Traitement médiatique des morts de la Covid-19 : entre avalanche de chiffres et récits de vie

Cet article s’intéresse au traitement médiatique des victimes de la Covid-19 en France pendant le premier confinement, à partir de deux sources : d’une part les points presse quotidiens du DGS, d’autre part la description des « victimes remarquables » dans la presse écrite. Les données hebdomadaires de Santé Publique France sont aussi mobilisées. Ces données soulignaient le grand âge et le poids des comorbidités parmi les victimes, mais ces deux caractéristiques ont fait l’objet d’un traitement médiatique très partiel par les deux autres sources. Les chiffres ont été mobilisés pour décrire une épidémie massive, mortelle, dont personne n’est à l’abri, jeunes compris, pour promouvoir et justifier l’action des autorités, et enrôler le public dans la guerre contre le virus. Les récits de vie des articles nécrologiques, comme le choix des victimes pour donner un visage à l’épidémie, brossaient un tableau très similaire. D’ordinaire, on attend des chiffres qu’ils nous éclairent, qu’ils nourrissent la réflexion et le débat. Mais l’avalanche sélective de nombres lors des points presse semblait plutôt destinée à effrayer le public, et à imposer une certaine lecture de la situation, et l’absolue nécessité du confinement.We investigated how the Covid-19 deaths were described by the French media during the first lockdown. We studied the daily press conferences held by the Director-General for Health and the ‘remarkable’ deaths in the print media, as well as the weekly data from Santé Publique France. These data pointed out the high mean age of victims, as well as the prevalence of comorbidities among them, but these two aspects were partially absent in the two other media contents. Figures have been used to describe a massive and deadly pandemic, sparing no one, including the youth, but also to promote and justify the action of authorities, and to enroll the public in the war against the virus. In the print media, the choice of ‘remarkable’ deaths and the corresponding life stories contributed to a very similar narrative. Usually, figures are supposed to enlighten us, to provide food for thought and debate. But during the press conferences the selective flood of figures was rather frightening and contributed to impose a specific reading of the situation, and the absolute necessity of lock

Analysing breast cancer survivors' acceptance profiles for using an electronic pillbox connected to a smartphone application using Seintinelles, a French community-based research tool.

peer reviewedIntroduction: Up to 50% of breast cancer (BC) survivors discontinue their adjuvant endocrine therapy (AET) before the recommended 5 years, raising the issue of medication non-adherence. eHealth technologies have the potential to support patients to enhance their medication adherence and may offer an effective way to complement the healthcare. In order for eHealth technologies to be successfully implemented into the healthcare system, end-users need to be willing and accepting to use these eHealth technologies. Aim: This study aims to evaluate the current usability of eHealth technologiesin and to identify differences in BC SURVIVORS BC survivors accepting a medication adherence enhancing eHealth technology to support their AET to BC survivors that do not accept such a medication adherence enhancing eHealth technology. Methods: This study was conducted in 2020 including volunteering BC survivors belonging to the Seintinelles Association. Eligible participants were women, diagnosed with BC within the last 10 years, and been exposed to, an AET. Univariable and multivariable logistic regression analyses were performed to investigate medication adherence enhancing eHealth technology acceptance profiles among BC survivors. The dependent variable was defined as acceptance of an electronic pillbox connected to a smartphone application (hereafter: medication adherence enhancing eHealth technology). Results: Overall, 23% of the participants already use a connected device or health application on a regular basis. The mean age of the participants was 52.7 (SD 10.4) years. In total, 67% of 1268 BC survivors who participated in the survey declared that they would accept a medication adherence enhancing eHealth technology to improve their AET. BC survivors accepting a medication adherence enhancing eHealth technology for their AET, are younger (OR = 0.97, 95% CI [0.95; 0.98]), do take medication for other diseases (OR = 0.31, 95% CI [0.13; 0.68]), already use a medication adherence enhancing eHealth technology or technique (OR = 1.74, 95% CI [1.06; 2.94]) and are willing to possess or currently possess one or more connected devices or health applications (OR = 2.89, 95% CI [2.01; 4.19]). Conclusion: Understanding acceptance profiles of BC survivors is fundamental for conceiving an effective eHealth technology enhancing AET among BC survivors. Hence, such profiling will foster the development of personalized medication adherence enhancing eHealth technology

Return to work and continued employment after a cancer diagnosis : socially differentiated trajectories

