Projet Approche Patient Partenaire de Soins (APPS) - Projekts Ansatz der Patienten-Partner-Betreuung

Conference given outside the academic context (2022)

Notre projet a permis d’observer une volonté affichée d’évoluer vers davantage d’engagement du patient dans la relation de soin et dans les structures de soins de santé. Le développement attendu passera ... [more ▼]

Notre projet a permis d’observer une volonté affichée d’évoluer vers davantage d’engagement du patient dans la relation de soin et dans les structures de soins de santé. Le développement attendu passera par une approche systémique de l’engagement tant sur des aspects micro (de la relation de soin) méso (dans la coordination des structures de soins) et macro (avec l’engagement des politiques de santé). Le développement doit s’appuyer sur les initiatives existantes : en ce sens le projet Interreg est une belle façon de promouvoir les échanges de bonnes pratiques au service de cet engagement du patient. [less ▲]

Cross-border mobility in European countries: associations between cross-border worker status and health outcomes

in BMC Public Health (2021), 21

Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk ... [more ▼]

Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status as well as (3) with income and health index among CBWs. Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking non-cross border workers (NCBWs) as the reference group, controlling by demographic background and labour status variables. A sample of 22,828 observations (2456 CBWs vs. 20,372 NCBWs) was retained. The CBW status is negatively associated with chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Luxembourg have the best health outcomes, whereas commuters to Germany the worst. CBWs are healthier and have more income. Interpretations suggest (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union. [less ▲]

Social protection and inclusion policy responses to the COVID-19 crisis. Luxembourg.

Report (2021)

Between Monday 3 February 2020 and Sunday 18 April 2021, the total number of confirmed COVID-19 cases per 100,000 people was 6,740 for the EU-27 as a whole; in Luxembourg, it was 10,545. The total number ... [more ▼]

Between Monday 3 February 2020 and Sunday 18 April 2021, the total number of confirmed COVID-19 cases per 100,000 people was 6,740 for the EU-27 as a whole; in Luxembourg, it was 10,545. The total number of deaths per 100,000 people was 126 for the EU-27, and also for Luxembourg. Section 1 presents more data on the impact of the pandemic on the demographic, economic and social situation. A total of 14 different social protection and inclusion measures deployed by the Luxembourg government to counter and mitigate the effects of the pandemic are described in Section 2 in terms of the targeted population, the timing and their novelty. These measures relate to: unemployment benefits; job protection; sickness benefits and sick pay; health insurance; minimum-income schemes and other forms of social assistance; housing support; leave for parents whose children are unable to attend school or a pre-school service by reason of COVID-19; and leave for family support. This section also analyses the social impact and the relevance of these measures, including, where appropriate, the concrete description of the benefits and (estimated) numbers of targeted populations and/or effective recipients. Some of these measures are only of a regulatory nature and do not require any expenditure of money by the government or others (e.g. the National Health fund, employers or landlords), others are associated with more or less extensive expenditure, depending on whether they are aimed at many potential recipients or only a few. In Section 3, a preliminary and tentative estimate of the induced costs of these measures is provided. According to this, the global cost would amount to roughly €996 million in 2020, which represents around 1.5% of 2019 GDP. Some of the measures have been new ones, whereas others have only been adjustments or extensions of existing measures; in either case, not all of them will continue to be in force once the pandemic is over (some have already stopped). Whether, or the degree to which, any of these temporary measures will become permanent is not predictable at this time. In general, the social protection system in Luxembourg has proved quite resilient to the COVID-19 crisis. However, a number of shortcomings have also been highlighted, several of which will most probably persist. This is the case for the growing number of people at risk of poverty, which has not been offset by the minimum income reform. The increase in the percentage of NEETs (young people not in employment, education or training), as well as in the number of unemployed people aged 16-29, is to be mentioned, together with the fact that there are still groups that are not covered by the national health insurance system. Specific groups such as non-EU migrants and homeless people have been particularly exposed to the crisis and they are also in general more heavily exposed to the risk of poverty. The shortcomings of the housing market, with ever growing prices and the spill-over effects on rent levels, have certainly been somewhat cushioned by the measures, but there have been no structural changes to a situation that keeps getting worse. In addition, the crisis has exacerbated the crucial importance of the medical workforce, which is in danger of shrinking in the next years because of upcoming retirements. Finally, the crisis has revealed the problem of self-employed people not being sufficiently covered by social security cushions. There is also a need to rethink social policy beyond the Luxembourg borders, and to improve the European co-ordination of national healthcare systems. [less ▲]

Adolescent Body Dissatisfaction in ContrastingSocioeconomic Milieus, Coming from a French andLuxembourgish Context

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 ▲]

Hospital practices for the implementation of patient partnership in a multi-national European region

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 ▲]

Life Satisfaction and mobility: Their associations with career attitudes, and health-related factors among postgraduates having studied in universities intra EU and outside EU

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 ▲]

Auf AugenHöhe : Grossregion-Projekt "Patient-als-Partner Ansatz" in der Gesundheitsversorgung.

