La dépendance à l'exercice comme construit multidimensionnel (étude de ses origines, caractéristiques et conséquences)

Cette thèse avait pour objectif de mieux comprendre le phénomène de la dépendance à l exercice en étudiant la relation de celle-ci avec des facteurs motivationnels et personnels variés. Différentes théories concernant la motivation, le perfectionnisme et l estime de soi ont été utilisée afin de déterminer les facteurs les plus fortement liés avec la dépendance à l exercice. Après le développement d échelles de passion et de perfectionnisme adaptées à une population d âges diverses, trois études empiriques ont été réalisées. La première étude a révélé quatre clusters distincts basés sur les profils motivationnels des individus. Le cluster incluant un grand nombre d individus avec des scores très élevés pour la passion obsessive et le perfectionnisme socialement prescrit obtenait les scores les plus élevés pour la dépendance à l exercice. La deuxième étude a démontrée, à l aide des corrélations canoniques, une forte relation entre la passion obsessive et les différentes composantes de la dépendance à l exercice. Finalement la troisième étude a démontré que la relation entre le perfectionnisme et la dépendance à l exercice peut être médiée par la passion obsessive et par l estime de soi dépendant du sport. La conclusion de cette thèse est alors que la passion obsessive est fortement liée à la dépendance à l'exercice, et que le perfectionnisme et une estime de soi fortement dépendant du sport jouent probablement un rôle important dans le développement de cette dépendance à l exercice.The objective of this thesis was to gain a better understanding of the concept of exercise dependence, by studying its relationship with a variety of motivational and personal factors. Different theories concerning motivation, perfectionism and self-esteem have been used in order to determine which of those factors were most strongly related to excercise dependence. After adapting the passion and perfectionism scales for use in populations of different ages, three empricial studies have been realized. The first study revealed four different clusters based on the motivational profiles of the individuals included. The cluster containing an important number of individuals with very high scores on obsessive passion and socially prescribed perfectionism obtained the highest scores for exercise dependence. The second study has shown, by using canonical correlations, a strong relationship between obsessive passion and the different composing factors of exercise dependence. Finally, the third study has revealed that the relationship between perfectionism and exercise dependence can be mediated by obsessive passion and by a self-esteem depending on sport. The conclusion of this thesis is therefore that obsessive passion is strongly related to exercise dependence, and that perfectionism and a form of self-esteem extremely dependant on sport, probably play an important role in the development of this exercise dependence.PARIS11-SCD-Bib. électronique (914719901) / SudocSudocFranceF

Effects of Match Result and Social Comparison on Sport State Self-Esteem Fluctuations

International audienceObjectiveThe principal aim of this study was to test fluctuations of sport state self-esteem components (Perceived Athletic Competence [PAC] and Satisfaction with Current Sport Performance [SCSP]) depending on match results (win, loss) and social comparison which is defined in three directions: downward, lateral or upward comparison.Method95 tennis players (33 women, 62 men; Mage = 28.06; SD = 10.22) volunteered to complete a State Self-Esteem Scale (EESES; Bardel, Fontayne, & Colombel, 2008) before and after a tennis competition. Subjects of this study are categorised according to their opponent's tennis level (respectively an inferior, comparable or a superior ranking).ResultsThe results highlight: (1) a main effect of match result on PAC and SCSP levels (win > loss) and, (2) an interaction effect of match result and social comparison on PAC level. More precisely, PAC significantly decreases in case of defeat against an inferior ranked opponent (downward comparison). SCSP only fluctuates in relation with match result.ConclusionIt seems that failure has more impact on state self-esteem level than success. This study shows that sport state self-esteem level can fluctuate according to match result and social comparison

Anderhalvelijnszorg voor knie- en heupartrose

Om het aantal verwijzingen naar tweedelijnszorg orthopedie terug te dringen zijn in Nederland diverse anderhalvelijnszorgpilotprojecten voor knie- en heupartrose opgezet. In een aantal van deze projecten leveren orthopeden consulten in de huisartsenpraktijk. Uit een evaluatie van 3 van deze pilotprojecten blijkt dat ze de multidisciplinaire communicatie en de toegankelijkheid van de zorg verbeterden. Bovendien vergrootten ze de kennis en vaardigheden van zorgverleners. Deze vorm van zorg had ook gevolgen voor het aantal verwijzingen naar fysiotherapie en de tweede lijn

