Mieux situer la place de l’Approche Patient Partenaire de Soins en Grande Région

in Muller, L.; Laguette, V.; Dany, L. (Eds.) Pratiques et interventions en psychologie de la santé. (2020)

Nos résultats appellent également à un développement de la culture de l’approche patient-partenaire de soins. Même si ce genre de démarche, favorisant l’implication du patient, est recommandé depuis de ... [more ▼]

Nos résultats appellent également à un développement de la culture de l’approche patient-partenaire de soins. Même si ce genre de démarche, favorisant l’implication du patient, est recommandé depuis de nombreuses années, c’est tout le paradigme de l’organisation des systèmes de santé qui doit évoluer en parallèle à l’évolution des besoins sanitaires. Ce paradigme touche aux valeurs, aux représentations de ce que constitue l’acte même de soigner. L’exploration menée auprès des professionnels de santé et des patients révèle des envies d’évolution des pratiques de soins et de la relation soignant-soigné. Cependant, ces volontés sont freinées par des ambiguïtés sur le concept même du patient-partenaire de soins, une connaissance et des compétences limitées en matière d’approche patient-partenaire de soins et des éléments de contexte de travail qui rendent cette évolution impossible. Le point positif est la mise en évidence d’une volonté commune d’évoluer vers un patient plus acteur dans les soins, plus autonome, avec une série d’avantages perçus. On peut dire qu’il existe un décalage important entre la vision souhaitée et ce qui est actuellement possible. 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 ▲]

Orienter les soins vers le patient partenaire. Un livre blanc pour la Grande Région

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 ▲]

Generation of Patients-as-Partner Items Through a Qualitative Data Analysis : Initial Item Reduction

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 ▲]

“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 ▲]

Resources and Competences required at the Institutional Level for a Patient – Healthcare Professional Partnership

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 ▲]

New cultural competences needed for healthcare teams as a priority in treatment of chronic diseases

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 ▲]

Factors that contribute to work satisfaction of master students and graduates

in Pracana, Clara; Wang, Michael (Eds.) International psychological Applications Conference and Trends (2016)

From employers to university managers, they all want their employees or students to be the most satisfied in their work or studies respectively. Our study aim was to analyze the associations between work ... [more ▼]

From employers to university managers, they all want their employees or students to be the most satisfied in their work or studies respectively. Our study aim was to analyze the associations between work satisfaction (WS) with psychosocial job-related factors, general and psychological quality of life, and socioeconomic characteristics. An online questionnaire was completed by Master students (N=66) and graduates (N=71). WS was assessed with a single item (1 to 10=very satisfied). Determinants of Postgraduates’ WS were: physical working conditions, recognition you get for good work, opportunity to use ones abilities as well as general and psychological quality of life. These results show that their entrance into the job market is recent and hasn’t yet allowed them to feel the reinforcement they are entitled to expect. Indeed, for Masters Students, the higher their WS was, the better the financial situation they declared was, and the higher the freedom to choose their own work methods and relationships with colleagues and fellow workers were. Whereas for graduates, it is the amount of responsibility they are given, which was higher. The perceptions of graduates’ WS in relation to their career attitudes and at different stages of their careers must be further explored with a longitudinal study. [less ▲]

What enhances the Life Satisfaction of postgraduates who studied in Luxembourg, in the EU or out-EU universities?

in Papanikos, Gregori. T. (Ed.) Education (2016)

Postgraduate students’ Life Satisfaction (LS) has been few explored, in a context where mobility towards universities abroad is increasing. In Luxembourg, more than half of students pursue their studies ... [more ▼]

Postgraduate students’ Life Satisfaction (LS) has been few explored, in a context where mobility towards universities abroad is increasing. In Luxembourg, more than half of students pursue their studies in a different country, and must be able to cope with this transition. Our research questions were (1) which factors are associated with students’ LS, according to their country of studies, and in relation to their mental health, career attitude and socioeconomic characteristics? and (2) which determinants contribute to a better LS for each group? For the years 2012 and 2013, all postgraduates who had obtained a financial aid from the Luxembourgish government were contacted by post to complete an online questionnaire. For the 492 respondents, the regression analysis showed that a higher health satisfaction leads to higher LS. Career optimism and planning were positively associated with LS for students in Luxembourg. Higher were autonomy and career adaptability, and lower was worry, better was the LS for those studying in EU. To enhance students’ LS, it is suggested a preparation for a successful mobility organized by the corresponding CEDIES of every country. Moreover, an accompaniment realized by the hosting university should be also proposed to students in mobility. [less ▲]

