[Obstacles, difficulties, and facilitators in setting up a research project funded by the Hospital Program for Nursing and Paramedical Research : Lessons learned from a mental health research project] / Freins, difficultés et facilitateurs dans la mise en place d'une recherche financée par le Programme hospitalier de recherche infirmière et paramédicale (PHRIP) : retour d'expérience d'un projet de recherche en santé mentale.

Nursing research continues to grow and become self-sustaining. It was in this context that we received funding from the Hospital Program for Nursing and Paramedical Research for our research project on schizophrenia. Schizophrenia is a mental disorder that affects 1% of the general population, and is a crippling disease both cognitively and socially. Cognitive remediation and therapeutic education are nursing practices deemed suitable for the psychosocial rehabilitation of schizophrenia patients. We hypothesized that a therapeutic education program placed upstream of cognitive remediation would have beneficial effects. We planned to include eighty patients aged eighteen to sixty, randomized into two groups, one combining cognitive remediation and therapeutic education, the second using just cognitive remediation. Each patient was assessed using a range of neuropsychological scales. Due to difficulties encountered in including and following up with participants, our statistical results could not be used. We therefore turned our focus to the factors that facilitate and hinder the setting up of a nursing research project. We organized these factors into three areas : those related to the nurse ; those related to the care facility and the organization ; and those related to the research. The results were consistent with the literature and show how important it is to encourage nurses to be more involved in a scientific approach.

Freins, difficultés et facilitateurs dans la mise en place d'une recherche financée par le Programme hospitalier de recherche infirmière et paramédicale (PHRIP) : retour d'expérience d'un projet de recherche en santé mentale.

Nursing research continues to grow and become self-sustaining. It was in this context that we received funding from the Hospital Program for Nursing and Paramedical Research for our research project on schizophrenia. Schizophrenia is a mental disorder that affects 1% of the general population, and is a crippling disease both cognitively and socially. Cognitive remediation and therapeutic education are nursing practices deemed suitable for the psychosocial rehabilitation of schizophrenia patients. We hypothesized that a therapeutic education program placed upstream of cognitive remediation would have beneficial effects. We planned to include eighty patients aged eighteen to sixty, randomized into two groups, one combining cognitive remediation and therapeutic education, the second using just cognitive remediation. Each patient was assessed using a range of neuropsychological scales. Due to difficulties encountered in including and following up with participants, our statistical results could not be used. We therefore turned our focus to the factors that facilitate and hinder the setting up of a nursing research project. We organized these factors into three areas : those related to the nurse ; those related to the care facility and the organization ; and those related to the research. The results were consistent with the literature and show how important it is to encourage nurses to be more involved in a scientific approach.

[Psychopathology of intrafamily violence]. / Psychopathologie des violences intrafamiliales.

Intrafamily violence is a major public health problem, due to its frequency and the severity of its consequences. The aim is to establish links between violence and psychopathology, for the perpetrators as well as the victims. Data reveal a higher frequency of certain mental health disorders and history of abuse in the perpetrators, without it being systematic. It is important to adopt a global and multidisciplinary approach, and a holistic perspective faced with the people concerned by these acts. Health professionals, from the social sector and associations must therefore work together in a network to manage and attempt to prevent crisis situations.

Forensic Autopsy of Human Decomposed Bodies as a Valuable Tool for Prevention: A French Regional Study.

Post mortem changes due to putrefaction sometimes make people wrongly consider the autopsy of a decomposed body as unrewarding. A 5-year retrospective study was conducted and included all types of decomposed body subject to medicolegal autopsy, excluding bone remains and charred bodies. Sociodemographic, medical, and forensic data were collected. In the 350 cases included, most were socially isolated mature males discovered at home. The cause of death was determined in 80% of cases, and the manner of death in 86.6%. Identification was considered effective in 99.7% of cases by the chief prosecutor. The authors show that such an autopsy usually answers most questions raised by the investigation but can also be a valuable tool in the prevention, making it possible to define a profile of persons at risk of dying alone. In addition, they underline that forensic scientists should be cautious in their identification of conclusion as diverging views regarding the concept of "presumed identity" may lead to ethical tensions between judiciary and prosecutors as well as the medical community.

FORENSIC Autopsy of People Having Committed Suicide in 2002 and in 2012: Comparison of Epidemiological and Sociological Data.

This work compares epidemiological and sociological data on persons having committed suicide in 2002 and in 2012 through a retrospective study of every suicide case having led to an autopsy at the Institute for Forensic Medicine of Lyon in 2002 and in 2012. The study included sociodemographic data, medical data, and toxicological data. A total of 486 cases were included (242 cases in 2002 and 244 cases in 2012). People committing suicide were on average older in 2012 than in 2002 with a larger proportion of over 55. There was also an increase in the proportion of psychiatric antecedents (p < 0.001). Whatever the date of death by suicide, the most affected age range is the 45-54. The results highlight the necessity of bolstering the prevention plans, in particular for people over 45.

[Screening psychological distress in breast cancer patients on treatment]. / Dépistage de la détresse psychologique chez les patientes en cours de traitement du cancer du sein.

OBJECTIVE: The aim of our study was to evaluate emotional distress among women with breast cancer treated by radiotherapy, using a Visual Analogue Scale (an adaptation of the "Distress Thermometer" French version) associated with a Needs Scale with several items, in order to identify patients requiring psychological care. METHOD: Our sample is composed of 277 women treated for breast cancer with radiotherapy. Our psychological evaluation is made of a first enquiry using a visual analogue distress scale and complemented by a Needs Scale with several items. A grade above 3 on the visual analogue distress scale is a reliable indicator; a grade above 4 out of 20 leads us to propose the patient a consultation with a psychologist. RESULTS: Two hundred and sixty-four female patients with a mean age of 61 years are the object of the study. Among them, 59.2% of patients display a disarray of low intensity (psychological suffering graded between 0 and 2) whereas 40% show a grade equal or superior to 3, considered as pathological on a psychological side: 30% of the patients have a grade between 3 et 5 and less than 2% of the patients display a grade reaching 9 or 10. Concerning the Needs Scale, more than 80% of the patients show a total score below 10 out of 20 and we observe a positive correlation between the total score of the Needs Scale with several items and the Visual Analogue Distress Scale score. CONCLUSION: Our results highlight the difficulty for most of the patients to cope with emotional distress linked to their disease. We discuss the necessity to increase awareness among caregivers on this psychological distress, through the use of simple tools such as a Visual Analogue Scale associated with a Needs Scale, so as to provide a holistic care for women with breast cancer.

[Emergency nurse faced with death in pre-hospital situations]. / L'infirmier urgentiste face à la mort en pré-hospitalier.

The occurrence of a death in the out-of-hospital environment is often brutal and the reactions of the deceased's family and friends, unprepared for this event, can be unpredictable. After the technical procedures have been carried out and within a limited period of intervention, the caregivers, and in particular the nurse of the mobile emergency and intensive care service, must provide the family and friends with support enabling them to begin the grieving process. To help the caregivers in this mission, a pedagogical tool remains to be developed.