Chaque jour en France, plus de quatre-cents personnes actives ou en âge de l’être apprennent qu’elles ont un cancer. Or, plusieurs études françaises et internationales mettent en lumière l’impact négatif de la maladie sur la vie professionnelle, ce qui positionne le sujet du retour au travail et du maintien en emploi après le diagnostic d’un cancer au cœur d’enjeux sociaux et politiques, puisqu’il constitue un des objectifs du 3ème Plan Cancer. Cette recherche a pour objectif de participer à la compréhension des difficultés rencontrées par ces personnes dans la poursuite de leur vie professionnelle en dépit des dispositifs disponibles. Afin d’apporter une vision complète du sujet, cette recherche s’inspire de théories de santé publique, sociologique mais également économique, et mobilise des méthodes mixtes alliant analyses quantitatives et qualitatives. Nos résultats corroborent ceux de la littérature : les personnes ayant les caractéristiques socioéconomiques les moins favorables sont les plus vulnérables face au maintien en emploi à distance du diagnostic. En complément, l’approche individuelle souligne le rôle actif du patient tout au long du processus de retour au travail. Néanmoins, la capacité individuelle à se maintenir en emploi est altérée par l’accès socialement différencié aux dispositifs d’aide. Ainsi, cette thèse plaide pour un accompagnement personnalisé des personnes atteintes de cancer qui doit être réalisé précocement afin de prendre en considération simultanément les inégalités socioprofessionnelles et les motivations individuelles.As survival rates has increased for most cancers, more and more people face decisions about return to work. This rate was found to vary according to individual sociodemographic features, occupational characteristics, and clinical aspects related to the worker’s health status and to the disease. This doctoral research aims 1) to explore the continuation of working life after a cancer diagnosis in a medium-term, identifying factors associated with a deterioration of the professional life, and 2) to study the mechanism of return to work and job retention, focusing on an individual approach. To that end, this research proposes a mixed approach of the subject using quantitative and qualitative data. Our results support those of the literature: individuals considered as the most vulnerable were less likely to still be employed five years after a cancer diagnosis. In addition, this research highlights the interest to consider other indicators to report the continuation of professional life after a cancer diagnosis such as the part of working time reduction, the part of occupational change, and the financial well-being. Furthermore, the individual approach emphases the active role of the patient in the return to work process. Nevertheless, the individual capacity to remain employed may be undermined by the socio-differentiated access to arrangements which are strongly associated with continued employment at middle term. Consequently, this thesis called for personalized support of cancer survivors in order to take into consideration their motivation and to face social inequalities found to be barriers for their continued employment

Psychological support in general population during the COVID-19 lockdown in France: Needs and access.

IntroductionWith France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17-May 10). This study explored the perception of the adult population about the need for-and access to-psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown.Material and methodThis online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7-10, 2020).ResultsOne in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35-64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019.ConclusionThe perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities' understanding of the population's psychological needs in this situation and to enhance HCPs' abilities to meet them. In particular, further research of its specific impact on youth is necessary

Inequality in income change among cancer survivors five years after diagnosis: Evidence from a French national survey

International audienceWorldwide, around 18 million people receive a cancer diagnosis each year, most of whom survive long enough to face additional cancer-related costs. In France, most costs directly related to cancer are covered by the National Health Insurance Fund, and cancer patients can receive treatments without paying advance fees. In this context, the costs faced by cancer survivors are mostly social costs. Drawing on fundamental cause theory, this study aimed to explore the socially-differentiated evolution of cancer survivor's income five years after diagnosis. Our study draws on the findings of VICAN5, a French national survey that was conducted in 2015/2016 in a representative sample of 4,174 cancer survivors to obtain information on living conditions five years after diagnosis, and that was restricted to 12 tumour sites accounting for 88% of global cancer incidence in France. We used the multiple imputation method and the Heckman selection model to identify the factors associated with a decrease in household income per consumption unit (HICU), while accounting for missing data. Among survivors still working five years after diagnosis, 17.6% reported lower income at survey than at diagnosis. After adjustment for socio-demographic and medical characteristics, the decrease in HICU was more frequent in women, singles, low educated survivors, and survivors with reduced working time. Finally, subjective measures of income variation and economic well-being were a useful complement to objective measures since 31.6% of cancer survivors still working five years after diagnosis reported a perceived decrease in household income. In conclusion, inequalities in economic well-being persist long after diagnosis in France, and this despite the fact that most cancer-related costs are covered by the French National Health Insurance Fund. Consequently, more attention should be paid to cancer patients with low socio-economic status to help reduce inequalities in post-diagnosis living conditions

