Psychosocial factors associated with pain in patients treated by haemodialysis

Introduction : la douleur est un symptôme fréquent chez les patients en dialyse et qui peut être influencé par différents facteurs psychosociaux. La littérature actuelle sur le sujet ne permet pas de déterminer quels facteurs sont à prendre en compte dans ce domaine. L'objectif de cette étude était de déterminer quels facteurs psychosociaux sont associés aux douleurs ressenties par les patients traités par hémodialyse. Méthode : l'échantillon était composé de 89 patients et 5 infirmier(e)s. À l'inclusion, plusieurs variables sociodémographiques et médicales ont été évaluées ainsi que la douleur, la personnalité, les stratégies de coping, la symptomatologie anxio-dépressive, la qualité de vie et l'alliance thérapeutique. Une partie de ces variables a été ré-évaluée 2 mois plus tard. De plus, entre ces deux temps de mesure, des auto-évaluations de la douleur ont été faites lors de chaque séance de dialyse. Enfin, des entretiens individuels ont été menés auprès de 5 dyades patient-infirmier(e) visant à explorer un évènement douloureux apparu lors d'une séance de dialyse. Résultats : la douleur concerne 60% des patients, avec une sévérité et un impact sur le quotidien du patient importants. Le coping est la principale variable expliquant la douleur des patients, à l'inclusion, mais également en ce qui concerne les douleurs ressenties pendant les séances de dialyse. Par ailleurs, les résultats montrent des associations entre la douleur et l'attitude des infirmier(e)s pendant les séances. Les résultats des analyses thématiques des entretiens ont mis en avant 3 grandes thématiques. La première, le contexte de la maladie rénale, rappelle les contraintes de la maladie chez les patients. La seconde thématique fait référence à la douleur, la façon dont elle est nommée et comprise et ses caractéristiques, notamment temporelles. La troisième thématique concerne la relation patient-infirmier(e) et aborde les caractéristiques individuelles des patients (personnalité, état émotionnel), des infirmier(e)s (empathie, expérience) et les caractéristiques de leur relation (connaissance de l'autre, communication) associées à leurs interactions autour de la douleur. Conclusion : ces résultats montrent l'importance de prendre en compte la douleur des patients traités par hémodialyse et suggèrent des pistes de prises en charge, impliquant à la fois les patients et les soignants.Introduction: Pain is a frequent symptom in patients treated by haemodialysis, which can be influenced by several psychosocial factors. Literature on the subject does not specify which factors should be considered in this domain. The aim of this study was to evaluate which psychosocial factors are associated with pain in patients undergoing haemodialysis. Method: Our sample consisted of 89 patients undergoing haemodialysis and 5 nurses. At inclusion, medical and sociodemographic characteristics were evaluated, as well as pain, personality, coping strategies, anxiety and depressive symptoms, quality of life and therapeutic alliance. Several of these variables were re-evaluated after 2 month. In-between, patients also completed self-reported evaluations of pain during each dialysis session. Furthermore, individual interviews were conducted with 5 patient-nurse dyads to explore a pain event that occurred during a dialysis session. Results: Sixty percent of the sample experience pain. Pain severity and its daily interference are important. Coping strategies are the main variables explaining patient's levels of pain severity and interference at inclusion and pain experienced during dialysis sessions. Moreover, results show that pain is associated with nurses attitudes during dialysis sessions. The results of the thematic analysis of the interviews highlighted 3 major themes. The first one refers to the context of the renal disease and its burden on the patient's life. The second thematic deals with pain and its characteristics, such as its identity and temporality. The last theme raises the topic of the patient-nurse relationship and specifies characteristics that are associated with their interactions during a pain event (i.e. patient's personality or emotional state, nurses' empathy and work experience, patient-nurses' communication and interpersonal knowledge). Conclusion: Those results highlight the importance to consider pain in patients undergoing haemodialysis and suggest psychological interventions, involving both patients and nurses

What do French school staff know about young carers? A qualitative study about their perceptions