Needs the Integration Contract Services of Luxembourg Should Cover, for the Successful Integration of Non-EU Citizens

in Migration and Integration (2015)

Integration of the foreign communities has been a forefront issue in Luxembourg for some time now. With a population of approximately 563,000, Luxembourg is a kaleidoscopic of cultures, comprising over ... [more ▼]

Integration of the foreign communities has been a forefront issue in Luxembourg for some time now. With a population of approximately 563,000, Luxembourg is a kaleidoscopic of cultures, comprising over 170 nationalities. The country’s continued progress depends largely on the successful assimilation of immigrants. To better understand what constitutes the best integration, the European Investment Fund for Non-EU nationals, together with the Welcome and Integration office of Luxembourg, funded this project. The aim of our study was to explore the definition of the integration according to Non-EU citizens residing in Luxembourg, and to evaluate the services of the integration contract of Luxembourg (CAI) which should cover their needs. Eleven focus group discussions with 50 volunteers (32 women, 18 men) recruited from among 233 Non-EU beneficiaries of the CAI were held. Semi-structured discussions (4 to 8 people) were facilitated in English, French, Spanish, Serbo-Croatian or Chinese and lasted between 1.5 to 2.5 hours. Encouraged, they delved into detailed explanations of the difficulties and challenges they face, their expectations upon arrival; considering the multicultural nature of Luxembourg, the differences between these expectations and the reality, their needs, both met and unmet, and their perceptions. To grasp the requirements covered or not covered by the CAI, and the problems faced by Non-EU citizens, eight questions exploring the contract were posed. To direct these discussions were four main guidelines: (1) The quality of services and activities proposed, (2) the organization (3) the availability of the personnel and (4) the utility of the information received. Transcriptions were analysed with the help of NVivo 10. A systematic and reiterative analysis of decomposing and reconstituting the data was conducted following three main steps. (1). Identification in the transcriptions were read in order to identify potential answers to the aims of the research and main categories (difficulties, challenges and integration needs). These informed subsequent analyses (2). Similar verbatim regrouped in category and an item was formular. (3). Categories were regrouped together in dimension. Three dimensions were identified professional career, linguistic acquisitionand socio-cultural activities or events which are two core elements essential to the success of the immigrant’s integration – recognition of the role of time in the process, and deliberate effort on the part of the immigrants, the society around and the formal institutions charged with the responsibility of helping with integration. Further, there was a majority consensus on good quality of services in at least one of the components of CAI, and on the availability of the personnel. The organisation and content utility was suitable for some, but maladapted to the needs of others, since they did not address their current concerns. The one fits all structure of the CAI, would need revision through considering smaller groups with specific needs separately. [less ▲]

The integration process of Non-EU citizens in Luxembourg From an empirical approach towards a theoretical model

in International Journal of Social Welfare (2015), 9(11), 3868-3875

Integration of foreign communities has been a forefront issue in Luxembourg for some time now. The country’s continued progress depends largely on the successful integration of immigrants. The aim of our ... [more ▼]

Integration of foreign communities has been a forefront issue in Luxembourg for some time now. The country’s continued progress depends largely on the successful integration of immigrants. The aim of our study was to analyze factors which intervene in the course of integration of Non-EU citizens through the discourse of Non-EU citizens residing in Luxembourg, who have signed the Welcome and Integration Contract (CAI). The two year contract, offers integration services to assist foreigners in getting settled in the country. Semi-structured focus group discussions with 50 volunteers were held in English, French, Spanish, Serbo-Croatian or Chinese. Participants were asked to talk about their integration experiences. Recorded then transcribed, the transcriptions were analyzed with the help of NVivo 10, a qualitative analysis software. A systematic and reiterative analysis of decomposing and reconstituting was realized through (1). The identification of predetermined categories (difficulties, challenges and integration needs) (2). Initial coding – the grouping together of similar ideas (3). Axial coding – the regrouping of items from the initial coding in new ways in order to create sub-categories and identify other core dimensions. Our results show that intervening factors include language acquisition, professional career and socio-cultural activities or events. Each of these factors constitutes different components, whose weight shifts from person to person and from situation to situation. Connecting these three emergent factors are two elements essential to the success of the immigrant’s integration – the role of time and deliberate effort from the immigrants, the community and the formal institutions charged with helping immigrants integrate. We propose a theoretical model where the factors described may be classified in terms of how they predispose, facilitate and / or reinforce the process towards a successful integration. Measures currently in place propose one size fits all programs, yet integrative measures which target to the family unit and those customized to target groups based on their needs would work best. [less ▲]