[Psychosocial skills and therapeutic education of patients with type 1 diabetes: a systematic review]. / Compétences psychosociales et éducation thérapeutique du patient diabétique de type 1: une revue de littérature.

INTRODUCTION: It has been established that the psychosocial skills of patients need to be strengthened in the context of therapeutic patient education, to help them to more effectively manage their disease and the associated treatments. This intervention is barely feasible at the present time because of unresolved conceptual, methodological and operational problems, particularly problems concerning the identification and evaluation of the psychosocial skills to be developed. OBJECTIVES: This study established an inventory of psychosocial skills targeted by educational intervention, and identified the criteria used to demonstrate acquisition of these skills. METHOD: A systematic review of the literature was performed on 60 articles dealing with evaluation of educational intervention in patients with diabetes. RESULTS: Skills were identified in one quarter of these articles. They referred to communication and interpersonal relations, decision-making and critical thinking, and also to coping and self-management. These articles used more often used medical endpoints than psychosocial endpoints. DISCUSSION: Psychosocial skills are poorly explained and poorly evaluated. Interventions, often based on a biomedical approach, focus more on self-care skills. The paper concludes on the importance of developing a psychosocial approach to provide a better conceptualization of the notion of social skills.

The stigma of smoking among women: A systematic review.

BACKGROUND: Smoking stigma has been well documented, but little is known regarding its specific features and effects on women. Notably, women face unique social, cultural, and economic challenges that may interact with smoking stigma and impact health outcomes. This review investigates the extent to which smoking women encounter and internalise stigma, while examining the various coping mechanisms they employ to manage these negative experiences. METHODS: In November 2022, major databases were systematically searched with no time restrictions. After applying inclusion and exclusion criteria, 23 studies (three quantitative and 20 qualitative) met our criteria. We conducted a quality assessment and summarised the findings pertaining to public stigma, self-stigma, and coping strategies. RESULTS: The stigma about smoking emerges from a variety of sources, such as family, healthcare providers, or internet forums. Women smokers are universally aware of the negative image they have in society. Yet, their experiences and management of the stigma of smoking are shaped by other variables such as cultural background, social class, or motherhood status. Smoking stigma produces ambivalent effects, such as concealment, reduced usage of support services, and to a lesser extent, smoking cessation motivation. CONCLUSIONS: These results indicate that smoking stigma is an important social justice and public health issue and that further research is needed to better prevent its effects on women's well-being and health behaviours.

'Adolescents are reckless': Representations at stake in the construction of the relationship of trust in paediatric diabetology.

A total of 10 focus groups were held with adolescents living with diabetes, their parents and health professionals in order to explore their needs in therapeutic education. The analysis showed that the relationship of trust was a central concern for a number of participants. Several adults were divided between a feeling of confidence inspired by the need to empower adolescents to cope with the chronic condition and a sense of distrust inspired by the idea of carelessness and irresponsibility thought to characterize adolescence. Adolescents, for their part, seemed relatively clear-sighted about how they can be perceived, and blamed adults for not trusting them. These findings emphasize the importance of considering the representations at stake in the dynamics of the therapeutic relationship in order to better understand the construction of the relational climate.

Legitimizing Intimate Partner Violence: The Role of Romantic Love and the Mediating Effect of Patriarchal Ideologies.

Romantic love in heterosexual relationships is recognized as an important aspect to be considered in relation to the psychosocial mechanisms associated with the persistence of intimate partner violence and the help-seeking barriers faced by female victims. However, few studies have explored the processes underlying the relationship between this form of love and attitudes toward this kind of violence. To do this, the current study aims to analyze the relationship between the adherence to romantic love and the legitimization of intimate partner violence (i.e., perceived severity of violence, victim blame, and exoneration of the perpetrator). It was also to test the mediating effect of patriarchal ideologies (i.e., ambivalent sexism and domestic violence myths) on this relationship. Two hundred thirty-five French adults (51.1% women) were surveyed. The data were analyzed with structural equation models to study the mediations between the variables considered. Consistent with our hypotheses, the results showed that the more the participants adhered to romantic love, the more they blamed the victim and exonerated the perpetrator. They also showed a positive link between romantic love, ambivalent sexism, and domestic violence myths. Finally, the results demonstrated that the relationship between romantic love and the legitimization of violence is mediatized by ambivalent sexism and domestic violence myths. The findings illustrate the need to deconstruct romantic love ideology and the psychosocial logics underlying the legitimization of intimate partner violence.

