[Pre-, per- and post-allogeneic haematopoietic stem cell transplant rehabilitation (Atelier SFGM-TC)]. / Réhabilitation pré, per et post-allogreffe de cellules souches hématopoïétiques (atelier SFGM-TC).

Allogeneic transplantation of haematopoietic stem cells is still the only curative treatment for certain haematological malignancies. This treatment can be responsible for a number of side-effects, leading to multiple and interdependent physical and psychological deficiencies that affect patients' quality of life and social participation, and can be experienced as a handicap, sometimes for several years after the transplant. For several years now, the integration of post-transplant rehabilitation pathways has been becoming more widespread, and initiatives to provide multidisciplinary care at an increasingly early stage are being studied. The aim of this early management is to improve the patient's overall functional state before, during and after the transplant, in order to limit the impact of the treatment and ensure the quickest possible return to a life that is as satisfying as possible. The international literature and the experiments carried out throughout the French-speaking world describe heterogeneous practices. Based on this literature and experience, the aim of this study is to issue homogenous recommendations for good clinical practice and to identify areas for further research into pre-transplant, per-transplant and post-transplant rehabilitation of haematopoietic stem cells.

[Medico-economic evaluation of the PRADO-BPCO post-exacerbation support program]. / Évaluation médicoéconomique du PRADO-BPCO, programme d'accompagnement post-exacerbation.

INTRODUCTION: The "Programme d'Accompagnement du retour à Domicile" (PRADO) COPD is a home discharge support program dedicated to organizing care pathways following hospitalization for COPD exacerbation. This study aimed at assessing its medico-economic impact. METHODS: This was a retrospective database study of patients included in the PRADO BPCO between 2017 and 2019. Data were extracted from the National Health Data System. A control group was built using propensity score matching. Morbi-mortality and costs (national health insurance perspective) were measured during the year following hospitalization. RESULTS: While the proportion of patients with a care pathway complying with recommendations from the National Health Authority was higher in the PRADO group, there was no significant effect on mortality and 12-month rehospitalization. In the PRADO group, the rehospitalization rate was lower when the care pathway was optimal. Healthcare costs per patient were 670 € higher in the PRADO group. CONCLUSIONS: The PRADO COPD improves quality of care but without decreasing rehospitalizations and mortality, although rehospitalizations did decrease among PRADO group patients benefiting from an optimal care pathway.

[Time and space in the care pathways of women suffering from breast cancer]. / Temps et espaces dans les parcours de soins de femmes souffrant d'un cancer du sein.

Facing breast cancer, women in precarious situations are more likely to be diagnosed at an advanced stage, and when detected at the same stage, they are more to die as well as faster. In this paper, we analyze a corpus of 40 semi-structured interviews conducted in six cancer services in hospitals of the Paris area on the care pathways of women with breast cancer. The analysis focuses on the beginning of the pathways (until the first treatments) and concentrates on their spatial and temporal dimension in the light of precariousness. Depending on the women's situations with regard to precariousness, the spatial and temporal organization of the pathways differs. There are socially differentiated latency periods that delay diagnosis (prior to meeting a medical professional) or the beginning of treatment (in relation to rights, the responsiveness of the health care system, and the interactions between women and the system). Spatially, the geometry of the pathways is variable and reflects different expectations of health institutions and medical staff according to the social profiles of the women. However, a detailed analysis of the pathways allows us to nuance these differences in terms of precariousness. The women's capacity to be autonomous, their network of contacts, the accessibility and responsiveness of the health care system, as well as the sensitive and emotional dimension of this stressful event affect the pathways both in terms of time and space.

[Nurses, a lever for reinforcing the healthcare offer]. / L'infirmier, un levier pour renforcer l'offre de soins.

Nurses are omniscient in the French healthcare system. They are an essential link in the healthcare system, and their added value is unquestionable. The profession needs to be revamped to keep pace with current developments in nursing practices and the needs of the population.

[Collaboration between advanced practice nurses and physicians: a tool to enhance the care offered]. / La collaboration entre l'IPA et le médecin, un outil au service de l'offre de soins.

The role of advanced practice nursing in France is still in its definition phase. While the prefiguration of the model was mainly in primary care, notably through the activities of the Asalée association, the first university graduates are mainly future hospital professionals, with a specialized orientation. Whether working in general or organ medicine, the advanced practice nurse (APN) is committed to making the patient's care experience more fluid, as part of a multi-professional team. Thanks to the acquisition of new skills and a structuring legal framework, collaboration between doctors and APNs is becoming a lace-making process, to best meet local needs.

