7 research outputs found
Therapeutic Patient Education of the asthmatic bilingual French-Creole patients in Guadeloupe : what tools, what impact?
No full textCette étude a pour missions essentielles de comprendre et d’expliquer comment le passage d’une langue à une autre voire le mélange des deux codes langagiers qui se côtoient au sein de la population de la Guadeloupe, département français d’outre-mer, le français et le créole, peuvent, dans le cadre des échanges médicaux éducatifs, influencer la compréhension des mécanismes de la maladie par le patient, son acceptation et sa gestion.La justification de cette étude tient du constat que la prévalence de cette maladie chronique en Guadeloupe, l’asthme bronchique, est relativement importante, que la prise en charge reste perfectible malgré les recommandations de bonnes pratiques édictées par les sociétés savantes, et que certains patients ont du mal à comprendre les termes utilisés en français par leur médecin lors de l’annonce du diagnostic, ainsi que par les éducateurs chargés de leur apporter les outils de bonne gestion de cette maladie, ce qui n’est pas sans incidents en termes de morbidité et de mortalité.L’auteur décompose sa recherche autour de cinq grands thèmes :- La description du territoire d’étude, sur le plan géographico-climatique, historico-économique, sanitaire et social, la naissance d’une ère culturelle nouvelle générant une langue partagée par plus de 95% de la population et transmise au sein des familles et dans la communauté.- La présentation de l’éducation thérapeutique, démarche considérée par la communauté scientifique comme essentielle pour améliorer la prise en charge du patient et l’autogestion de la maladie, les plans gouvernementaux successifs traitant de cette matière.- L’état des connaissances sur l’asthme bronchique en France, dans le monde et en Guadeloupe plus particulièrement.- L’impact de la langue créole dans le processus de compréhension de la maladie à travers la relation soignant-soigné, et ses conséquences chez les natifs bilingues en termes d’acquisitions des outils d’autogestion en comparaison à l’utilisation du français.- La formulation de propositions de contextualisation didactique, tant en termes de formation des professionnels de santé par la préconisation de l’utilisation de la langue créole, par l’adaptation des outils psychopédagogiques au contexte local, que d’encouragement du patient à utiliser sa langue maternelle dans l’expression de ses ressentis.La recherche montre que la langue créole, utilisée autant au cours de la consultation par le médecin traitant et par le malade que pendant les séances d’éducation thérapeutique par les éducateurs et le public, influence les indicateurs de gestion de cette maladie.En conclusion, l’auteur défend l’hypothèse selon laquelle l’utilisation de la langue créole dans les échanges médicaux éducatifs chez les adolescents asthmatiques bilingues français-créole favoriserait la compréhension des mécanismes de la maladie asthmatique, la prise de conscience de sa gravité et la nécessité de se soigner pour éviter les complications, corollaire d’une bonne qualité de vie.In Guadeloupe, a French Overseas Territory, the population uses French and Creole linguistic codes. The main goals of this thesis are to understand and to explain how a better use of French and Creole, within the framework of educational medical exchanges, can improve the understanding of the mechanisms of the disease by the patient, its acceptance and its management.The bronchial asthma is a chronic disease, which affects an important part of the Guadeloupian population. In spite of the recommendations promulgated by the medical scholars, the care of the patients can be improved in Guadeloupe. Certain patients have difficulty understanding the terms used in French by their doctor during the announcement of the diagnosis, as well as by the educators in charge of bringing them the tools of good management of this disease what is not without incidents in terms of morbidity and mortality.The author elaborates his research around five main themes:- The thorough description of the space studied in this thesis; the geography of the land, the history of the population, the impact of the economic; the presentation of the social and health care infrastructures; and furthermore the birth of a new cultural era generating a language shared by more than 95 % of the population and passed on within families and communities.