'Similar but different': Social representations of health according to gender for French youth.

This study focuses on life experiences and social representations related to gender in the context of health among young French lay people aged from 18 to 21 years (N = 47). Qualitative analysis of the discursive content of nine focus groups illuminated the lay thinking underlying gender issues in the health context. Broadly speaking, group composition (i.e. unisex, mixed) had an impact on participants' discourse construction. Through their discourses, participants came to 'naturalise' the health issues and practices of each sex/gender through the biological specificities of men and women. In addition, discourse content underscores a differentiated 'imperative of health'.

Exploring the link between stigma and social representations among people with and without schizophrenia in the French context.

We explored the representations that individuals associate with schizophrenia in the French context, as well as the relationships between their own representations and the representations they attribute to other French people. Data were collected from individuals in the general population (N = 98) and those with schizophrenia (N = 59). Using a verbal association technique, participants produced words spontaneously based on the inductor word "schizophrenia". The instruction invited them to respond on their own behalf, but also "as the French would in general". Prototypical and similarity analyses were carried out. Results indicated that the representations of participants from the general population were associated with a vocabulary relative to schizophrenia as an illness and with stigmatizing stereotypes, such as madness, dangerousness and split personality when they expressed themselves on their own behalf, as well as psychopathy and confinement when they imagined how French people express themselves regarding schizophrenia. Participants with schizophrenia who had a clear view of the general population's stereotypes mostly referred to negative experiences and emotions such as loneliness, suffering and fear. These findings underline the value of considering the representations associated with schizophrenia in designing awareness campaigns, but also in clinical care for people with schizophrenia.

Representations and experiences of well-being among diabetic adolescents: Relational, normative, and identity tensions in diabetes self-management.

We explore representations of well-being in adolescents with Type 1 diabetes in order to better understand their expectations and needs in therapeutic patient education. In total, 28 interviews were performed and then submitted to thematic content analysis and lexicometric analysis. Results show the intervention of psychosocial processes in the relationship that adolescents maintain with well-being and self-management. More specifically, we observed that well-being is impacted by areas of tension between the expectations of adolescents and the therapeutic objectives expressed by health professionals. These tensions should be taken into account in the conception, implementation, and evaluation of therapeutic education programs.

Representações sociais e educação terapêutica: questões teórico-práticas / Social representations and therapeutic education: theoretical-practical questions

Resumo Apresentamos a contribuição da psicologia social da saúde por meio da abordagem sociorrepresentacional para refletir acerca da educação terapêutica do(a) adolescente com diabetes mellitus tipo 1. O adoecimento crônico na adolescência coloca desafios específicos para o cuidado, o olhar psicossocial permite compreender a prática de avaliação e o fortalecimento das habilidades do paciente contextualizando a educação terapêutica enquanto conjunto de relações sociossimbólicas entre os atores da situação. Essa abordagem pode servir como uma ferramenta teórico-metodológica e prática para alcançar um diagnóstico psicossocial e um planejamento de intervenção. Um programa de três pesquisas realizadas na França com adolescentes diabéticos, suas famílias e profissionais ilustra questões e desafios contemporâneos no campo da educação terapêutica, centrando sua análise nos significados que os atores mobilizam para, assim, determinar estratégias de intervenção adaptadas às tensões psicossociais que possam surgir no cuidado. Ressaltamos a importância das dinâmicas socioidentitária e ideológica advindas do contexto social e cultural de referência dos atores engajados na educação terapêutica.

Abstract We introduce the contribution of social psychology of health to the reflection on the therapeutic education of adolescents with type 1 diabetes mellitus via a socio-representational approach. Chronic illnesses during adolescence pose specific challenges for health care, and the psychosocial perspective allows one to understand the practice of evaluating and consolidating patient's abilities, contextualizing therapeutic education as a set of socio-symbolic relations between the social actors involved in such scenario. This approach can be used both as a theoreticalmethodological and practical instrument to achieve a psychosocial diagnosis and intervention planning. A program of three studies conducted in France with diabetic adolescents, their families and professionals, illustrates contemporary issues and challenges in the field of therapeutic education. This study is focused on the meanings mobilized by the social actors to determine intervention strategies adapted to the psychosocial tensions that may arise in health care. We emphasize the importance of the socio-identity and ideological dynamics arising from the social and cultural context of the social actors engaged in therapeutic education.