[Sexual health in female under treatment for opiate dependence using diacetylmorphine]. / La sexualité au féminin chez les patientes traitées par diacétylmorphine.

Sexual health is a key element to the well-being and quality of life of individuals. However, it is rarely incorporated into care delivery for women with an addictive condition. Female with severe dependence to opiate have their medical and social conditions improved by diacetylmorphine treatment. Which allows them to escape situations of high-risk of sexual violence. However, this pharmacotherapy can also induce adverse effects on the sexual sphere. This paper describes the relevance of integrating psycho-socio-sexological counselling into the care provision for the opiate dependence. The counselling should be oriented to respond to the specific relational and sexual issues faced by these female patients and empowering them on their lives and in recovering a better quality of life.

La santé sexuelle constitue un élément important au bien-être et à la qualité de vie, or c'est un élément peu abordé au cours des soins des patientes souffrant de trouble addictologique. Le traitement de diacétylmorphine améliore la situation médicale et sociale des patientes souffrant d'une dépendance sévère aux opiacés et leur permet de sortir de situations à haut risque de violences sexuelles ; mais il peut également induire des effets indésirables sexuels. Cet article décrit l'importance d'intégrer à la prise en charge addictologique un accompagnement psychosocio-sexologique axé sur les difficultés sexuelles et relationnelles spécifiquement rencontrées par les patientes afin de leur offrir la possibilité de retrouver du pouvoir sur leur vie et une meilleure qualité de vie.

[Relationship and dependency in a hemodialysis unit]. / Relation et dépendance dans un service de dialyse.

Dialysis substitutes a deficient organ. To perform dialysis requires qualified nurses and physicians, necessitates time and is an expensive procedure. In a society which valorises autonomy, dialysis leads to dependency and therefore is associated with a very bad image. This loss of autonomy is one of the most common complains of dialyzed patients. For this reason, patients and caregivers valorise renal transplantation. It illustrates how the concept of autonomy and dependency may influence the life experience of dialyzed patients. We propose another approach which is oriented to the aspects of relations during dialysis. This approach is illustrated by two case reports. This concept allows to change the perception of the dialyzed patient and thus to change his life experience.