[The role of the coordinating nurse in a transverse clinical nutrition unit]. / Rôle de l'infirmier de coordination dans une unité transversale de nutrition clinique.

Malnutrition is a common pathology, often underdiagnosed, and is associated with numerous chronic diseases. Transversal clinical nutrition units (TCNU) are being implemented to improve the screening and management of malnutrition. The coordinating nurse plays a key role within a TCNU: organizing and coordinating personalized care pathways for malnourished patients, especially those with complex pathologies requiring multidisciplinary care. This article outlines the responsibilities of the coordinating nurse based on the experience of the TCNU established at the Pitié-Salpêtrière Hospital (Assistance Publique-Hôpitaux de Paris).

[The added value of a patient pathway nurse coordinator in prehabilitation and rehabilitation in surgery]. / La plus-value d'un infirmier coordinateur de parcours patient dans la préhabilitation et la réhabilitation en chirurgie.

The nurse coordinator works within a healthcare network to ensure the continuity and quality of the care provided to patients. They act as the interface between medical, paramedical and social care. In some departments, they coordinate the surgical prehabilitation and enhanced rehabilitation program, which aims to optimize the physical, nutritional and psychological state of each patient prior to major surgery. Knowing how to guide patients and their families, advise them and re-explain the medical prescription for discharge sheds light on their situation and reassures them, while enabling them to plan their discharge.

[Optimizing the management of heart failure: structuring the care pathway]. / Optimisation de la prise en charge de l'insuffisance cardiaque : structuration du parcours de soins.

The incidence of chronic heart failure continues to rise in Western countries, justifying the implementation of an optimized multidisciplinary organization based on medical and nursing convergence. Around the main heart failure, assistance and transplantation unit at Toulouse University Hospital, several structures have been put in place to better manage heart failure patients and improve their care pathway.

[The nurse coordinator, a central element in the improved rehabilitation pathway after surgery]. / L'infirmier coordonnateur, élément central du parcours de réhabilitation améliorée après chirurgie.

Enhanced Rehabilitation after Surgery (ERAS) is a paradigm involving a new organization of surgical care pathways. Its main objective is to maximize the rehabilitation of people undergoing surgery. It is a multimodal approach based on evidence-based data and high-level recommendations, combined with daily assessment of the quality of the patient's surgical pathway using clinical indicators grouped around some twenty recommendations. This implementation requires the involvement of all professionals involved in the care process. The ERAS nurse coordinator is one of them.

[Nurse coordinators and IPAs in Parkinson's expert centers: what are their roles?] / Infirmières coordinatrices et IPA en centre expert Parkinson : quels sont leurs rôles ?

The creation of Parkinson's expert centers (PEC) led to the emergence of new nurses, known as coordination nurses. And in 2018, the emergence of advanced practice nursing led to the creation of a new category of professionals, advanced practice nurses (APN). Nurses coordinators and APN play a major role in meeting the public health challenges posed by Parkinson's disease. They are the guarantors of the implementation of a personalized care pathway, the aim of which is to offer patients an optimized quality of life. They forge an indispensable link between the city's healthcare services and the PEC, collaborating with the many healthcare professionals who work with people suffering from Parkinson's disease.

[Can health forums dedicated to breast cancer be useful to caregivers? Analysis of initial messages on the National League Against Cancer forum over a one-year period]. / Les forums de discussion dédiés au cancer du sein peuvent-ils être utiles aux soignants ? Analyse des messages initiaux du forum de la Ligue nationale contre le cancer pendant une année.

OBJECTIVES: Forums are a source of health information and exchange. They can be studied to determine patients' needs and improve caregivers' practices. The aim of this study was to identify the needs of breast cancer patients based on messages posted on a discussion forum. METHODS: Initial messages posted in 2021 on the Ligue nationale contre le cancer (LNCC) breast cancer forum were analyzed quantitatively. Message content was classified into three categories: testimonial, request for advice or request for medical opinion. The tone of the message (positive, neutral, or negative) was recorded. The temporality of the illness during which the patient expressed herself was defined. Analysis was carried out on the initial messages using the Chi2, Fisher, and Kruskal-Wallis tests, with a significance level of<0.05. RESULTS: In 2021, 640 initial messages posted on the LNCC forum dedicated to breast cancer were analyzed. Messages were posted by 312 authors, including 275 patients and 37 family members. Three main types of messages were identified: requests for medical advice (n=339), advice (n=164), and testimonials (n=137). Requests for medical advice elicited fewer responses than testimonials (P<0.001). A need for supportive care was identified in 42.8% of messages, mostly concerning social (17.3%) and psychological (13%) care. CONCLUSION: Our study revealed a need for more information especially regarding the social impact of the disease and the side-effects of treatment. The period of greatest need of information was the diagnostic waiting time. However, patients using discussion forums are not representative of all women with breast cancer and our results should not be generalized to all patients treated for breast cancer.

