RESUMO
BACKGROUND: In oncology, the suffering of patients and the burnout of health professionals are key issues. Mindfulness meditation is a holistic approach that can help to improve well-being. While numerous studies have shown the benefits of meditation for both patients and health professionals, the added value of offering shared meditation to groups of patients, health professionals and third persons has not been assessed. Beyond strengthening the relationship between carers and patients, opening up meditation sessions to third parties (neither carers nor patients) enables patients to escape the stigma of their illness. We previously conducted a pilot study that validated the feasibility and the relevance of shared meditation with a specifically designed programme. METHODS/DESIGN: IMPLIC-2 is a two-arm randomised study designed to assess the added value of this meditation programme (optimised following the pilot study), particularly for cancer patients (our target population). People motivated to follow the programme, without previous regular practice of meditation and able to participate in the sessions are eligible. The study will include 96 participants: 16 health professionals, 16 third persons and 64 patients. The latter will be randomized in two arms: the experimental arm ("Shared" meditation) consisting of 4 mixed groups of 8 patients, 4 health professionals and 4 third parties, and the control arm ("Patient" meditation) consisting of 2 groups of 16 patients. Validated questionnaires will be used to measure the effects of the programme, notably in terms of quality of life, perceived stress, feelings of self-efficacy, qualities of mindfulness and self-compassion, and carers' burn-out. Participants' perception of a change in their quality of life and satisfaction will be measured at the end of the programme. A complementary qualitative focus-group approach will be used to optimise implementation of the programme beyond the study. DISCUSSION: The well-being of oncology patients would be improved. Dealing with overworked carers would have a beneficial impact on the way they interact with patients. In addition, encounters between the three types of population will allow otherness to be viewed differently and alleviate suffering by promoting collective humanity. TRIAL REGISTRATION: NCT06041607, registered: 09/18/2023. PROTOCOL VERSION: Version n°1.2 dated from 08/29/2023.
Assuntos
Pessoal de Saúde , Meditação , Atenção Plena , Neoplasias , Humanos , Neoplasias/psicologia , Neoplasias/terapia , Meditação/métodos , Pessoal de Saúde/psicologia , Atenção Plena/métodos , Qualidade de Vida , Projetos Piloto , Masculino , Feminino , Cuidadores/psicologia , Adulto , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
The right to visit our next of kin and friends has been challenged since the beginning of COVID epidemic. In Health and social care services, the visits’ limitation has and continues to have consequences on the persons under care, their relatives and the care workers. This article aims to review the investigations of the Normandy Ethical Support Unit who has set up at the beginning of the COVID crisis, in response to the referrals from the fields in connection with the visits’ restrictions. This crisis served as a reminder of the importance of physical contact in maintaining social interactions. It also drew collective attention to the implementation of digital tools to counterbalance geographical distance, lack of time, and more broadly the evolution of society. The deployment of the digital tool raises many ethical questions and must be considered without neglecting physical contact.
Assuntos
COVID-19 , Visitas a Pacientes , Humanos , COVID-19/epidemiologiaRESUMO
People with cancer often experience psychological distress and in addition, the practice of oncology is one of the most stressful areas of medicine for health professionals. Mindfulness meditation has been used to alleviate stress-related symptoms. We therefore ran a pilot study to assess the feasibility of a mindfulness intervention involving cancer patients, health professionals, and third persons together, as part of a comprehensive project aiming to evaluate the added value of 'meditating together'. Following on from our quantitative analyses of the project, we investigated its qualitative aspects through focus groups to explore the perceptions of participants regarding their experience. Focus groups conducted in 7 patients, 7 health professionals, and 8 third persons after the intervention showed that 'meditating together' was generally appreciated, particularly by patients, who found it motivating and a way to relieve their feelings of loneliness in the face of illness. All participants reported better stress management. They also shared benefits and difficulties concerning the practice of meditation and the programme's modalities. In addition, they all stated that the programme should be lasting. The opinion of the patients (our target population) will be decisive in building an optimized programme that will suit them the best. In conclusion, the protocol and the qualitative findings of the present study validate the rationale for conducting a fully powered randomized trial to demonstrate the potential added value of shared meditation and how it improves well-being by promoting bridge-building between cancer patients, health professionals and others.Trial Registration: ClinicalTrials.gov. NCT04410185. Registered on June 1, 2020.
Assuntos
Meditação , Atenção Plena , Neoplasias , Humanos , Meditação/métodos , Grupos Focais , Projetos Piloto , Neoplasias/terapia , Neoplasias/psicologia , Atenção Plena/métodosRESUMO
In France, between 2,500 and 3,000 people donate their bodies to science each year after their death; they contribute therefore to the teaching of anatomy, to research and to the learning and improvement of surgical practices. The decision to donate must be made during the donor's lifetime and consent must be expressed in writing to one of the 27 donation centers throughout the country. Following the scandal of the Parisian center of the Saints Pères, which revealed a lack of respect for bodies and fundamental ethical principles, the decree of April 27, 2022 concerning the donation of bodies for teaching and research purposes, which is part of the new bioethic laws, was eagerly awaited to clarify certain practices. However, this decree raises new questions because many of the rules it proposes do not appear to be relevant to the values of donation and the functioning of donation centers. The new modes of regulation proposed by the decree generate questions among donors and professionals in the field with a risk of poor regulation, detrimental to all with regard to major ethical issues. If the public authorities do not commit themselves to a regulation that is better adapted to the field, if the ethical stakes are not better clarified and if the universities do not have the means to implement these new organizations, the perpetuation of body donation and of donation centers could become challenging.
Title: Don du corps à la science - Un nouveau cadre de régulation qui répond à certaines questions mais en soulève bien d'autres ! Abstract: En France, entre 2 500 et 3 000 personnes donnent leur corps à la science chaque année après leur mort ; elles contribuent ainsi à l'enseignement de l'anatomie, à la recherche et à l'apprentissage et l'amélioration des pratiques chirurgicales. La décision doit être prise de son vivant et le consentement exprimé par écrit auprès d'un des vingt-sept centres de don du corps répartis sur le territoire national. Suite au scandale du centre parisien des Saints-Pères, le décret du 27 avril 2022 relatif au don de corps à des fins d'enseignement et de recherche, qui s'inscrit dans le cadre des nouvelles lois de bioéthique, était très attendu pour clarifier certaines pratiques. Mais ce décret soulève de nouvelles questions car nombreuses sont les règles qu'il propose qui ne nous apparaissent pas pertinentes au regard des valeurs du don et du fonctionnement des centres de don. Les nouveaux modes de régulation proposés génèrent des questions chez les donneurs et les professionnels de terrain avec un risque de mauvaise régulation. Nous pensons que si la puissance publique ne s'engage pas dans une régulation plus adaptée au terrain, si les enjeux éthiques ne sont pas mieux clarifiés et si les universités n'ont pas les moyens pour mettre en Åuvre ces nouvelles organisations, la pérennisation du don du corps et des centres de don pourrait devenir difficile.