KNOWLEDGE, ATTITUDES AND READINESS TO MANAGE INTIMATE PARTNER VIOLENCE AMONG PERINATAL CARE PROVIDERS PRACTICING IN GYNECOLOGY AND OBSTETRICS IN FRANCE

International audienc

Quality Indicators during Delivery and the Immediate Postpartum Period: A Modified Delphi Study

International audienceBackground: Our research hypothesis was that most French indicators of quality of care have been validated by experts who are not clinicians and might not always be meaningful for clinicians. Our objective was to define a core set of measurable indicators of care quality during delivery and the immediate postpartum period relevant to clinical practice. Methods: A steering committee comprising nine specialists in obstetrics and/or public health conducted a literature review to develop potential indicators. A panel of obstetrician-gynecologists and midwives working in a delivery unit rated each indicator for appropriateness in a two-round Rand-modified Delphi procedure and a physical meeting. The consensus among the panelists was assessed. Results: In the first round, 145 panelists (110 obstetrician-gynecologists and 35 midwives) assessed 77 indicators and 3 definitions: 6 related to labor onset, 20 to delivery, 3 to pain management, 23 to neonatal morbidity/mortality, and 28 to maternal morbidity. In the second round, 132 panelists (98 obstetriciangynecologists and 34 midwives) assessed 42 indicators and 1 definition. The final set comprised 50 indicators and 2 definitions. Conclusions: This Delphi procedure selected 50 indicators that reflect the quality of perinatal care. These indicators should be recorded in each French maternity ward's birth register for each delivery

Clinical Decision-Making in the Treatment of Schizophrenia: Focus on Long-Acting Injectable Antipsychotics

The purpose of this study was to identify clinician characteristics associated with higher prescription rates of long-acting injectable (LAI) antipsychotics, as well as the sources that influence medical decision-making regarding the treatment of schizophrenia. We surveyed 202 psychiatrists during six regional French conferences (Bordeaux, Lyon, Marseille, Nice, Paris, and Strasbourg). Data on the characteristics of practice, prescription rates of antipsychotic, and information sources about their clinical decisions were collected. Most psychiatrists used second-generation antipsychotics (SGAs), and preferentially an oral formulation, in the treatment of schizophrenia. LAI SGAs were prescribed to 30.4% of schizophrenic patients. The duration and type of practice did not influence the class or formulation of antipsychotics used. The clinicians following the higher percentage of schizophrenic patients were associated with a higher use of LAI antipsychotics and a lower use of oral SGAs. Personal experience, government regulatory approval, and guidelines for the treatment of schizophrenia were the three main contributing factors guiding clinicians’ decision-making regarding the treatment of schizophrenia. The more clinicians follow schizophrenic patients, the more they use LAI antipsychotics. The development of specialized programs with top specialists should lead to better use of LAI antipsychotics in the treatment of schizophrenia

Intérêt de la técarthérapie sur une cicatrice de césarienne douloureuse : protocole d’un essai clinique randomisé

International audienc

Knee Osteoarthritis People are Less Active than the General Population: an epidemiological study.

International audienceObjective. Describing the level and factors affecting the physical activity practices of knee osteoarthritis (OA) patients.Design. Propective epidemiological study.Patients and Methods. 548 knee osteoarthritis patients were interviewed via self-administered anonymous questionnaires. Main Outcome Measurement The main outcome was physical activity level, evaluated by the International Physical Activity Questionnaire (short version) (IPAQ). Secondary outcomes included sociodemographic and clinical data, comorbidities, as well as barriers to and facilitators of practicing regular physical activity evaluated over 24 specific elements. Results. The study population’s mean age was 67.6 years (SD 7.9), including 73.9% women and 30.9% obese individuals with a mean body mass index (BMI) of 28.2 kg/m2 (SD 5.7). Multi-joint osteoarthritis (OA) affected 92%, 71.6% of whom had comorbidities. The mean Visual Analogue Scale (VAS) pain intensity score was 4.5/10 (SD 2.5), 51.4% better than the Patient Acceptable Symptom State (PASS). Mean WOMAC function was 36.6/100 (SD 20.7), 57.5% better than PASS; 67% of patients used analgesics, half of them at least once a week. According to the IPAQ, 42.6% of patients reported high activity levels, 38.6% moderate, 18.8% low, the median IPAQ total activity score was 2628 metabolic equivalent of task (MET)-min/week and time spent sitting was 257.1 min/week. Only a third of patients received non-pharmacological treatment corresponding to the latest recommendations. Variables significantly related to inactive/minimally active physical activity levels were BMI (p=0.0294), gender (p=0.0008), and biomedical barriers, related to self-efficacy (p=0.0118).Conclusions. The OA study population was less active, more sedentary, and had more comorbidities and more barriers to physical activity practice than the overall population. This study could help better adapt health care measures, while taking into account patients’ overall status, including symptoms of OA pathology and comorbidities, providing tailored educational strategies with respect to physical activity

Qualité de vie liée à la santé des conjoints de patients âgés souffrant d’un épisode dépressif

International audienc

Physical activity level and association with behavioral factors in knee osteoarthritis.

International audienceBackground: The effects of physical activity (PA) in disease prevention and therapy have well-known effects on lower-limb osteoarthritis (OA), decreasing pain and improving function.Objective: We aimed to describe the level and factors affecting PA practices of people with knee OA.Design: Prospective epidemiological study.Setting: In all, 548 people with knee OA were interviewed by use of self-administered anonymous questionnaires.Main outcome measurement: The main outcome was physical activity level evaluated by the International physical activity questionnaire (IPAQ) (short version). Secondary outcomes included sociodemographic and clinical data, comorbidities, and barriers to and facilitators of practicing regular PA evaluated by 24 specific elements.Results: The mean (SD) age of the study population was 67.6 (7.9) years; 73.9% were women and 30.9% had obesity (mean [SD] body mass index [BMI] 28.2 [5.7] kg/m2). Multi-joint OA affected 92% of the population, and 71.6% had comorbidities. The mean (SD) visual analog scale score for pain intensity was 4.5/10 (2.5), which was 51.4% better than the patient acceptable symptom state (PASS). The mean (SD) Western Ontario and McMaster Universities Osteoarthritis Index function score was 36.6/100 (20.7), which was 57.5% better than the PASS. In total, 67% of patients used analgesics, half of them at least once a week. According to the IPAQ 42.6% of patients reported high, 38.6% moderate, and 18.8% low PA level; the median IPAQ total activity score was 2628 metabolic equivalent of task (MET)-min/week and time spent sitting was 257.1 min/day. Only one third of participants received non-pharmacological treatment corresponding to the latest recommendations. Variables significantly related to inactive or minimally active PA levels were BMI (P = 0.0294), sex (P = 0.0008), and biomedical barriers, related to self-efficacy (P = 0.0118).Conclusions: The OA study population was less active, more sedentary, and had more comorbidities and more barriers to PA practice than the overall population

Health-related quality of life among community-dwelling people aged 80 years and over: a cross-sectional study in France.

International audienceThe proportion of people living to a very old age is continuously increasing. One of the possibilities explored in policies and services to meet this health and societal challenge is to encourage the very old to continue living at home. This initiative is in line with the wishes of most elderly people. However, owing to the great changes that occur during old age attention should be paid to health-related quality of life (HRQoL). The aims of this study were to assess HRQoL in French community-dwelling people aged 80 years and over and to investigate the sociodemographic and health characteristics and life events associated with HRQoL

Validation of the French version of the LEIPAD in community-dwelling people aged 80 years and above

International audienc