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1.
Qual Life Res ; 30(2): 425-436, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33025372

RESUMO

PURPOSE: Cancer patients often report low self-esteem and high emotional distress. Two factors seem particularly linked to these symptoms: emotion regulation strategies and mindfulness. The interest of hypnosis and self-care to relieve these symptoms is not well documented. Our randomized controlled trial aimed at assessing the effect of a group intervention combining self-hypnosis and self-care on self-esteem, emotional distress, emotion regulation, and mindfulness abilities of post-treatment cancer patients, as well as investigating the links between these variables. METHODS: One hundred and four patients who had suffered from cancer were randomized into the intervention group (N = 52) and the wait-list control group (N = 52). They had to answer questionnaires before (T1) and after the intervention (T2). Nine men were excluded from the analyses, leading to a final sample of 95 women with cancer. Group-by-time changes were assessed with MANOVA, and associations with self-esteem and emotional distress were investigated with hierarchical linear regression models. RESULTS: Participants in the intervention group (mean age = 51.65; SD = 12.54) reported better self-esteem, lower emotional distress, a decreased use of maladaptive emotion regulation strategies, and more mindfulness abilities after the intervention, compared to the WLCG. This increase in mindfulness explained 33% of the improvement of self-esteem and 41.6% of the decrease of emotional distress in the intervention group. Self-esteem and emotional distress also predicted each other. CONCLUSION: Our study showed the efficacy of our hypnosis-based intervention to improve all the investigated variables. Mindfulness predicted the improvement of self-esteem and emotional distress. The primary impact of our intervention on mindfulness abilities seems to explain, at least in part, its efficacy. Registration: ClinicalTrials.gov (NCT03144154). Retrospectively registered on the 1st of May, 2017.


Assuntos
Hipnose/métodos , Intervenção Baseada em Internet/tendências , Atenção Plena/métodos , Qualidade de Vida/psicologia , Autocuidado/métodos , Autoimagem , Estresse Psicológico/psicologia , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Adulto Jovem
2.
Patient Educ Couns ; 103(1): 5-14, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31447194

RESUMO

OBJECTIVES: Several concepts on collaboration between patients and healthcare systems have emerged in the literature but there is little consensus on their meanings and differences. In this study, "patient participation" and related concepts were studied by focusing on the dimensions that compose them. This review follows two objectives: (1) to produce a detailed and comprehensive overview of the "patient participation" dimensions; (2) to identify differences and similarities between the related concepts. METHODS: A scoping review was performed to synthesize knowledge into a conceptual framework. An electronic protocol driven search was conducted in two bibliographic databases and a thematic analysis was used to analyse the data. RESULTS: The search process returned 39 articles after exclusion for full data extraction and analysis. Through the thematic analysis, the dimensions, influencing factors and expected outcomes of "patient participation" were determined. Finally, differences between the included concepts were identified. CONCLUSION: This global vision of "patient participation" allows us to go beyond the distinctions between the existing concepts and reveals their common goal to include the patient in the healthcare system. PRACTICE IMPLICATIONS: This scoping review provides useful information to propose a conceptual model of "patient participation", which could impact clinical practice and medical training programs.


Assuntos
Participação do Paciente , Humanos
3.
Rev Med Liege ; 73(12): 621-628, 2018 Dec.
Artigo em Francês | MEDLINE | ID: mdl-30570233

RESUMO

Patient engagement in health care system can be regarded as a lever for the general improvement of people's health, the quality and safety of care. Among the many approaches that co-exist, the model of Patient Partner is relatively recent and declares itself as the most successful to promote this engagement. The authors of this article propose to present briefly the above model and to raise the remaining questions on its operational application. We will then present the research program «Patient Partner Approach to Care¼ (INTERREG Va) that questions the Patient Partner model in an interregional context (Wallonia - Grand Duchy of Luxembourg - Lorraine - Rhineland-Palatinate and Saarland).


