Martine Batt

Healing gardens and cognitive behavioral units in the management of Alzheimer's disease patients: the Nancy experience.

The French Alzheimer Plan 2008-2012 anticipates the implementation of new Units specialized in cognitive rehabilitation and psycho-behavioral therapy of Alzheimers disease (AD) patients. Conceived for AD and other dementia patients of all ages, their objectives are to propose a cognitive rehabilitation program, to prevent or treat psycho-behavioral crises, and to provide support and educational therapy to the family and professional caregivers, in order to ease the patients return to his or her previous way of life. Studies on green spaces and healing gardens in health-care settings have revealed objective and measurable improvements in the patients well-being. The Plan officially stipulates for the first time the need to make healing gardens an integral part of these Units, but it does not provide specific recommendations or criteria for implementing such gardens. Although green spaces and gardens are available in many French Care Units, they are rarely specifically adapted to the needs of AD patients. In Nancy, the Art, Memory and Life garden, a specific concept guided by a neuropsychological approach, was developed and complemented by an artistic vision based on cultural invariants. The main objective of this article is to describe the various steps of the process that led to the creation of this garden: the collection of experiences and information by a pilot group, surveys of patients, visitors, and caregivers before and after establishment of the garden, and implementation of a multi-professional group project. The specifications, the organizational criteria, the therapeutic project, and the criteria for the conception of such a garden stemming from our clinical experience with the Art, Memory and Life garden in Nancy, are described herein. We also present the first assessment following the implementation of the project.

Ergonomie cognitive d’un conseil génétique pour le test présymptomatique de maladie de Huntington

Resume Dans cet article, nous analysons l’activite d’une equipe pluridisciplinaire en consultation medicale predictive. Plus precisement, nous etudions deux interactions qui se deroulent entre une personne asymptomatique qui demande un test predictif de maladie de Huntington et deux medecins successivement. Nous mettons a jour les processus en jeu dans ce rapport de face a face et nous demontrons l’echec de la tentative des professionnels a agir sur la conviction, ou la rationalite personnelle, de la consultante vis-a-vis du risque genetique. Nous montrons ainsi que les pratiques communicationnelles engendrees par la medecine moderne sont delicates et gouvernees par des processus qui en sont independants.

Analyse interlocutoire d’une plainte exprimée par une équipe mobile de soins palliatifs

Resume Dans cet article, les auteurs presentent la construction collaborative d’une plainte exprimee par une equipe de soins placee en situation d’interaction entre deux passations individuelles (pre-test/post-test) du Questionnaire de Climat d’Entreprise (QCE). L’analyse de l’interdiscours realisee avec la logique interlocutoire met en evidence la syntaxe de cette elaboration ainsi que le tissage d’une representation de leur situation professionnelle par les participants, tous membres d’une equipe mobile de soins palliatifs d’un centre hospitalier.

Etude des Facteurs psychosociaux, du burnout, de la Vigueur et des troubles musculosquelettiques chez les soignants hospitaliers

Resume Alors que cohabitent chez les soignants hospitaliers, les facteurs psychosociaux, le burnout et les troubles musculosquelettiques, l’originalite de cette etude consiste a evaluer leurs liens dans une perspective ergonomique. Avec un questionnaire construit a partir des theories de Karasek (1990) et Siegrist (1996) pour les facteurs psychosociaux, de Shirom (2004) pour le Burnout et la vigueur et de Kuorinka (1987) pour les troubles musculosquelettiques, auquel ont repondu 176 infirmier(e)s et aides-soignant(e)s hospitalier(e)s francais(e)s, nous proposons un modele theorique predictif du burnout et de la douleur ressentie.

L’équipe paramédicale à l’hôpital psychiatrique : Retentissement actuel d’une évolution de deux décennies Analyse d’un entretien de supervision

Resume A l’aube de la reforme de la formation des infirmiers en France, ce travail tente de faire le point sur l’evolution de l’exercice de l’infirmier et de l’insertion des aides-soignants dans les services d’hospitalisation psychiatrique. Postulant que l’interaction est une interface ouverte sur l’individu d’un cote et sur les systemes collectifs de l’autre, les auteurs abordent leur etude par l’analyse d’un entretien de supervision d’une equipe soignante d’une institution hospitaliere psychiatrique.

