Have patients become impatient to act in our healthcare system?

For some 40 years now, in France, the progressive recognition of the knowledge and experience of patients has been accompanied by an institutionalization of their participation and a diversification of the spaces in which they act. In this contribution, we offer an analytic look at the different forms of patient participation in the health world, in France and abroad. This non exhaustive overview underlines the need to pay particular attention to the conditions required if the shared experiences of care providers and patients are to serve as an occasion to optimize and revitalize the approach to medical care.

Type 2 diabetes patient education in Reunion Island: perceptions and needs of professionals in advance of the initiation of a primary care management network.

AIM: This study focused on issues in the education of type 2 diabetes patients in primary care on Reunion Island which, in a medical context, is broadly similar to metropolitan France, but with a much greater prevalence of diabetes. The aim was to assess the perceptions, training, reported practices and needs of health care providers in the field of patient education in advance of the initiation of a health care management network for diabetic patients. METHODS: A total of 74 physicians and 63 nurses completed a detailed questionnaire comprising 52 items divided into six parts: professional activity, initial and postgraduate training, educational practices, objectives of patient education, perceived barriers and prospects for optimization. RESULTS: Educational activities for patients are almost nonexistent. Information and explanations given during a face-to-face encounter with the physician or nurse that combine technical and caring approaches are the main reasons reported for patient education. The obstacles reported by professionals that need to be overcome are limited available time, patient passivity and inadequate staff training. Practitioners and nurses are poorly taught as regards patient education and self-management of chronic diseases. The suggested improvements include professional acknowledgement, more convenient and available tools and improved postgraduate training. CONCLUSION: Patient education in primary care is still mostly an illusion, with many gaps that hinder education for both patients and professionals. The training of health professionals needs to meet the challenge of chronic diseases by integrating aspects from the fields of education and the social sciences.