- The presentation of the therapeutic education, the approach considered by the scientific community as essential to improve the management of the patient and the self-management of the disease, the successive governmental plans dealing with this subject.- The state of the knowledge on the bronchial asthma in France, in the world and in Guadeloupe more particularly.- The impact of the Creole language in the process of understanding of the disease within the healthcare relationships and its consequences at the bilingual natives in terms of acquisitions of the tools of self-management in comparison to the use of French.- The formulation of proposals of didactic contextualization regarding the training of the healthcare professionals; the recommendation to the healthcare workers to use the Creole language; the adaptation of the psycho-pedagogical tools to the local context; the encouragement to the patients to use their native language in the expression of their feelings.- Researches show that the Creole language used during the consultation by the regular doctor, but also during the educational sessions therapeutics by the educators influence the indicators of management of this disease. In conclusion, the author defends the hypothesis according to which, the use of the Creole language in the educational medical exchanges at the bilingual asthmatic teenagers French-Creole would favor the understanding of the mechanisms of the asthmatic disease, the awareness of its gravity and the necessity of looking after oneself to avoid the complications, corollary of a good quality of life
Respir Res
No full textBackground: Sexual function is often affected in patients suffering from chronic diseases especially chronic obstructive pulmonary disease (COPD). However, the effect of COPD on sexual satisfaction is underappreciated in clinical practice. The aim of this study is to evaluate the impact of COPD on patient’s sexuality and the explanatory variables of sexual dissatisfaction. Methods: Questionnaires were emailed to participants and they submitted their responses on the Santé Respiratoire France website. Data about sexual well-being (Arizona Sexual Experience Scale, ASEX), Quality of life (VQ11), anxiety, depression (Hospitalized anxiety and depression, HAD) and self-declared COPD grade were collected. Results: Seven hundred and fifty one subjects were included and were characterized as follows: women—51%, mean age—61 years, in a couple—62% and 70%—retired. Every grade of COPD was represented. Out of 751 participants, 301 participants (40%) had no sexual activity and 450 (60%) had sexual activity. From the 450 participants, 60% needed to change their sexual life because of their disease (rhythm, frequency and position). Subjects often used medications to improve sexual performance (43% used short-acting bronchodilator and 13% -specific erectile dysfunction drugs). ASEX questionnaire confirmed patients’ dissatisfaction (diminution of sexual appetite for 68% and sexual desire for 60%) because of breathlessness and fatigue. Eighty one percent of the responders had an altered quality of life (VQ11 mean score 35) and frequent suspected anxiety or depression (HAD mean score 10.8). Ninety percent declared that sexual dysfunction had never been discussed by their doctors, while 36% of patients would have preferred to undergo a specialized consultation. Conclusion: Sexual dysfunction is frequent among COPD patients and leads to an altered well-being, however being a cultural taboo, it remains frequently neglected. Sexual guidance should be a part of patient’s consultations improve quality of sexual life. © 2020, The Author(s)
A new look at the pathogenesis of asthma
