L’usage de la poésie haïku en psycho-oncologie

International audienceAbstract Aim: Our study aims to describe the discourseeffects of specific and structured protocol focused on severalhaiku poems about one patient, who have experienced cancer.Procedure: The protocol consists of 4 steps: a preliminaryexploratory interview, fifteen haiku proposed without a partof the poem (a creative writing filled in by the patient), a freeform haiku composed by the patient, and finally, a finalinterview.Clinical case: A man, D., aged 25, had tumor.Result: Using this protocol, we showed discourse variationson the illness before and after the experience of poetrywriting, by Tropes V8.4 software.Conclusion: Haiku poetry can be a useful tool in the contextof supportive interventions or as preparatory work for engagementin psychotherapeutic intervention. We believe thatthe formal structure of haikus can create conditions for aspecific poetic work composed of: poetic evocation, synthesis,and mapping of the most intimate experiences in oncologyenvironment.Résumé Objectif : Cette étude qualitative et exploratoirevise à décrire les effets d’un protocole poétique centré surles haïkus en psycho-oncologie sur l’approche de la maladiechez un patient atteint de cancer.Matériel et méthodes : Il s’agit d’un protocole d’écriturepoétique composé de quatre étapes : un entretien préliminaire,la proposition de 15 haïkus (sans le vers du milieu)tirés de grands auteurs japonais, la réalisation d’un poèmecomposé librement par deux patients atteints de cancer, unentretien final sur l’expérience de l’écriture poétique.Cas clinique : Un homme, M. D., âgé de 25 ans, qui est entraitement pour un cancer.Résultats : Nous montrons les variations discursives utiliséesavant et après l’expérience de l’écriture poétique, à travers lelogiciel Tropes V8.4.Conclusion : Le travail poétique avec le haïku peut être unoutil utile, dans un contexte de support clinique en institutionou comme préparation à un travail de psychothérapie. Nouspensons que la structure formelle des haïkus peut inviter à untravail poétique spécifique : évocation poétique, synthèse etschématisation des vécus plus intimes en milieu oncologique

Bimetallic PdZn nanoparticles for the selective hydrogenation of acetylenic alcohols

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Bimetallic PdZn nanoparticles for the selective hydrogenation of acetylenic alcohols

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Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study.

Objective: To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods: Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). Results: A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. Conclusion: Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline

Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study

Objective: Consistent evidence-practice gaps in osteoarthritis (OA) care are observed in primary care settings globally. Building workforce capacity to deliver high-value care requires a contemporary understanding of barriers to care delivery. We aimed to explore barriers to OA care delivery among clinicians and students. Design: A cross-sectional, multinational study sampling clinicians (physiotherapists, primary care nurses, general practitioners (GPs), GP registrars; total possible denominator: n = 119,735) and final-year physiotherapy and medical students (denominator: n = 2,215) across Australia, New Zealand and Canada. Respondents answered a survey, aligned to contemporary implementation science domains, which measured barriers to OA care using categorical and free-text responses. Results: 1886 clinicians and 1611 students responded. Items within the domains ‘health system’ and ‘patient-related factors’ represented the most applicable barriers experienced by clinicians (25–42% and 20–36%, respectively), whereas for students, ‘knowledge and skills’ and ‘patient-related factors’ (16–24% and 19–28%, respectively) were the most applicable domains. Meta-synthesis of qualitative data highlighted skills gaps in specific components of OA care (tailoring exercise, nutritional/overweight management and supporting positive behaviour change); assessment, measurement and monitoring; tailoring care; managing case complexity; and translating knowledge to practice (especially among students). Other barriers included general infrastructure limitations (particularly related to community facilities); patient-related factors (e.g., beliefs and compliance); workforce-related factors such as inconsistent care and a general knowledge gap in high-value care; and system and service-level factors relating to financing and time pressures, respectively. Conclusions: Clinicians and students encounter barriers to delivery of high-value OA care in clinical practice/training (micro-level); within service environments (meso-level); and within the health system (macro-level)