[Percutaneous aortic valve replacement: outcome of patients evaluated by EMG at Toulouse University Hospital preprocedure]. / Remplacement valvulaire aortique par voie percutanée : devenir des patients évalués par l'EMG au CHU de Toulouse en préprocédure.

Transcatheter Aortic Valve Implantation has become the preferred method of aortic valve replacement in the elderly. Preoperative standardized geriatric assessment (SGA) helps guide the decision to proceed, taking into account geriatric parameters not targeted by surgical risk scores. This is a descriptive, retrospective study of patients who underwent EGS at the Toulouse University Hospital, analyzing their length of stay and postoperative care pathway.

[Heart failure cooperation protocol: A new way of thinking about the care of heart failure patients]. / Protocole de coopération en insuffisance cardiaque : penser autrement la prise en charge.

To meet the care needs of heart failure patients, a nationwide cooperation protocol has been developed. This heart failure cooperation protocol (PCIC) enables nurses to acquire new skills by delegating medical acts.

[Transition, a complex and holistic process]. / La transition, un processus complexe et holistique.

Transition is a complex process that enables a young person living with a chronic illness to become an adult. It begins early in adolescence and ends once the transfer to the adult service is complete. The high risk of disruption during this transition calls for coordinated care focused on the patient and his or her life course. Many programs are dedicated to this delicate stage, including Jump, developed within the neurology department of a Paris hospital.

[The benefits of implementing IPA psychiatry and mental health in prisons]. / Intérêt de l'implantation IPA psychiatrie et santé mentale en milieu carcéral.

Supporting people placed under house arrest is a contemporary challenge. Between popular demand for risk control, judicial demand for recidivism prevention and hospital prerogatives, the articulation between care providers is often perilous. The advanced practice nurse plays a key role in the transition from inside to outside.

[The city-hospital link in the care of severely obese patients]. / Le lien ville-hôpital dans le parcours de soins des patients obèses sévères.

After the initial weekday hospital stay, a personalized, multidisciplinary care pathway is offered to each patient followed at the specialized obesity center (CSO). This article illustrates the support approach adopted by the CSO at Caen Normandy University Hospital.

[The pain resource nurse, the guiding light for implanted neurostimulation]. / L'infirmière ressource douleur, fil conducteur de la neurostimulation implantée.

Chronic pain affects a large number of French people, and has a considerable impact on their quality of life. Spinal cord stimulation is a technique for managing and reducing this pain, which is often resistant to (poorly tolerated) medication. Between the consultation with the specialist and the operation, a specific procedure is imperative: the pre-implantation assessment. Numerous appointments and tests are required to verify the patient's eligibility. The pain resource nurse plays a key role in supporting the patient through this process: she is the guiding light in the care process.

[Empowering patients suffering from chronic pain]. / Rendre son pouvoir d'agir au patient souffrant de douleur chronique.

Living with chronic, daily pain generates a variety of reactions for every individual. To provide the best possible support for sufferers, management strategies have diversified, becoming multimodal and encompassing pharmacological, non-pharmacological, psychological, physiotherapeutic and educational therapies. It is within this framework that therapeutic patient education, hypnoanalgesia and self-hypnosis have been deployed.

[Care pathways for young transgender people]. / Parcours de soins des jeunes personnes transgenres.

Gender incongruence corresponds to the mismatch between gender identity and gender/sex assigned at birth gender/sex assigned at birth. It can be accompanied by psychological distress. In line with the literature, an increase in consultations for gender incongruence has been observed, especially among young people. Multidisciplinary care should be offered to this population; here we provide an example of healthcare proposed at the university hospital of Nancy.

[The place of IPA in the follow-up of elderly patients with acute myeloid leukemia]. / La place de l'IPA dans le suivi du patient âgé porteur d'une leucémie aiguë myéloïde.

Since 2020, a promising new treatment has been offered to elderly patients with acute myeloid leukemia. However, adverse events complicate their treatment, which is performed on an outpatient basis. The advanced practice nurse could provide assistance in the follow-up of these elderly and polypathological patients, who require regular clinical and biological monitoring, adaptation of their therapies and the establishment of city-hospital coordination likely to guarantee their maintenance at home.