No full textAsthma is an inflammatory disorder of the conducting airways that has strong association with allergic sensitization. The disease is characterized by a polarized Th-2 (T-helper-2)-type T-cell response, but in general targeting this component of the disease with selective therapies has been disappointing and most therapy still relies on bronchodilators and corticosteroids rather than treating underlying disease mechanisms. With the disappointing outcomes of targeting individual Th-2 cytokines or manipulating T-cells, the time has come to re-evaluate the direction of research in this disease. A case is made that asthma has its origins in the airways themselves involving defective structural and functional behaviour of the epithelium in relation to environmental insults. Specifically, a defect in barrier function and an impaired innate immune response to viral infection may provide the substrate upon which allergic sensitization takes place. Once sensitized, the repeated allergen exposure will lead to disease persistence. These mechanisms could also be used to explain airway wall remodelling and the susceptibility of the asthmatic lung to exacerbations provoked by respiratory viruses, air pollution episodes and exposure to biologically active allergens. Variable activation of this epithelial-mesenchymal trophic unit could also lead to the emergence of different asthma phenotypes and a more targeted approach to the treatment of these. It also raises the possibility of developing treatments that increase the lung's resistance to the inhaled environment rather than concentrating all efforts on trying to suppress inflammation once it has become established.<br/
Quality of life of patients with chronic obstructive pulmonary disease in the Gulf Cooperation Council countries
No full textObjective: To assess the health-related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD) in 4 Gulf Council Cooperation (GCC) countries. Methods: We conducted a cross-sectional survey between December 2011 and March 2012 in the following countries: Kingdom of Saudi Arabia (Riyadh, Dammam, and Jeddah), Kuwait, Bahrain, and the United Arab Emirates. The HRQL was measured using the COPD Assessment Test (CAT) and the Chronic Respiratory Disease Questionnaire-Self-Administered Standardized questionnaire (CRQ-SAS). Results: We recruited 120 patients from 6 centers in 4 countries. Their average forced expiratory volume (FEV)1 was 49.3percent (± 13.4) of predicted, and the ratio of FEV1 to forced vital capacity was 0.58 (± 0.11). The average COPD Assessment Test (CAT) score was 20.4 ± 7.6; CAT scores were highest for Riyadh (24.1 ± 7.7); and lowest for Kuwait (18.5 ± 9.2), with no significant difference between the centers. For the CRQ-SAS, the dyspnea domain score was 4.6 ± 1.6, the fatigue domain score was 4.3 ± 1.3, the emotional domain was 4.6 ± 1.2, and the mastery domain was 4.8 ± 1.4. The correlation coefficients of the association between the CAT score and the 4 domains of the CRQ-SAS for all of the centers combined was statistically significant. Conclusion: The CAT and CRQ-SAS revealed that the patients with COPD experienced a moderate to severe impact from the disease, and a considerably compromised quality of life in the GCC countries.Al Moamary Mohamed S, 2012, J Infect Public Health, V5, P159, DOI 10.1016-j.jiph.2012.01.002; Al Moamary MS, 2011, BMC PULM MED, V11, DOI 10.1186-1471-2466-11-21; Al Ghobain M, 2011, ANN SAUDI MED, V31, P129, DOI 10.4103-0256-4947.77485; Al-Haqwi AI, 2010, ANN THORAC MED, V5, P145, DOI 10.4103-1817-1737.65044; Al-Hazzaa HM, 2012, SAUDI MED J, V33, P459; Al-Moamary MS, 2011, SAUDI MED J, V32, P1028; Al-Moamary MS, 2008, SAUDI MED J, V29, P271; Al Moamary MS, 2010, MED PRIN PRACT, V19, P373, DOI 10.1159-000316376; Al Mutairi SS, 2006, RESPIROLOGY, V11, P449, DOI 10.1111-j.1400-1843.2006.00873.x; Al-Riyami AA, 2003, SAUDI MED J, V24, P875; Al-Turki YA, 2006, SAUDI MED J, V27, P700; [Anonymous], 1995, AM J RESP CRIT CARE, V152, P1107; Bednarek M, 2008, THORAX, V63, P402, DOI 10.1136-thx.2007.085456; Behbehani NN, 2004, SAUDI MED J, V25, P585; Bullinger M, 2003, ADV EXP MED BIOL, V528, P113; Chaouachi K, 2009, MED HYPOTHESES, V73, P623, DOI 10.1016-j.mehy.2009.06.016; De Civita M, 