Assuntos
Modelos Organizacionais , Participação do Paciente , Humanos
4.
BMC Cancer ; 18(1): 677, 2018 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-29929493

RESUMO

BACKGROUND: Prostate and breast cancer can have a lot of negative consequences such as fatigue, sleep difficulties and emotional distress, which decrease quality of life. Group interventions showed benefits to emotional distress and fatigue, but most of these studies focus on breast cancer patients. However, it is important to test if an effective intervention for breast cancer patients could also have benefits for prostate cancer patients. METHODS: Our controlled study aimed to compare the efficacy of a self-hypnosis/self-care group intervention to improve emotional distress, sleep difficulties, fatigue and quality of life of breast and prostate cancer patients. 25 men with prostate cancer and 68 women with breast cancer participated and were evaluated before (T0) and after (T1) the intervention. RESULTS: After the intervention, the breast cancer group showed positive effects for anxiety, depression, fatigue, sleep difficulties, and global health status, whereas there was no effect in the prostate cancer group. We showed that women suffered from higher difficulties prior to the intervention and that their oncological treatments were different in comparison to men. CONCLUSION: The differences in the efficacy of the intervention could be explained by the baseline differences. As men in our sample reported few distress, fatigue or sleep problems, it is likely that they did not improve on these dimensions. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT02569294 and NCT03423927 ). Retrospectively registered in October 2015 and February 2018 respectively.


Assuntos
Neoplasias da Mama/psicologia , Fadiga/prevenção & controle , Hipnose , Neoplasias da Próstata/psicologia , Qualidade de Vida , Autocuidado , Transtornos do Sono-Vigília/prevenção & controle , Estresse Psicológico/prevenção & controle , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
5.
Rev Med Liege ; 73(2): 88-93, 2018 Feb.
Artigo em Francês | MEDLINE | ID: mdl-29517872

RESUMO

The transformations of the health system and the preferences of the patients themselves have led healthcare professionals to rethink the place and role of the patient in the healthcare system, putting the caregivercare relationship and communication at the heart of public health issues. The literature shows that empathic communication is associated with better adherence to treatment, better patient satisfaction and less litigation. However, the initial training programs of health professionals are little oriented towards this field. Moreover, they are mainly based on a direct transition from theory to clinical practice with all the risks that this entails for patients. Some recent studies suggest an interest in virtual reality simulation for the development of these communication skills. This article offers an overview of the potential of virtual clinical simulation as a complementary or even alternative method to traditional teaching methods. Different studies will illustrate these innovations in the training of physicians in clinical reasoning, empathic communication, and in a highly emotional situation such as breaking bad news.


Assuntos
Comunicação , Relações Médico-Paciente , Treinamento por Simulação , Realidade Virtual , Humanos
6.
Rev Med Liege ; 72(1): 32-36, 2017 Jan.
Artigo em Francês | MEDLINE | ID: mdl-28387075

RESUMO

Health Literacy (HL) is defined as «the knowledge, motivation, and competences to access, understand, appraise and apply health information in order to make judgments and take decisions in everyday life concerning health care, disease prevention and health promotion to maintain or improve quality of life¼. This concept begins to be recognized as a priority area for action at political level in Belgium. Indeed, a limited HL may affect health by leading, for example, with poorer management of chronic diseases, more hospital admissions and premature deaths. This paper addresses the question of HL evaluation, improvement interventions as well as the many challenges that remain in this area. HL seems fundamental to the development of better health management. It would allow patients to play a more active role in health care, to involve all health stakeholders, and to contribute to a more sustainable health system. Improving HL could allow better equal access to health care.e.


Assuntos
Letramento em Saúde , Disparidades em Assistência à Saúde , Bélgica , Letramento em Saúde/métodos , Letramento em Saúde/organização & administração , Disparidades em Assistência à Saúde/organização & administração , Humanos
7.
Rev Med Liege ; 71(10): 455-459, 2016 Oct.
Artigo em Francês | MEDLINE | ID: mdl-28383854

RESUMO

Caring for a sick child represents a high risk activity that requires technical and non-technical skills related to several factors such as the rarity of certain events or the stress of caring for a child. As regard these conditions, medi¬cal simulation provides a learning environment without risk, the control of variables, the reproducibility of situations, and the confrontation with rare events. In this article, we des¬cribe the steps of a simulation session and outline the current knowledge of the use of simulation in paediatrics. A session of simulation includes seven phases following the model of Peter Dieckmann, particularly the scenario and the debriefing that form the heart of the learning experience. Several studies have shown the advantages of simulation for paediatric trai¬ning in terms of changes in attitudes, skills and knowledge. Some studies have demonstrated a beneficial transfer to prac¬tice. In conclusion, simulation provides great potential for training and research in paediatrics. The establishment of a collaborative research program by the whole simulation com¬munity would help ensure that this type of training improves the quality of care.