Young carers (YCs) are children and adolescents who provide a significant help to family member(s) with a disease or a disability. They often remain hidden, especially in France where awareness levels and policy responses regarding YC are just emerging. Several studies show that YC often have difficulties at school because of their situation. However, school staff seems to have difficulties to identify and support YC. The aim of this study was to explore schools teachers and other professionals' levels of awareness and their perceptions of the potential impacts of caring on pupil attainment, achievement, and wellbeing. Thirty‐three professionals working with pupils from 6 to 18 years old (primary, secondary, and high schools) took part in a semi‐structured interview and in a short phone interview. The results showed that almost all had already met a YC. Despite knowledge and perceptions of potential impacts for their pupils, few undertook actions to support them. Healthcare professionals and school counsellors seemed more aware of these situations than teachers and more prone to offer support. These results underline the need to enhance all school staff's knowledge about YC and help them develop appropriate support

<p>What Is Relatives’ Role in Arthritis Management? A Qualitative Study of the Perceptions of Patient-Relative Dyads</p>

International audienc

Patients and relatives coping with inflammatory arthritis: Care teamwork

International audienceOBJECTIVE: To explore how patients and relatives experience and talk together about their life with inflammatory arthritis.DESIGN: Qualitative research.SETTING: A convenience sample was used. Participants were recruited in seven rheumatology departments in France.PARTICIPANTS: Patients with rheumatoid arthritis or spondyloarthritis, agreeing to participate in the study with a relative, age at least 18 years.DATA COLLECTION AND ANALYSIS: Two psychologists conducted face-to-face interviews with 20 patient-relative dyads (40 individuals). A thematic analysis followed a general inductive approach.RESULTS: Saturation was reached after interviews with 20 dyads. The analysis revealed four main themes: (a) disease 'lived' together: a new role for the relative (providing help in physical tasks, emotional support, acting as a driving force, having a role in medical care) and communication around the disease (not focusing on the disease); (b) impact of the disease on the relationship; (c) social impact of the disease on the dyad (social isolation); (d) difficulties and needs of the relative (need to better know the disease).CONCLUSION: This study has highlighted the importance of recognizing the role of the relative in the management of inflammatory arthritis disease, especially when medical decisions are shared with professionals. A joint approach to treatment is a basis for coping with the disease. This approach supposes (a) discussions about relatives' new roles to clarify them, (b) patients' and relatives' communication skills and (c) a good understanding of each other, which can be improved by providing information on the disease and coping strategies for both the patient and the relative

ICU Survivors Experience of ICU Diaries: An Ancillary Qualitative Analysis of the ICU Diary Study

OBJECTIVES:. To investigate patients’ experience of ICU diaries 6 months after ICU discharge among survivors. This study was designed to add insight into a large randomized study, which found no benefit of the ICU diary to post-traumatic stress disorder among critically ill patients having received mechanical ventilation. DESIGN:. A preplanned qualitative substudy of patients receiving an ICU diary written by ICU caregivers and families. Six months after ICU discharge, survivors were contacted by a psychologist for a telephone interview using a semi-directive guide. SETTING:. Thirty-five French ICUs. PATIENTS:. All ICU survivors having received an ICU diary. INTERVENTION:. An ICU diary written by both ICU staff and families. MEASUREMENTS AND MAIN RESULTS:. Among the 332 patients randomized in the intervention group (having had an ICU diary filled by both ICU staff and families), 191 (57.7%) were alive at 6 months and 101 of 191 (52.9%) participated in a telephone interview. They were (median [interquartile range]) 64 years old (53–70 yr old); 65 (64.4%) were men, and 79 (78.2%) were medical patients. Duration of ICU stay was 13 days (8–21 d). Three themes were derived from the thematic analysis: 1) reading the diary: between emotion and pain, 2) how the diary helped, and 3) the bittersweet representation of the diary. For half of the patients, the diary is a good memory of difficult times (55/101, 54.5%), others seem to be more ambivalent about it (28/101, 27.8%), and 37 of 101, 36.6% see it as a painful representation of a time to be forgotten. CONCLUSIONS:. When reading their ICU diaries, ICU survivors experienced mixed emotions, related to family messages, medical caregiving, and to the severity of their illness. Patients described diaries as a help or a hindrance to recovery, depending on their wish to remember the period or move on from it

Patients and spouses coping with inflammatory arthritis: Impact of communication and spousal perceived social support and burden

International audienc

Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation

International audienc

Additional file 2: of The ICU-Diary study: prospective, multicenter comparative study of the impact of an ICU diary on the wellbeing of patients and families in French ICUs

World Health Organization Trial Registration Data Set*. (XLSX 10 kb