[Refusal of care by the elderly]. / Le refus de soins en gériatrie.

Refusal of care is a frequent occurrence in geriatric medicine, especially among people with neurocognitive diseases, particularly in the advanced stages. These refusals of care are a daily burden, not only for the patients themselves, but also for their carers and caregivers. Although they can be prevented, the absence of a single, simple strategy for overcoming them is a real challenge for professionals and carers alike. Their management calls for an approach that is essentially non-pharmacological, always interdisciplinary, humanistic and ethically grounded.

[The place and function of the gender of child psychiatric carers]. / Place et fonction du genre des soignants en pédopsychiatrie.

In a child psychiatry unit, where it is said that men are reassuring and women are mothering, the group experience of carers on the function of their gender in child care was explored. Gender is relevant to institutional care, but creates a divide. Representations focus on fear, sexuality, violence and fragility. Caregivers, ambivalent about neutralising gender, suffer from representations of what it does to children and to the institution.

[The contribution of a mental health patient trainer to carers]. / L'apport d'une patiente-formatrice en santé mentale auprès des soignants.

As peer support becomes more professional, it is becoming increasingly recognised and diversified. When a mental health patient-trainer works with psychiatric carers, the latter gain a better understanding of the patient's point of view. In addition, valuing their experiential knowledge can support peer helpers in their recovery. However, we mustn't forget that these are fragile people and that their past can come back to haunt them if they are not careful. Testimonial.

[Identify the needs of the patient or resident]. / Cerner les besoins du patient ou du résident.

Patients, residents, all have needs linked to their situation. Identifying them makes it possible to increase their physical or psychological comfort and thus improve the quality of the caregiver-patient relationship. This objective requires increased attention, particularly towards requests, behaviors, and emotions.

[The cultural diversity of professionals in migrant care]. / La diversité culturelle des professionnels au profit des soins aux personnes migrantes.

A qualitative study was carried out with five professionals in a pediatric intensive care unit in 2022. Semi-structured interviews were used to find out how they felt about patients from their own culture, and about the role of their mother tongue in hospital care. Caregivers find it difficult to bring their own culture to the fore when caring for their patients. A description of the obstacles they encounter, as well as the advantages, is included.

Psychological consequences of the COVID-19 pandemic: A qualitative study.

Multiple psychological health problems related to the COVID-19 pandemic among both the general public and health-care workers have been identified in the scientific literature. However, most studies used quantitative methods with scales selected on the basis of the researchers' pre-established knowledge derived from the experience of other situations and which can therefore induce biases. The dual aim of the present study was to explore qualitatively the perceived psychological consequences of lockdown on members of the general public and the perceived psychological consequences of COVID-19 on health-care workers. We recruited 241 participants from the general public and 120 health-care workers. They consented online to participate and completed open-ended questions evaluating the consequence of the health crisis on their life as a couple, on their friendships, family life, work, studies, psychological health, stress, and vision of the future. Finally, participants were asked to add any further consequences that had not been mentioned. We used double coding to process the data. We identified five main themes among the participants from the general public: improved and maintained social relationships, deterioration of health, improved health, personal growth, and lack of direct social contact. We also identified five main issues among the health-care workers: psychological and emotional impact, adjusting, negative impact on work, worries, and uncertainty about the future. The results confirmed the existence of psychological health problems related to the COVID-19 pandemic. They also highlighted positive consequences. Health-care workers tended to perceive more negative consequences than the participants from the general public.

[Technology at the heart of vulnerability]. / La "techné" au cœur de la vulnérabilité.

The ubiquitous presence of the elderly in care services raises questions about the evolution and limits of new techniques and technologies in the care relationship. We carried out a cross-sectional study in a geriatric ward, using parallel patient and carer questionnaires to assess how each felt about innovations, analyze their opportunities and evaluate their dangers in care provision.

[Being a caregiver in psychiatry: beyond skills, commitment]. / L'être-soignant en psychiatrie : au-delà des compétences, l'engagement.

The caregiver-patient relationship goes against the grain of the "diagnosis-action-result" model. To live this relational adventure, the caregiver must be motivated, committed and convinced of the validity of this approach: there must be "being a caregiver". At a time when former psychiatric caregivers have almost disappeared, in a context where psychiatry, like other disciplines, is being deserted by doctors and nurses, the question arises as to the legacy of care that allows for the encounter with the other. There is a risk of non- transmission of nursing know-how, jeopardizing the daily clinic and the very essence of the nursing posture in psychiatry.

[The revolution in the relationship between caregiver and patient]. / La révolution du rapport soignant-soigné.

The caregiver-patient relationship has progressively evolved to focus on the development of the patient's autonomy. The mobilization of the patient's resources is fundamental to their participation in the co-construction of the care protocol. Identifying these resources is an essential component of caregiving know-how. Differents tools are available to help patients develop their own abilities and skills. These strategies have a positive impact on their quality of life and the satisfaction they experience, through a renewed sense of efficacy over their lives.

[Learning about the caregiving relationship in the internship]. / L'apprentissage de la relation soignante en stage.