Article for general public (2019)

Emotional and social repercussions of stroke on patient-family caregiver dyads: Analysis of diverging attitudes and profiles of the differing dyads

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 ▲]

The Generation of suffering related items: A process integrating consensus experts and Sorensen’s similarity analysis.

in 33 nd Annual Conference on the European Health Psychology Society. Methodology.Publisher: EHPS (2019)

Health psychology and public health aspire to find ways for evaluating the suffering of patients. Quantitative assessment of pain-related suffering exists, but methodological frameworks implying ... [more ▼]

Health psychology and public health aspire to find ways for evaluating the suffering of patients. Quantitative assessment of pain-related suffering exists, but methodological frameworks implying qualitative approach based on a direct communication with participants are missing. Our aim was to analyse the procedure generating pain and suffering-related items and explore the validity of their content. Volunteers were all right-handed and of European origin. After received information concerning the aims of the study, they signed a consent to accept the experimental pain stimulation protocols and to receive financial compensation. Descriptors of pain-related suffering were gathered through 106 semi-structured interviews of 31 particpants (16 men ;15 women), age 18-33 years. A thematic categorical content analysis on the transcriptions was conducted. Verbatim were extracted and classified under categories. Cluster analysis on word of verbatim using the index of Sorensen was performed with N’Vivo12. The content of each category was validated through consensus by multidisciplinary experts (some have lived the experimental pain stimulation). Then they formulated 70 items to capture the overall pain-related suffering experience. In accordance to theories and with the help of the Sorensen’s similarity analysis, a conceptual framework with different dimensions (physical, mental, etc.) has been discussed and elaborated. The list obtained constitutes a first classification for laboratory use and a basis for the development of a routine clinical suffering assessment tool. This generation process should guarantee that the items are acceptable, comprehensive and relevant (reflecting the lived experience of the participants) ensuring a content validity of the future questionnaire [less ▲]

“Patient participation” and related concepts: a scoping literature review on their dimensional composition

in Archives of Public Health (2019), 77(suppl 1), 7

The Greater Region (GR) is Europe’s cross-border region including Lorraine, Luxembourg, Rhineland-Palatinate, Saarland and Wallonia. These regions share a consortium founded by five Univer sities. In the ... [more ▼]

The Greater Region (GR) is Europe’s cross-border region including Lorraine, Luxembourg, Rhineland-Palatinate, Saarland and Wallonia. These regions share a consortium founded by five Univer sities. In the GR, emergency initial training for polytrauma patients’ management is heterogeneous. Moreover, learners encounter diffi culties in acquiring knowledge and skills on trauma due to case limi tations. This lack of experience can lead to adverse events and care errors. Lastly, WHO requests that states of the European Union intro duce training in prehospital trauma care. Consequently, the five uni versities are designing a common competency framework to define technical and non-technical skills needed to manage polytrauma patients. Methods: To design this competency framework, several steps have been planned: 1) a literature review on Medline Databases and CINAHL using key words related to training and polytrauma manage ment, and consultation of reference books; 2) a first proposal of com mon frame; 3) face-to-face and experts’ meetings; and 4) a Delphimethod to finalise and validate the framework. The first two havealready been carried out. Results: The literature review allowed selecting two books and 23 arti cles. The first proposal of competency framework is divided into three parts. The first part presents prerequisite knowledge and skills of the emergency physicians. The second part describes the rational of the frame, and essential concepts as the Golden hour6 and a timeline forolytrauma patients’ management. The last part describes seven med ical skills using CanMEDS system presented in two sections: five Non Technical Skills (Professional attitude, Long-life learning, Communicator,Collaborator and Leader), and several Technical Skills to use during Pre hospital phase and In-hospital phase. Conclusions: Designing a common framework for polytrauma pa tients’ management in the GR is the first step of an Interreg project. Based on CanMEDS system, seven skills have been defined. A Delphi method will validate this proposal. [less ▲]