Vol. 17 No. 3 (2023)

  • Open Access

    Article

    Article ID: 3856

    Recherche interventionnelle et dispositifs de soutien aux personnes touchées par un cancer et leur entourage : résultats d’une analyse descriptive

    by Anne-Fleur Guillemin, Iris Cervenka, Jérôme Foucaud

    Psycho-Oncologie, Vol.17, No.3, 2023; 9 Views

    Population health intervention research (PHIR) was initiated in the field of primary prevention by proposing a research paradigm focusing on intervention and the theory of solutions. The intervention was coconstructed with the stakeholders as part of a global approach until its deployment in the local area. The development of PHIR raises the question of its application to tertiary prevention. This study proposes some initial thoughts on the similarities and specificities of PHIR projects-funded by the French National Cancer Institute (INCa)-of support systems for people affected by cancer and their families, which were based on a descriptive analysis. The selected projects were obtained from the databases of PHIR projects funded from 2010 to 2021, which included 72 projects to which the inclusion and exclusion criteria were applied. A descriptive analysis was carried out for each project using the application files and the interim or final reports sent to INCa. A total of 30 projects were selected, half of which were in the public health field. Almost all of the projects involved a university–hospital partnership, and onethird involved healthcare professionals and patients in the research process. Patient involvement was classified into four types, which were linked to the supporting structure and the target population. The main themes of the projects were quality of life and adapted physical activity, which were assessed in hospitals through randomized controlled trials targeting specific cancers. Research has revealed several specificities and similarities between support systems for people affected by cancer and their families developed in PHIR projects; however, these support systems vary widely, and PHIR in tertiary prevention can be conducted in several ways. Any modeling of the systems is complicated; PHIR is evolving in its application and is the subject of research and evaluation.

  • Open Access

    Article

    Article ID: 3857

    Etude de faisabilité SKYPE « Suivi en Kinésithérapie et Yoga - Projet Educatif » auprès de patientes présentant des douleurs dues à l’hormonothérapie après un cancer du sein

    by Kerstin Faravel, Marie-Eve Huteau, Marta Jarlier, Laetitia Meignant, Pierre Senesse, William Jacot, Anne Stoebner

    Psycho-Oncologie, Vol.17, No.3, 2023; 8 Views

    Approximately 50% of breast cancer patients under hormone therapy experience osteoarticular pain, which increases the risk of treatment discontinuation and relapse. The aim of the study was to assess the feasibility of yoga practice associated with patient education (PE) for at-home practice in breast cancer patients under hormone therapy. We also evaluated osteoarticular pain, flexibility and patients’ satisfaction. In this study, intervention was split into two 6-week periods (P): P1 consisting of a supervised yoga-PE session of 90 minutes/week and 15-minutes of daily at-home yoga, and P2, involving daily autonomous athome yoga sessions. Feasibility was evaluated by patient adherence defined as completion of at least 4 out of the 6 supervised yoga-PE sessions and 70% or more of the at-home yoga sessions. Evaluations (at inclusion and at the end of each period) consisted in assessment of osteoarticular pain, forward flexibility and patient satisfaction. Twenty-four women with a median age of 53 years [36–72] were included. Feasibility was validated with a successful adherence rate reaching 83%, combined with a mean satisfaction score of 10/10 [8–10]. In addition, 58% of patients reported reduced osteoarticular pain, with a 2-point reduction on the numerical rating scale. The forward flexibility also improved, with a median gain of 8 cm. Combined physiotherapy-yoga-PE intervention is a feasible strategy, increasing at-home yoga practice with potential benefit on pain, flexibility, and patient satisfaction. Evaluation of this innovative program is ongoing in a larger randomized multicenter trial.

  • Open Access

    Article

    Article ID: 3862

    Proposer un accompagnement au sevrage tabagique aux patients atteints de cancer : le rôle des associations proposant des soins de support. Exemple de la Ligue Contre le Cancer Gironde

    by Océane Phanatzis, Rébecca Ratel, Isabelle Barcos, Marie Daspas, Emmanuelle Clairembault, François Alla

    Psycho-Oncologie, Vol.17, No.3, 2023; 3 Views

    Aims:  This article aims to explore the interventional and contextual components of smoking cessation support for cancer patients in the context of supportive care in cancer provided by an association, that is viable and effective in the French context, and to describe the partnership research process in which they were developed.  Procedure:  The intervention was developed from a dataset collected during a viability study for the development of a smoking cessation intervention carried out at the Ligue Contre le Cancer Gironde, a scoping review of evidence-based interventions and two narrative reviews on the determinants and ethical issues of smoking cessation in cancer.  Results:  The results confirmed a tangible opportunity to develop smoking cessation services within the relevant case because of the obstacles that can be overcome, the facilitators that can be mobilized, and the gaps existing in this field. In addition, they enabled the design of an intervention adapted to the context, guided by a voluntarist, multidisciplinary approach, and focused on patients’ well-being.  Conclusion:  The associations providing supportive care in cancer can initiate and participate in the process of smoking cessation. They can play a key role in mediating between oncology and addictology.

