to improve adherence to the secondary preventive recommendations. Across the lifespan, it highlights the role of physicians in reversing their patients’ social gradient. [less ▲]

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See detailSudoses et inégalités sociales
Origer, Alain; Baumann, Michèle UL

Article for general public (2017)

Des chercheurs du Ministère de la Santé (Dr. Alain ORIGER) et de l’unité de recherche INSIDE, Institut Santé & Comportement (Pr. Michèle BAUMANN et son équipe) ont publié récemment dans la revue ... [more ▼]

Des chercheurs du Ministère de la Santé (Dr. Alain ORIGER) et de l’unité de recherche INSIDE, Institut Santé & Comportement (Pr. Michèle BAUMANN et son équipe) ont publié récemment dans la revue scientifique PLoS ONE un article intitulé : A social gradient in fatal opioids and cocaine related overdoses ? Sélectionné par un jury d’experts internationaux, cet article a été primé au Scientific Award 2016 dans le cadre de l’European Monitoring Centre for Drugs and Drug Addiction.h ttps://insideblog.uni.lu/surdoses-et-inegalites-sociales/ [less ▲]

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