"Fortunately I felt pain, or I would have thought I was on my way out": experiencing pain and negotiating analgesic treatment in the context of cancer.

OBJECTIVES: To explore cancer patients' experience of pain and coping strategies as well as beliefs and representations associated with pain, pain management and treatments. METHOD AND PARTICIPANTS: A qualitative study based on semi-structured interviews was conducted among 16 patients with cancer. The inductive research strategy adopted derived from the Grounded Theory approach and the data transcribed verbatim were gradually analyzed involving researcher triangulation. FINDINGS: The experience of pain and the coping strategies developed by patients to deal with it are shaped by the experience and representations of cancer associated with death and suffering. Pain acts both as an indication to the patients that they are still alive and as an indicator of the progression of the disease. Cancer also models patients' relationships to analgesic treatments and health care providers, since pain is an area in which patients can take back control of what is happening to them. Patients' expression of reluctance to accept analgesic treatments is also influenced by the significance of opioid treatments in this context, which are perceived as an indication that the end of life is close. CONCLUSIONS: The contextualization of pain through the particularities of cancer is critical in order to understand cancer patients' experience of pain. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS: Not only patients' knowledge but also the meaning-making of pain should be incorporated in interventions targeting pain management.

[Sophrology for developing strategies to help patients adapt to cancer treatments]. / La sophrologie pour développer des stratégies d'adaptation aux traitements du cancer.

Radiotherapy forms a significant part of cancer treatment. Caregivers support and advise patients to help them to adapt to the treatment and limit the occurrence of side effects. A nurse and member of a mobile support care and palliative care unit shares her experience of working in a team using sophrology to relieve the anxiety resulting from the wearing of a mask in radiotherapy.

Determinants of favourable opinions about euthanasia in a sample of French physicians.

BACKGROUND: The question whether euthanasia should be legalised has led to substantial public debate in France. The objective of this study in a sample of French physicians was to establish the potential determinants of a favourable opinion about euthanasia in general and when faced with a specific situation as embodied in the Humbert affair. METHODS: The study was a cross-sectional survey investigating two different samples of medical doctors: (1) those specialised in palliative care and affiliated to the French Society for Patient Accompaniment and Palliative Care; (2) medical interns (medical doctors in training course) in a French medical university (Marseille). A questionnaire was sent (email) to each voluntary participant including sociodemographics, professional status, mention of believing in God, and opinion about euthanasia (the question was designed to assess the general opinion about euthanasia and the opinion about a specific case, the Vincent Humbert' case (a man who was rendered quadriplegic, blind, and mute after an accident and has requested euthanasia). RESULTS: A total of 413 physicians participated in the research (participation rate: 48.5%). Less than half of the population were favourable to euthanasia in general and almost two-thirds of the population were favourable to Vincent Humbert's request for euthanasia. Based on the multivariate analysis, individuals believing in God and being a medical intern were significant independent factors linked to having a favourable opinion about euthanasia in general and about the Vincent Humbert's request. DISCUSSION: There is still no study in France on the development of opinion about euthanasia and its impact. The issue goes beyond the strictly professional sphere and involves broader socio-political stakes. These stakes do not necessarily take into account medical practices and experiences or the desires of end-of-life patients. The professional upheaval that the future French legal framework will doubtlessly trigger will require further research. CONCLUSION: The professional upheaval that the future French legal framework will doubtlessly trigger will require further research.

[A study of the social representations in chemotherapy: a way to analyse the relations between patients and oncologists]. / Etude des représentations sociales de la chemiothérapie: une voie d'analyse des relations entre patients et médecins oncologues.

This research aims to study social representations throughout chemiotherapy, out of a population composed of doctors specialized in Oncology on one hand, and patients dealing with cancer during their chemiotherapy on the other hand. Our methodology is situated among quantitative methods using SPSS for Anovas to analyze statistics datas, EVOQ and Alceste for the pragmatic analysis of the discourse. The datas were collected from a questionnaire including items and words associations. We were interested in chemiotherapy which appears as a social object likely to generate a representative process from which emerges a serie of adaptative strategies belonging to both cognitivo-behaviourism and emotional spheres. chemiotherapy leads to an adaptation of the patient and remains a mediator in the doctor-patient's relation. As far as representations are "action guides", the existence of a representation specific to patients and doctors, allowes us to point out, through a semantic and emotional gap a technical medicine which is, in the future, likely to tend to existentialism.