  • Open Access

    Article

    Article ID: 3864

    Implémentation d’une intervention psychosociale StomieCare auprès de patients opérés d’un cancer du rectum avec stomie temporaire : une étude pilote de faisabilité, d’acceptabilité et d’efficacité

    by Stéphane Faury, Katia M’Bailara, Eric Rullier, Quentin Denost, Bruno Quintard

    Psycho-Oncologie, Vol.17, No.3, 2023; 13 Views

    Objective:  This study aims to evaluate the feasibility, acceptability, and efficacy of  StomieCare  for rectal cancer patients undergoing surgery with a temporary stoma.  StomieCare  (three individual sessions) comprises thematic discussions, information and education, and teaching problem-solving and cognitive restructuring.  Methods:  Thirty-seven rectal cancer participants treated by surgery and temporary stoma were recruited and randomized to control (routine care approach, n = 20) and intervention (routine care and  StomieCare , n = 17) groups. Outcomes were psychological distress (anxiety and depression, HADS), body image (BIS, ESS), and quality of life (FACT-C), at one week before surgery (T1) and 3 months after stoma closure (T2). Interand intragroup statistical analyses were performed.  Results:  This study demonstrated that  StomieCare  is feasible and acceptable. At T2, depression scores were higher for controls than for the intervention group. The mean scores for quality of life, depression, and body image decreased in the control group but remained stable in the intervention group. Anxiety scores significantly decreased between T1 and T2 only for the control group.  Conclusion:  StomieCare  is a feasible and acceptable intervention for the prevention of depressive symptomatology.

  • Open Access

    Article

    Article ID: 3865

    Le projet Sav-AQ : étude des freins et facteurs à l’utilisation d’un site internet dédié aux patientes atteintes de cancer du sein, l’exemple de la Nouvelle-Aquitaine

    by Valérie Berger, Hélène Hoarau, Florence Saillour

    Psycho-Oncologie, Vol.17, No.3, 2023; 13 Views

    The development of digital platforms is transforming caregiver-patient interactions and the dissemination of knowledge. Obtaining information from the Internet has become a habit for many patients and must be considered by caregivers. Thus, understanding the use of digital tools by patients is a public health issue. The Sav-AQ study aims to understand patterns of use by women with breast cancer and the role of health professionals. Sav-AQ is an exploratory feasibility study with a mixed design, exploring patient and healthcare experience before and after the integration of a specific website into their care pathways. The research is based on the digital platform “My Breast Cancer Network”, which was built by and for patients with breast cancer. A group of 30 breast cancer patients and six healthcare professionals using the platform were followed. The results show that for all users, the activity on the website decreases over time. At the beginning of the course, patients were more assiduous, which can be explained by the search for elements related to an unknown care pathway. The results also show that technical skills to use the platform are necessary for patients and must be accompanied by a health professional. It is of interest to devise a larger study to assessing the impact of such a platform on patient healthcare uptake and health skills development.

  • Open Access

    Article

    Article ID: 3866

    Conception et production d’un guide patient pour accompagner la reprise du travail après un cancer du sein : une application de l’Intervention Mapping

    by Guillaume Broc, Julien Carretier, Sabrina Rouat, Laure Guittard, Julien Péron, Béatrice Fervers, Laurent Letrilliart, Philippe Sarnin, Jean-Baptiste Fassier, Marion Lamort-Bouché

    Psycho-Oncologie, Vol.17, No.3, 2023; 15 Views

    Aims:  Return to work (RTW) after breast cancer is a complex process that questions the individual trajectories of patients and stakeholders. Program planning in this context requires relying on appropriate methods like Intervention Mapping (IM) which encompasses such complexity. The aim of the methodological study is to describe an application of IM for both the design and production of a patient guide supporting RTW after breast cancer.  Procedure:  According to IM, the guide was co-constructed with a Community Advisory Board (CAB) of stakeholders (patients/associations, health professionals, companies, institutions) after considering other options (interactive website, mobile application). The design was done with empirical and theoretical anchoring, guided here by an Ecosystem Process of Change model. A communication agency was chosen to produce the document. Pre-tests were conducted with a representative panel of the target audience to assess the different prototypes elaborated, using questionnaires and a focus group.  Results:  The final structure of the guide is presented with comments in order to concretely illustrate the management of IM steps 3 and 4. The final structure of the guide is presented, along with a description of its components that target women (according to Prochaska et Di Clemente’s stages of change) and their environment (by use of levers they may activate). The results of the pre-test led to the simplification of the guide and its structure.  Conclusion:  IM allows a rich integration of experiential knowledge in the planning of complex health and public health programs. The development of the guide has attempted to integrate its aspects, in particular to promote both its implementation and its effects. Reflections are brought about the realistic evaluation of such complex interventions.