Assuntos
Pesquisa Biomédica/métodos , Educação Médica/métodos , Treinamento com Simulação de Alta Fidelidade , Pediatria/educação , Criança , Humanos , Aprendizagem
8.
Cancer Radiother ; 19(3): 161-7, 2015 May.
Artigo em Francês | MEDLINE | ID: mdl-25776195

RESUMO

PUPOSE: This national survey aims, on the one hand, to perform a comparative analysis of working conditions, job strain and burnout of Belgian nurses, physicists and radiation oncologists working in radiotherapy and, on the other hand, to explore the role of emotional labor in the development of stress and burnout. METHODS: We used the Working Conditions and Control Questionnaire, the Positive and Negative Occupational States Inventory, the Maslach Burnout Inventory, the negative work-home interaction subscale of the Survey Work-Home Interaction Nijmegen (NEGWHI), Perceived Organizational Support Scale and Emotional Labor Scale. One open question asked about problematic job situations. RESULTS: Ninety-eight nurses and physicists participated (33 % response rate), in addition to 66 radiation oncologists from a previous study. Although global scores of working conditions, job strain and burnout corresponded to normal scores, comparative analysis identified physicists as focus group concerning job strain and burnout. Moreover, nurses and physicists surface acting was a good predictor of job strain (ß=0.22, P=0.01), emotional exhaustion (ß=0.32, P<0.001) and depersonalization (ß=0.43, P<0.001). Nevertheless, perceived organizational support was a moderator in this relation. CONCLUSION: Radiotherapy employees were in the norms. The importance of organizational support was demonstrated to avoid potential health problems, for workers experiencing high levels of emotional demands.


Assuntos
Atitude do Pessoal de Saúde , Esgotamento Profissional/epidemiologia , Despersonalização/epidemiologia , Pessoal de Saúde/psicologia , Radioterapia , Estresse Psicológico/epidemiologia , Adulto , Bélgica , Esgotamento Profissional/psicologia , Despersonalização/psicologia , Emoções , Relações Familiares , Feminino , Grupos Focais , Física Médica , Humanos , Masculino , Pessoa de Meia-Idade , Radioterapia (Especialidade) , Apoio Social , Inquéritos e Questionários , Carga de Trabalho , Local de Trabalho
9.
Cancer Radiother ; 18(8): 723-9, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25306448

RESUMO

PURPOSE: This national survey has measured the working conditions, work engagement, job strain, burn out, and the negative work-home interaction among Belgian radiation oncologists with validated questionnaires. In fact, previous studies had in general shown an interest to burn out and its association with working conditions among oncology workers, but not focused on radiation oncologists in particular. Moreover, few studies concerned work engagement and its association with working conditions although this could be important in preventing burn out. METHODS: We used the WOrking Conditions and Control Questionnaire, the Positive and Negative Occupational States Inventory, the Maslach Burn out Inventory, and the negative work-home interaction subscale of the Survey Work-home Interaction Nijmegen. One open question asked about problematic job situations. RESULTS: Sixty-six radiation oncologists participated (30% response rate). Median scores of most of working conditions corresponded to normal scores. Control over time management (45.8) was close to low score, while control over future (60.9) was high. Median score of job strain (48.9) was normal, whereas median score of work engagement (60) was high. Median score of burn out was low. The mean of negative work-home interactions (1.1) was higher than the mean of 0.84 in a reference sample (t=4.3; P<0.001). The most frequent problematic situations referred to work organization (e.g. time pressure) and specific resources (e.g. chief support). CONCLUSIONS: Radiation oncologists showed a very high level of work engagement and experienced several job resources. However, some resources (as supervisor support) were missing and needed to be developed. These results were discussed in the context of motivational process described in the Job Demands-Resources Model.