Nursing students are confronted with the mysteries of the patient encounter during their internship in psychiatry. From this discovery, questions and enigmas remain to be solved. This ephemeral primary relationship, in a time span of a few weeks, is a source of frustration for them. In this context, the presence and professionalism of the team are precious assets that the student must seize. Discovery of the profession of psychiatric nurse illustrated by the testimonies of two students.

[Ethical issues surrounding death in pre-hospital medicine]. / Enjeux et éthique face à la mort en médecine préhospitalière.

Mobile emergency and resuscitation teams are confronted with death on a daily basis. In the home, the management of a death is complex. It raises ethical questions and sometimes destabilizes personal or collective values. Our single-center qualitative survey, conducted over a one-month period (2022), questioned 64/154 caregivers about the moral burden and challenges of such situations. The consequences of operational experience are discussed: time, fatigue, emotions and training. The quality of presence is an alternative to the success or failure of cardiac arrest care at home.

[The particularity of large-scale simulation: from learning by observation to professionalization]. / La particularité de la simulation à grande échelle : de l'apprentissage par l'observation vers la professionnalisation.

A full-scale exercise designed to test emergency plans, large-scale simulation in the face of nuclear, radiological, biological, chemical and explosive (NRBCe) risks also contributes to the health response and the organization of the health system. For future caregivers working in hospitals, it allows them to take into consideration the impact of an event outside the hospital on their hospital care. It enables them to pool their responses to a possible disaster, in particular by identifying the health response (Health Response Organization) and the security response (Civil Security Response Organization).

[Thadeo, a listening service for caregivers]. / Thadeo, un service d'écoute pour les soignants.

Caregivers, like all working people, can encounter difficulties in the course of their professional activities. These difficulties, compounded by the particularities of caregiving practice, can lead to situations of isolation, overwork, exhaustion, disagreement and even ethical dilemmas in complex situations. Thadeo's free listening service offers support to caregivers who need it.

[The benefits of home visits for patients on home hemodialysis]. / Intérêt des visites à domicile pour les patients traités par hémodialyse à domicile.

The success of home hemodialysis depends on several criteria. On the one hand, the patient's willingness to be autonomous, his or her degree of understanding, the technical feasibility at home, and the presence of a third party. Secondly, the quality of initial training (which must respect the patient's rhythm) and follow-up at home. This is a true patient-caregiver partnership, based on trust. Home visits are part of this approach, and help maintain the link, as a team at Caen University Hospital can testify.

[Care, a place of affectivity and emotions]. / Le soin, lieu d'affectivité et d'émotions.

Joy, fear, disgust, anger, sadness, surprise, emotions are fleeting and natural affects that catch us off guard. Care, as a face-to-face encounter with others, in a sometimes difficult context of serious or chronic pathologies, can become a place of affectivity, all the more so as care crosses the barriers of bodily intimacy. What to do with one's emotions in care?

[Practicing bad news]. / S'entraîner à l'annonce de mauvaises nouvelles.

Simulation has been in full expansion in France for the last ten years. In many teams, the use of procedural or high-tech simulation has been a new pedagogical means of training teams to manage emergency situations in different contexts. But simulation is also useful in other situations such as bad news.

[Complex psychotrauma and caregiver positioning]. / Psychotraumatisme complexe et positionnement soignant.

People who have suffered repeated traumatic events often present a complex clinical condition. This requires a very wide range of care and active coordination between health, social, legal and cultural workers. Nursing missions are at the heart of this coordination. They require availability and specific skills, especially with refugees. Care tools such as relaxation can also be used.

[Professional commitment and work in psychiatry]. / L'engagement professionnel et le travail en psychiatrie.

The practice of care in a psychiatric service, whether outpatient or inpatient, appears more than ever to be a personal commitment. How can we conceive it despite the difficulties of the profession, which make new professionals hesitate to join it? There is now open talk of a "crisis in psychiatry", of professionals leaving the profession. However, many observers and caregivers manage to give meaning to this demanding profession, at the crossroads between disciplines and institutions. The activity is constantly evolving, shaped as much by the advent of multiple theoretical frameworks as by societal movements. The number of people using this discipline, which is now also called "mental health" care, is constantly increasing, while at the same time all the players are struggling to recruit professionals. However, patients who have become users can testify to the quality of the caregivers.

[Caregivers' experiences with extreme prematurity]. / Vécu des soignants face à l'extrême prématurité.

Neonatal intensive care units receive very immature premature newborns. Mortality and morbidity rates remain high in this particularly fragile population. Caregivers involved with the child and his or her parents may experience moral distress. There are few studies on the experience of caregivers in these situations. Training, service architecture and sharing of experiences with specifically trained psychologists can improve this experience in these highly technical services.

[Trauma of intensive care workers in the face of a health crisis: a two-step psychological support]. / Traumatisme des soignants de réanimation face à la crise sanitaire.

The COVID-19 crisis has profoundly affected intensive care units. To protect themselves from the violence of the circumstances, the caregivers relied on their team membership, but it is in the aftermath that these situations seem to take their full traumatic dimension. A clinical case illustrates the two-step work of the psychologist with the caregivers and his role in the traumatic elaboration passing by an individual and collective reconquest of the caregiving function.