Understanding Patients' Perspectives and Educational Needs by Type of Osteoporosis in Men and Women and People with Glucocorticosteroid-Induced Osteoporosis: A Qualitative Study to Improve Disease Management.

The aim of the study was to investigate similarities and differences in health beliefs, experiences and educational needs by type of osteoporosis (OP), particularly in people with glucocorticoid-induced OP (GIOP) and men. A qualitative study was conducted via focus groups involving post-menopausal women with or without osteoporotic fractures, osteoporotic men and people with GIOP. Fifty-three participants were included in eight groups. A wide range of health beliefs was found for all types of OP. Osteoporosis was considered a natural consequence of ageing except in men or conversely a serious disease associated with risk of new fractures and disability. GIOP patients had heterogeneous knowledge of OP and reported fewer prevention behaviours, and their quality of life was affected by the causal illness. Men had difficulties coping with the loss of their functional abilities and felt that OP was a "women's" disease. Beliefs about treatments ranged from confidence to fear of adverse effects or doubt about efficacy in all types of OP. Participants were interested in physical activity, fall prevention and diet, and preferred group sessions. GIOP patients and men had an interest in face-to-face education. Men were also interested in brief information including via the Internet. Patients' beliefs about OP differed by type of OP. Specific populations such as men or people with GIOP need particular care owing to experiences and needs. Offering group sessions in educational interventions is of interest to allow for sharing experiences and also face-to-face education for men and GIOP patients or the Internet for men.

[Professional training in therapeutic education]. / La formation professionnelle en éducation thérapeutique.

The educational approach differs from the traditional clinical approach and requires specific skills. Which skills are used in patient therapeutic education? How can caregivers be effectively trained to fulfill this mission?

Assessment of a therapeutic education programme for asthma patients: "un souffle nouveau".

The aim of this study was to evaluate the impact of a new patient education programme on adults with asthma. This self-management programme included an individual assessment of patient's needs and two educational group sessions. Teaching methods and session content are described as well as caregivers training programme. The training sessions included a written asthma action plan based on symptoms and personal peak expiratory flow. Patients (n = 238) aged from 18 to 60 years were allocated to the intervention (group A) or control group (group B). Patients filled during 1 year a daily diary and questionnaire and they were administered telephone interviews. 127 patients were included in the treatment program and 111 in the control group. There was a significant improvement in the educated group with regard to symptoms free days (P = 0.03), number of awakenings (P = 0.04), consumption of corticosteroids (P = 0.03), consumption of beta2-agonists (P = 0.03), and quality of life score (P = 0.01). In conclusion, this study validates a specific educational approach named "un souffle nouveau".

Adherence: the goal to control asthma.

Asthma management requires adequate adherence to many recommendations, including therapy, monitoring of asthma control, avoidance of environmental triggers, and attending follow-up appointments. Poor adherence is common in patients with asthma and is often associated with increased health care use, morbidity, and mortality. Many determinants of poor adherence have been identified and should be addressed, but there is no clear profile of the nonadherent patient. Interventions to improve adherence therefore demand tailoring to the individual by including patient-specific education, addressing patient fears and misconceptions, monitoring adherence, and developing a shared decision process.