Vers une clinique de la temporalité

The discovery of time cells has expanded our knowledge in the field of spatial and temporal information coding and the key role of the hippocampus. The internal clock model complemented with the attentional gate model allows a more in-depth understanding of the perception of time. The motor representation of duration is ensured by the basal ganglia, while the cerebellum synchronizes short duration for the movement. The right prefrontal cortex seemingly intervenes in the handling of temporal information in working memory. The temporal lobe ensures the comparison of durations, especially the right lobe for the reference durations and the medial lobe for the reproduction of durations in episodic memory. During normal aging, the hypothesis of slowing of the temporal processor is evoked when noting the perception of the acceleration of the passage of time that seemingly occurs with advancing age. The various studies pertaining specifically to time cognition, albeit heterogeneous in terms of methodology, attest to the wide-ranging disturbances of this cognitive field during the course of numerous disorders, whether psychiatric - depression and schizophrenia notably - or neurological. Hence, perturbations in temporality are observed in focal brain lesions and in subcortical disorders, such as Parkinsons disease or Huntingtons chorea. Alzheimers disease represents a particularly fertile field of exploration with regard to time cognition and temporality. The objectified deconstruction of temporal experience provides insights into the very processes of temporality and their nature: episodic, semantic and procedural. In addition to exploration based on elementary stimuli, one should also consider the time lived, i.e. that of the subject, to better understand cognition as it relates to time. While the temporal dimension permeates the whole cognitive field, it remains largely neglected: integration of a genuine time cognition and temporality clinic in daily practice remains to be implemented.

Profil neuropsychologique et capacités métapragmatiques dans le syndrome de Schachman-Diamond

L’objectif principal de cette etude pilote est d’avancer des hypotheses quant au profil neuropsychologique des enfants et adolescents francais porteurs du Syndrome de Shwachman-Diamond (SSD), maladie genetique rare. Il s’agit egalement d’evaluer les capacites metapragmatiques a partir d’epreuves dialoguees de comprehension de trois formes non litterales de demandes indirectes specifiquement amenagees pour cette population. L’originalite de ce travail reside ainsi dans l’analyse des profils comportementaux et dans l’etude des fonctions cognitives superieures de 7 enfants SSD. Au-dela du faible potentiel cognitif observe pour notre echantillon, plus de la moitie des enfants SSD presentent des difficultes de cognition sociale et tous manifestent des problemes comportementaux (notamment d’adaptation sociale) et executifs. Les resultats obtenus mettent en evidence des profils particuliers de performances au sein des differentes epreuves evaluant la cognition sociale. L’hypothese d’une atteinte specifique de certains aspects de la theorie de l’esprit est ainsi soulevee.

Comment faciliter l’orientation des sujets âgés en situation de handicap psychique vers une alternative sanitaire à l’hospitalisation ?

This paper is aimed to improve the socio-psycho-therapeutic support for older patients with heavy psychiatric disability. First, we review the literature to question the specific grounds reported by professionals regarding the orientation of these vulnerable subjects. Secondly, we emphasize that integration of these subjects within alternatives to hospitalization requires a type of support similar to that usually proposed, an accompaniment of psychosocial rehabilitation. Then, we propose to build an indicator called the psychosocial age, which reduces the weight of the chronological age for the orientation of these subjects. Ultimately, we question the health policies in psychiatry.

From Dialogue to Calculation

The goal of this article is to describe a language that formalizes the constituting role of interlocution underlying the discovery of the solution to an arithmetic problem by two children conversing for this purpose. The interaction takes place from the experimental group of an experiment demonstrating that dyads are better than single subjects at solving a division of division problem. The authors propose a formal description of the natural unfolding of the interaction process that leads to the discovery of the solution, by identifying its microgeneses of the solving and the moment when an understanding irrupts. To show how the discourse precedes the calculation, the authors use interlocutory logic (Trognon and Batt, Interlocutory logic: a unified framework for studying conversation interaction. In: Streek J (ed) New adventures in language and interaction. Benjamins, Bruxelles, pp 9–40, 2010), a theory of the logical properties of natural interlocution .

Healing gardens in Alzheimer's disease: How to best leverage skills and experience between health and landscape professionals—The Nancy experience

P2-351 HEALING GARDENS IN ALZHEIMER’S DISEASE: HOW TO BEST LEVERAGE SKILLS AND EXPERIENCE BETWEEN HEALTH AND LANDSCAPE PROFESSIONALS—THE NANCY EXPERIENCE Therese Rivasseau Jonveaux, Fescharek Reinhard, Martine Batt, Alain Trognon, Soulon Laure, Demarche Laetitia, Christel Jacob, Alina Pop, Manon Yzoard, Malerba Gabriel, Bruno Bouvel, Athanase Benetos, CHU Nancy/Laboratoire InterPsy Pratiques Sociales Interactions, Vandoeuvre les Nancy, France; Fescharek Sculpture and Design &CHU Nancy, Marburg Lahn, Germany; Laboratoire InterPsy Pratiques Sociales Interaction EA 4432, Nancy, France; Laboratoire InterPsy Pratiques Sociales et Interaction EA 4432, Nancy, France; CHU Nancy, Nancy, France; CHU Nancy/ Laboratoire InterPsy Pratiques Sociales Interaction, 1 Rue Foller, France; Laboratoire Interpsy Pratiques Sociales Interaction EA 4432, Nancy, France; CHU Nancy Universit e de Lorraine, Vandoeuvre les Nancy, France. Contact e-mail: therese. jonveaux@dbmail.com