Intention to get vaccinated against COVID-19 among the general population in France: Associated factors and gender disparities

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The positive effect of workplace accommodations on the continued employment of cancer survivors five years after diagnosis

International audiencePurpose To address the gap highlighted in the literature on the effect of professional interventions to facilitate continued employment, this study aims to evaluate the effect of workplace accommodations on the continued employment 5 years after a cancer diagnosis. Methods This study is based on VICAN5, a French survey conducted in 2015-2016 to examine the living conditions of cancer survivors 5 years after diagnosis. Two subsamples, one with and one without workplace accommodations, were matched using a propensity score to control for the individual, professional, and medical characteristics potentially associated with receipt of workplace accommodations. Results The study sample was composed of 1514 cancer survivors aged 18-54 and employed as salaried at diagnosis. Among them, 61.2% received workplace accommodations within 5 years after diagnosis: 35.5% received a modified workstation, 41.5% received a modified schedule, and 49.2% received reduced hours. After matching, receipt of workplace accommodations appeared to improve the continued employment rate 5 years after cancer diagnosis from 77.8% to 95.0%. Conclusions Receipt of workplace accommodations strongly increases the continued employment of cancer survivors 5 years after diagnosis. More research is needed to better understand the differences in receipt of workplace accommodations along with the related selection effect

Intention de vaccination contre la COVID-19 en France. Analyse de l’enquête nationale COCONEL différenciée selon l’âge

International audienceLike in many countries, the French health authorities are pinning their hopes on vaccination to stop the spread of the COVID-19 pandemic. However, this requires the public to get the vaccine. Based on six COCONEL surveys carried out during and after the lockdown among the general French adult population, which aimed to explore life conditions during this period and individual perceptions of the situation, this paper aims to investigate the acceptability of a putative vaccine against COVID-19 among the French population, and more specifically to compare attitudes among the elderly, who are more vulnerable to the disease, with those of younger people. Out of the 8,036 respondents, 27.5% declared that they would refuse the vaccine if it were available. Among the age groups of particular interest, 29.2% of people aged 18–64 said they would refuse the vaccine, compared to 12.4% of respondents aged 65 or over. For both groups, this refusal rate fluctuated depending on the date of the survey, gender, household composition, level of household income, and uptake of the last flu vaccine. In conclusion, more attention should be paid to elderly people, as they were more likely to report hostility toward vaccination in general. Finally, considering that several vaccines are now available, further studies should be done to study vaccine uptake in relation to the vaccine offered.La campagne vaccinale contre la COVID-19 est une priorité sanitaire. Toutefois, l’adhésion de la population française à cette vaccination est un élément clé de sa réussite. À la lumière de six enquêtes COCONEL réalisées en population générale adulte pendant et après le confinement dans l’objectif de documenter les conditions de vie des Français pendant cette période ainsi que leur perception des mesures mises en place par les autorités, cet article propose d’analyser l’intention de se faire vacciner des Français à l’égard d’une vaccination contre la COVID-19, selon l’âge. Plus spécifiquement, l’intention des personnes âgées de 65 ans et plus, particulièrement vulnérables face à cette maladie, comparativement aux personnes plus jeunes. Parmi les 8 036 répondants, 27,5 % refuseraient ce vaccin s’il était disponible ; 29,2 % des 18-64 ans contre 12,4 % des 65 ans et plus. Quel que soit l’âge, ce refus de vaccination varie selon la date d’enquête, mais aussi selon le genre, la composition du foyer, le niveau de revenus, ainsi que la pratique vaccinale antérieure contre la grippe saisonnière. En conclusion, une attention particulière devra être portée aux personnes âgées de 65 ans et plus qui sont plus enclines à manifester une hostilité à la vaccination en général. Enfin, la mise sur le marché de différents vaccins devrait encourager à poursuivre les analyses de l’adhésion vaccinale au regard du vaccin proposé

Recours aux arrêts-maladie et au temps partiel thérapeutique après un diagnostic de cancer

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Recours aux arrêts-maladie et au temps partiel thérapeutique après un diagnostic de cancer

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