  • Open Access

    Article

    Article ID: 3867

    Les enjeux de l’identification et de la gestion des inégalités épistémiques dans les RISP : Illustration dans la conception et la mise en œuvre d’un dispositif d’ETP en oncologie

    by Philippe Terral, Charlotte Bruneau, Jean-Paul Génolini

    Psycho-Oncologie, Vol.17, No.3, 2023; 10 Views

    Aims:  The joint dynamics of knowledge (of patients, health professionals, decision-makers, researchers) and of the powers (of speech and action, asymmetries, and hierarchies established between individuals and their knowledge) of the people who carry them at the heart of the PHIR, are analyzed from the perspective of the management of epistemic inequalities. We study the nature of knowledge sharing or non-sharing between these different categories of agents involved in health interventions.  Procedure:  The qualitative methodology is based on 36 interviews and six years of ethnographic observations of the TPE program (design or implementation), as well as steering committees and workshops of the PHIR where researchers, decisionmakers, health professionals, and patients share their experiences and knowledge.  Results:  The research highlights three major theoretical and methodological issues of PHIR concerning epistemic inequalities. We argue for broadening the spectrum of health expertise (researchers, decision-makers, health professionals, patients) and for their pluralization. To account for the nature and evolution of collaborations, it is necessary to closely study the dynamics of the avenues of coordination between these fields of expertise. Finally, we call to identify the resources (knowledge, values, material elements, etc.) and strengths that enable these hybrid groups to bind (or not) and to potentially generate co-learning.  Conclusion:  Considering these three major issues allows PHIR to reflect and take action to reduce inequalities by linking epistemic and social issues.

  • Open Access

    Article

    Article ID: 3868

    Le projet IMPAQT : réflexions sur un dispositif participatif de recherche

    by Charlotte Bauquier, Myriam Pannard, Léa Baillat, Maëva Piton, Chantal Denieul, Isabelle Audouard, Stéphanie Jean-Daubias, Mouna Mouline, Murielle Sevenne, Annick Gerard, Marie Préau

    Psycho-Oncologie, Vol.17, No.3, 2023; 6 Views

    Over the last forty years, many methodologies have been initiated within the framework of the participatory approach, the objective of which is to encourage the involvement of citizens in the definition and implementation of projects and policies concerning them. The implementation of these participatory approaches in the field of interventional research in population health reveals several scientific, organizational, inter-individual, and ethical issues that must be discussed. Thus, we propose to present here the fruit of a collective reflection of the members of a research group, composed of patient-researchers and researchers in social psychology, on the implementation of the IMPAQT research project, which aimed to promote a community-based research approach in oncology. The discussion will be structured around three topics: the implementation of the participatory research mechanism, the sustainability of the commitment involved in participating in research, and the valorization of the participation of the patient-researchers. These issues are particularly important to consider in guiding the implementation of a solid and balanced partnership with those concerned in the co-construction of interventional research devices in cancerology.

  • Open Access

    Article

    Article ID: 3870

    Recherche participative : quels atouts pour penser une recherche sur le parcours de soin en cancérologie ? Regards de deux patientes co-chercheures

    by Sylvie Faiderbe, Nadège Berlioz

    Psycho-Oncologie, Vol.17, No.3, 2023; 13 Views

    Two patients relate their experience as co-researchers in a research project in the human and social sciences. From the genesis of the research project to the results, they detail their participation in each stage of this project alongside care professionals and researchers: their difficulties, their contributions, their pleasure, and speculations on the conditions for improving this type of active collaboration in a participative research project.

  • Open Access

    Article

    Article ID: 3871

    Rien ne sert de courir, il faut partir à point ; Leçons apprises d’une intervention psychologique en oncologie : de l’importance de conduire des études pilotes et/ou de faisabilité dans les interventions complexes

    by Sophie Lelorain, Christelle Duprez, Laura Caton, Marie-Mai Nguyen, Gildas d’Almeida, Guillaume Piessen, Alexis Cortot

    Psycho-Oncologie, Vol.17, No.3, 2023; 9 Views

    This article chronicles a failed research project. We designed and carried out a psychological intervention aimed at increasing esogastric and lung cancer patients’ emotional competencies after treatments. We present the final protocol of the study, a randomized controlled trial in a public hospital, and describe the difficulties encountered and our subsequent reflections, to provide researchers and clinicians with advice for the implementation of such interventions. Firstly, the role of psychology, emotions, and emotional competencies, is still underacknowledged in cancer care. Pedagogical efforts must be made to convince both physicians and patients of the importance of those elements. Secondly and consequently, even distressed patients sure to benefit from such an intervention, do not take it up. In particular, male patients often declined the intervention due to gender stereotypes, and as such creativity is needed to present such interventions in a motivating way for patients. Finally, and most importantly, even if there is a good rationale for a psychological intervention and all favorable conditions are present, it is essential to first conduct a feasibility/pilot study. Indeed, even the most thorough preparation is no guarantee of anticipating all issues due to important gaps between theory and practice.