Christine Durif-Bruckert

Medication and the patient-doctor relationship: a qualitative study with patients suffering from fibromyalgia.

Fibromyalgia is characterized by a diffuse and predominantly axial and chronic pain, for which there is no explicit rationale for treatment options.

Microbiote intestinal et émergence de nouvelles représentations du corps - Une approche psychosociale

In view of the growing importance attached to the gut microbiota in preventive medicine and treatment, it would seem essential to identify and analyse the modalities of its representation in a psychosocial approach. In the first part of this article, we will discuss the renewal of representations of the digestive tract brought about by scientific discourse on the gut microbiota, mainly regarding the anthropological status of the intestines and faeces. Then in the second part we will focus on ways of taking advantage of the variable nature of the microbiota by food choices, and we will also focus on therapeutic approaches that use transplantations of faecal matter, and the ensuing loss of privacy entailed (an anthropological notion of defil).

Moving towards shared decision making in the physician-patient encounter in France: State of the art and future prospects

In this paper we present the evolution of shared decision making since the mid-nineties in terms of legislation, official statements and guidelines. We outline the goals and declarations of the French Ministry of Health and the French National Authority for Health, for whom informing patients and shared decision-making are central concerns. Finally, we discuss research projects and clinical initiatives in shared decision-making in France and provide a general overview of progress and barriers to progress.

Adaptation d’une approche nutritionnelle dans le contexte du cancer du sein : points de vue croisés des personnes malades et des professionnels de santé

RésuméLe centre de lutte contre le cancer Léon-Bérard (Lyon, France) s’est engagé dans l’adaptation d’une approche nutritionnelle pour les patientes atteintes de cancer du sein, leur proposant un suivi diététique et des séances d’activité physique adaptée pendant leurs traitements. Cela soulève plusieurs problématiques concernant les barrières et facilitateurs à sa mise en place. Une étude qualitative par focus groups conduits avec des femmes atteintes d’un cancer du sein, en cours de chimiothérapie ou à distance de la maladie, et des professionnels de santé impliqués dans la prise en charge de ces patientes a été réalisée afin d’identifier et d’analyser, de leurs points de vue, les barrières et facilitateurs d’un tel dispositif. Le rôle de l’information et de l’accompagnement des patientes engagées dans un tel dispositif a été identifié comme un facteur prioritaire d’adhésion. La notion de motivation des patientes s’exprime dans les deux corpus comme un déterminant prioritaire de participation. L’importance des liens sociaux impliqués dans les attitudes d’adhésion ou de refus est également mise en exergue par les patientes. Cette étude centrée sur les patientes et les praticiens suggère des pistes d’amélioration et des éléments de structuration susceptible de s’inscrire dans une démarche d’éducation thérapeutique nutritionnelle pour les femmes atteintes d’un cancer du sein.AbstractThe French Cancer Center Léon-Bérard (Lyon, France) is committed to the adaptation of a nutritional approach for breast cancer patients, offering a dietary monitoring and physical activity sessions during their treatments. This raises several issues regarding the barriers and facilitators to its implementation. A qualitative study using focus groups with women with breast cancer undergoing chemotherapy or beyond treatment, and health professionals, was conducted in order to identify and analyze their views, barriers, and facilitators of such a program. The role of information and support for recipient patients has been identified as a priority factor for their involvement. The concept of patient motivation is expressed in both groups as a primary determinant of participation. The importance of social ties in accession or refusal attitudes to participate in the program is also highlighted by breast cancer patients. This study suggests ways of improving and structuring elements on diet and physical activity sessions that could be part of a therapeutic education approach for breast cancer patients.

Report on the employees' health: context and strategies

The purpose of this paper is to report, from a qualitative study, the individual and organizational factors and processes that lead an employee to build a unique relationship to is health. We discuss these processes in relation to the construction of health among a sample of 34 „workers” selected in diverse contexts, considering health as a dynamic and co-constructed object. From biographical interviews and records of interactions between workers and professionals who support them, we analyze we analyze the transactions made between work and health. These transactions, which are defined in dynamic and combined processes (psychological, cognitive, interactive and organizational), contribute to define the orientation of the relationship to work, the professional route, and determine the evolution of more objective health status and how it can be seen, lived and managed individually. This article examines three different contexts: small business employees, employees of a large firm, and job seekers. These three contexts are related with different types of strategies implemented by individuals on their health in relation to their position in the world of work.