Fatigue and health-related quality of life in relapsing-remitting multiple sclerosis after 2 years glatiramer acetate treatment are predicted by changes at 6 months:an observational multi-center study

Observational studies of up to 12 months duration showed that glatiramer acetate (GA) treatment of relapsing-remitting multiple sclerosis may result in decreased fatigue and improves health-related quality of life (HRQoL), with no changes in disability or mood. We investigated whether in the second year of treatment these improvements are sustained, disability or mood yet improved, and 2-year changes may be predicted by changes in the first 6 or 12 months. The multi-center FOCUS-Extension study was a prospective extension of the 12-month, international, observational FOCUS study and included 67 patients (38 treatment-na <ve, 29 pre-treated) of the Dutch FOCUS cohort. Fatigue, HRQoL, depression and disability were measured by the Fatigue Impact Scale (FIS), Leeds Multiple Sclerosis Quality of Life (LMSQoL) questionnaire, Beck Depression Inventory-Short Form and the Guy's Neurological Disability Scale. A 2-year period of GA treatment was associated with -0.52 and +0.66 standard deviation changes in mean FIS and LMSQoL scores compared to baseline, whereas disability and mood remained unchanged. For FIS and LMSQoL, the Pearson correlation coefficients between 6-month changes and 2-year scores were 0.47 and 0.50, and between 12-month changes and 2-year scores 0.65 and 0.62. After 2 years GA treatment, the improvements in fatigue and HRQoL observed at 1 year are sustained, whereas disability and mood remain unchanged compared to baseline. Moreover, the levels of fatigue and HRQoL at 2 years GA treatment are predicted by the improvements at 6 months

Fatigue and health-related quality of life in relapsing-remitting multiple sclerosis after 2 years glatiramer acetate treatment are predicted by changes at 6 months:an observational multi-center study

Observational studies of up to 12 months duration showed that glatiramer acetate (GA) treatment of relapsing-remitting multiple sclerosis may result in decreased fatigue and improves health-related quality of life (HRQoL), with no changes in disability or mood. We investigated whether in the second year of treatment these improvements are sustained, disability or mood yet improved, and 2-year changes may be predicted by changes in the first 6 or 12 months. The multi-center FOCUS-Extension study was a prospective extension of the 12-month, international, observational FOCUS study and included 67 patients (38 treatment-na <ve, 29 pre-treated) of the Dutch FOCUS cohort. Fatigue, HRQoL, depression and disability were measured by the Fatigue Impact Scale (FIS), Leeds Multiple Sclerosis Quality of Life (LMSQoL) questionnaire, Beck Depression Inventory-Short Form and the Guy's Neurological Disability Scale. A 2-year period of GA treatment was associated with -0.52 and +0.66 standard deviation changes in mean FIS and LMSQoL scores compared to baseline, whereas disability and mood remained unchanged. For FIS and LMSQoL, the Pearson correlation coefficients between 6-month changes and 2-year scores were 0.47 and 0.50, and between 12-month changes and 2-year scores 0.65 and 0.62. After 2 years GA treatment, the improvements in fatigue and HRQoL observed at 1 year are sustained, whereas disability and mood remain unchanged compared to baseline. Moreover, the levels of fatigue and HRQoL at 2 years GA treatment are predicted by the improvements at 6 months

Evaluation of intermediate care for knee and hip osteoarthritis: a mixed-methods study