Assuntos
Esgotamento Profissional/epidemiologia , Satisfação no Emprego , Oncologia , Motivação , Doenças Profissionais/epidemiologia , Radiologia , Estresse Psicológico/epidemiologia , Adulto , Bélgica , Feminino , Humanos , Masculino , Inquéritos e Questionários
10.
Cancer Radiother ; 17(8): 731-5, 2013 Dec.
Artigo em Francês | MEDLINE | ID: mdl-24184292

RESUMO

PURPOSE: Studies showed beneficial effect of light therapy on well-being at work. Our randomized cross-over study aimed at analyzing the effects of light exposition with the use of Luminette® in a hospital department without access to natural light. MATERIALS AND METHODS: The study design proposed an alternation between two periods of four weeks of use of Luminette® and two periods of four weeks without Luminette®. After every period, participants completed questionnaires (sociodemographic data, seasonal and general depression, anxiety, quality of sleep, slumber and general health). RESULTS: Twenty-five persons participated in the study (average age=36.5, SD=7.7). The sample showed several benefits after one month of Luminette®: diurnal slumber (P=0.046), general health perception (P=0.026), physical functioning (P=0.042), pains (P=0.023) and role limitations due to emotional problems (P=0.013). One month later, certain benefits remained without light therapy: diurnal slumber (P=0.028), pains (P=0.044) and emotional problems (P=0.042). CONCLUSION: This study has showed that the use of Luminette® could lead to similar positive results to those obtained with light therapy in other studies. This study has confirmed that Luminette® could have a positive effect on well-being at work.


Assuntos
Óculos , Recursos Humanos em Hospital/psicologia , Fototerapia/instrumentação , Adulto , Estudos Cross-Over , Depressão/prevenção & controle , Fadiga/terapia , Feminino , Promoção da Saúde , Nível de Saúde , Departamentos Hospitalares , Humanos , Masculino , Saúde do Trabalhador , Dor/prevenção & controle
11.
Br J Cancer ; 109(10): 2507-14, 2013 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-24129243

RESUMO

BACKGROUND: Although patients with cancer are often accompanied by a relative during breaking bad news (BBN) consultations, little is known regarding the efficacy of training programmes designed to teach residents the communication skills needed to break bad news in a triadic consultation. METHODS: Residents were randomly assigned to a 40-h dyadic and triadic communication skills training programme (n=48) or a waiting list (n=47). A simulated BBN triadic consultation was audiotaped at baseline, and after training for the training group, and 8 months after baseline for the waiting list group. Transcripts were analysed using content analysis software (LaComm). A coder determined the moment of bad news delivery and the relative's first turn of speech regarding the bad news. A generalised estimating equation was used to evaluate residents' communication skills, BBN timing, and the relative's inclusion in the consultation. RESULTS: Ninety-five residents were included. After training, the duration of the pre-delivery phase was found to be longer for the trained residents (relative risk (RR)=3.04; P<0.001). The simulated relative's first turn of speech about the bad news came more often during the pre-delivery phase (RR=6.68; P=0.008), and was more often initiated by the trained residents (RR=19.17; P<0.001). Trained residents also used more assessment (RR=1.83; P<0.001) and supportive utterances (RR=1.58; P<0.001). CONCLUSION: This study demonstrates that a training programme that focuses on the practice of dyadic and triadic communication skills can improve the communication skills of the participating residents in a BBN triadic consultation. Such a training should be included in resident curriculum.