Background: To evaluate intermediate care for knee and hip osteoarthritis (KHOA) in the general practice that incorporate specialist services into general practice to prevent unnecessary referrals to hospitals. Methods: We used a mixed methods approach including semi-structured interviews, patient experience questionnaires and data from medical records from three intermediate care projects. Semi-structured interviews were conducted with patients, general practitioners (GPs), orthopaedists and a healthcare manager in intermediate care. Satisfaction of patients who received intermediate care (n = 100) was collected using questionnaires. Referral data and healthcare consumption from medical records were collected retrospectively from KHOA patients before (n = 96) and after (n = 208) the implementation of intermediate care. Results: GPs and orthopaedists in intermediate care experienced more intensive collaboration compared to regular care. This led to a perceived increase in GPs’ knowledge enabling better selection of referrals to orthopaedics and less healthcare consumption. Orthopaedists felt a higher workload and limited access to diagnostic facilities. Patients were satisfied and experienced better access to specialists’ knowledge in a trusted environment compared to regular care. Referrals to physiotherapy increased significantly after the implementation of intermediate care (absolute difference = 15%; 95% CI = 7.19 to 22.8), but not significantly to orthopaedics (absolute difference = 5.9%; 95% CI = -6.18 to 17.9). Conclusions: Orthopaedists and GPs perceived the benefits of an intensified collaboration in intermediate care. Intermediate care may contribute to high quality of care through more physiotherapy referrals. Further research with longer follow-up is needed to confirm these findings and give more insight in referrals and healthcare consumption

Evaluation of intermediate care for knee and hip osteoarthritis

Background: To evaluate intermediate care for knee and hip osteoarthritis (KHOA) in the general practice that incorporate specialist services into general practice to prevent unnecessary referrals to hospitals. Methods: We used a mixed methods approach including semi-structured interviews, patient experience questionnaires and data from medical records from three intermediate care projects. Semi-structured interviews were conducted with patients, general practitioners (GPs), orthopaedists and a healthcare manager in intermediate care. Satisfaction of patients who received intermediate care (n = 100) was collected using questionnaires. Referral data and healthcare consumption from medical records were collected retrospectively from KHOA patients before (n = 96) and after (n = 208) the implementation of intermediate care. Results: GPs and orthopaedists in intermediate care experienced more intensive collaboration compared to regular care. This led to a perceived increase in GPs’ knowledge enabling better selection of referrals to orthopaedics and less healthcare consumption. Orthopaedists felt a higher workload and limited access to diagnostic facilities. Patients were satisfied and experienced better access to specialists’ knowledge in a trusted environment compared to regular care. Referrals to physiotherapy increased significantly after the implementation of intermediate care (absolute difference = 15%; 95% CI = 7.19 to 22.8), but not significantly to orthopaedics (absolute difference = 5.9%; 95% CI = -6.18 to 17.9). Conclusions: Orthopaedists and GPs perceived the benefits of an intensified collaboration in intermediate care. Intermediate care may contribute to high quality of care through more physiotherapy referrals. Further research with longer follow-up is needed to confirm these findings and give more insight in referrals and healthcare consumption.</p

Quality indicators for knee and hip osteoarthritis care: a systematic review

To provide an overview of quality indicators (QIs) for knee and hip osteoarthritis (KHOA) care and to highlight differences in healthcare settings. A database search was conducted in MEDLINE (PubMed), EMBASE, CINAHL, Web of Science, Cochrane CENTRAL and Google Scholar, OpenGrey and Prospective Trial Register, up to March 2020. Studies developing or adapting existing QI(s) for patients with osteoarthritis were eligible for inclusion. Included studies were categorised into healthcare settings. QIs from included studies were categorised into structure, process and outcome of care. Within these categories, QIs were grouped into themes (eg, physical therapy). A narrative synthesis was used to describe differences and similarities between healthcare settings. We included 20 studies with a total of 196 QIs mostly related to the process of care in different healthcare settings. Few studies included patients’ perspectives. Rigorous methods for evidence synthesis to develop QIs were rarely used. Narrative analysis showed differences in QIs between healthcare settings with regard to exercise therapy, weight counselling, referral to laboratory tests and ‘do not do’ QIs. Differences within the same healthcare setting were identified on radiographic assessment. The heterogeneity in QIs emphasise the necessity to carefully select QIs for KHOA depending on the healthcare setting. This review provides an overview of QIs outlined to their healthcare settings to support healthcare providers and policy makers in selecting the contextually appropriate QIs to validly monitor the quality of KHOA care. We strongly recommend to review QIs against the most recent guidelines before implementing them into practice