Assuntos
Competência Clínica , Internato e Residência , Relações Médico-Paciente , Médicos , Revelação da Verdade , Adulto , Competência Clínica/normas , Comunicação , Educação , Educação Médica/métodos , Educação Médica/normas , Feminino , Humanos , Internato e Residência/métodos , Internato e Residência/normas , Masculino , Simulação de Paciente , Médicos/psicologia , Médicos/normas , Melhoria de Qualidade , Adulto Jovem
12.
Occup Med (Lond) ; 62(1): 34-40, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22039092

RESUMO

BACKGROUND: Although studies have shown that medical residents experience poor psychological health and poor organizational conditions, their quality of work life (QWL) had not been measured. A new tool, the Quality of Work Life Systemic Inventory (QWLSI), proposes to fill the gap in the definition and assessment of this concept. AIMS: To confirm the convergent validity of the QWLSI, analyse Belgian medical residents' QWL with the QWLSI and discuss an intervention methodology based on the analysis of the QWLSI. METHODS: One hundred and thirteen medical residents participated between 2002 and 2006. They completed the QWLSI, the Maslach Burnout Inventory and the Job Stress Survey to confirm the correspondence between these three tools. RESULTS: Residents' low QWL predicted high emotional exhaustion (ß = 0.282; P < 0.01) and job stress (ß = 0.370; P < 0.001) levels, confirming the convergent validity. This sample of medical residents had an average QWL (µ = 5.8; SD = 3.1). However, their QWL was very low for three subscales: arrangement of work schedule (µ = 9; SD = 6.3), support offered to employee (µ = 7.6; SD = 6.1) and working relationship with superiors (µ = 6.9; SD = 5.3). CONCLUSIONS: The results confirm that the QWLSI can provide an indication of workers' health well-being and of organizational performance in different areas of work life. The problem factors found among Belgian medical residents suggest that prevention should focus on reduction of work hours, development of support and change in leadership style.


Assuntos
Neoplasias/terapia , Médicos/psicologia , Qualidade de Vida/psicologia , Estresse Psicológico/epidemiologia , Tolerância ao Trabalho Programado/psicologia , Adulto , Bélgica/epidemiologia , Esgotamento Profissional/epidemiologia , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Oncologia/estatística & dados numéricos , Reprodutibilidade dos Testes , Inquéritos e Questionários
13.
Rev Med Liege ; 66(5-6): 315-9, 2011.
Artigo em Francês | MEDLINE | ID: mdl-21826969

RESUMO

In occidental countries, breast cancer is the most frequent cancer in women. In the last 30 years, the therapeutical progresses have improved the prognosis and the survival rate. However, despite this hope of recovering, women continue to face the fear of death and vulnerability. Moreover, treatments can induce cognitive, emotional and behavioral reactions in patients but also in their relatives. Therefore, the treatments are associated with physical and psychosocial dysfunctioning influencing quality of life.


Assuntos
Neoplasias da Mama/psicologia , Feminino , Humanos , Qualidade de Vida , Estresse Psicológico/complicações
14.
Br J Cancer ; 103(2): 171-7, 2010 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-20628395

RESUMO

BACKGROUND: This study aims to assess the efficacy of a 40-h training programme designed to teach residents the communication skills needed to break the bad news. METHODS: Residents were randomly assigned to the training programme or to a waiting list. A simulated patient breaking bad news (BBN) consultation was audiotaped at baseline and after training in the training group and 8 months after baseline in the waiting-list group. Transcripts were analysed by tagging the used communication skills with a content analysis software (LaComm) and by tagging the phases of bad news delivery: pre-delivery, delivery and post-delivery. Training effects were tested with generalised estimating equation (GEE) and multivariate analysis of variance (MANOVA). RESULTS: The trained residents (n=50) used effective communication skills more often than the untrained residents (n=48): more open questions (relative rate (RR)=5.79; P<0.001), open directive questions (RR=1.71; P=0.003) and empathy (RR=4.50; P=0.017) and less information transmission (RR=0.72; P=0.001). The pre-delivery phase was longer for the trained (1 min 53 s at baseline and 3 min 55 s after training) compared with the untrained residents (2 min 7 s at baseline and 1 min 46 s at second assessment time; P<0.001). CONCLUSION: This study shows the efficacy of training programme designed to improve residents' BBN skills. The way residents break bad news may thus be improved.


Assuntos
Comunicação , Educação , Internato e Residência , Relações Médico-Paciente , Revelação da Verdade , Humanos
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