2005, PHARMACOECONOMICS, V23, P659, DOI 10.2165-00019053-200523070-00003; Gershon AS, 2010, ARCH INTERN MED, V170, P560, DOI 10.1001-archinternmed.2010.17; Global Initiative for Chronic Obstructive Lung Disease (GOLD), GLOB STRAT DIAGN MAN; Halbert RJ, 2006, EUR RESPIR J, V28, P523, DOI 10.1183-09031936.06.00124605; IBM Corp. Released, 2010, IBM SPSS STAT WIND V; Jones PW, 2011, EUR RESPIR J, V38, P29, DOI 10.1183-09031936.00177210; Jones PW, 2009, EUR RESPIR J, V34, P648, DOI 10.1183-09031936.00102509; Jordan RE, 2010, THORAX, V65, P492, DOI 10.1136-thx.2009.129395; Knishkowy B., 2005, PEDIATRICS, V116, P113; Mannino DM, 2007, LANCET, V370, P765, DOI 10.1016-S0140-6736(07)61380-4; Oh EG, 2009, INT J TUBERC LUNG D, V13, P580; Puhan MA, 2004, RESP MED, V98, P342, DOI 10.1016-j.rmed.2003.10.013; Raherison C, 2009, Eur Respir Rev, V18, P213, DOI 10.1183-09059180.00003609; Rodriguez-Roisin R, 2012, ARCH BRONCONEUMOL, V48, P286, DOI 10.1016-j.arbres.2012.02.018; Schunemann HJ, 2003, CHEST, V124, P1421, DOI 10.1378-chest.124.4.1421; Schunemann HJ, 2005, EUR RESPIR J, V25, P31, DOI 10.1183-09031936.04.00029704; Williams JEA, 2001, THORAX, V56, P954, DOI 10.1136-thorax.56.12.95433
Quality of life of patients with chronic obstructive pulmonary disease in the Gulf Cooperation Council countries
No full textObjective: To assess the health-related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD) in 4 Gulf Council Cooperation (GCC) countries. Methods: We conducted a cross-sectional survey between December 2011 and March 2012 in the following countries: Kingdom of Saudi Arabia (Riyadh, Dammam, and Jeddah), Kuwait, Bahrain, and the United Arab Emirates. The HRQL was measured using the COPD Assessment Test (CAT) and the Chronic Respiratory Disease Questionnaire-Self-Administered Standardized questionnaire (CRQ-SAS). Results: We recruited 120 patients from 6 centers in 4 countries. Their average forced expiratory volume (FEV)1 was 49.3percent (± 13.4) of predicted, and the ratio of FEV1 to forced vital capacity was 0.58 (± 0.11). The average COPD Assessment Test (CAT) score was 20.4 ± 7.6; CAT scores were highest for Riyadh (24.1 ± 7.7); and lowest for Kuwait (18.5 ± 9.2), with no significant difference between the centers. For the CRQ-SAS, the dyspnea domain score was 4.6 ± 1.6, the fatigue domain score was 4.3 ± 1.3, the emotional domain was 4.6 ± 1.2, and the mastery domain was 4.8 ± 1.4. The correlation coefficients of the association between the CAT score and the 4 domains of the CRQ-SAS for all of the centers combined was statistically significant. Conclusion: The CAT and CRQ-SAS revealed that the patients with COPD experienced a moderate to severe impact from the disease, and a considerably compromised quality of life in the GCC countries.Al Moamary Mohamed S, 2012, J Infect Public Health, V5, P159, DOI 10.1016-j.jiph.2012.01.002; Al Moamary MS, 2011, BMC PULM MED, V11, DOI 10.1186-1471-2466-11-21; Al Ghobain M, 2011, ANN SAUDI MED, V31, P129, DOI 10.4103-0256-4947.77485; Al-Haqwi AI, 2010, ANN THORAC MED, V5, P145, DOI 10.4103-1817-1737.65044; Al-Hazzaa HM, 2012, SAUDI MED J, V33, P459; Al-Moamary MS, 2011, SAUDI MED J, V32, P1028; Al-Moamary MS, 2008, SAUDI MED J, V29, P271; Al Moamary MS, 2010, MED PRIN PRACT, V19, P373, DOI 10.1159-000316376; Al Mutairi SS, 2006, RESPIROLOGY, V11, P449, DOI 10.1111-j.1400-1843.2006.00873.x; Al-Riyami AA, 2003, SAUDI MED J, V24, P875; Al-Turki YA, 2006, SAUDI MED J, V27, P700; [Anonymous], 1995, AM J RESP CRIT CARE, V152, P1107; Bednarek M, 2008, THORAX, V63, P402, DOI 10.1136-thx.2007.085456; Behbehani NN, 2004, SAUDI MED J, V25, P585; Bullinger M, 2003, ADV EXP MED BIOL, V528, P113; Chaouachi K, 2009, MED HYPOTHESES, V73, P623, DOI 10.1016-j.mehy.2009.06.016; De Civita M, 2005, PHARMACOECONOMICS, V23, P659, DOI 10.2165-00019053-200523070-00003; Gershon AS, 2010, ARCH INTERN MED, V170, P560, DOI 10.1001-archinternmed.2010.17; Global Initiative for Chronic Obstructive Lung Disease (GOLD), GLOB STRAT DIAGN MAN; Halbert RJ, 2006, EUR RESPIR J, V28, P523, DOI 10.1183-09031936.06.00124605; IBM Corp. Released, 2010, IBM SPSS STAT WIND V; Jones PW, 2011, EUR RESPIR J, V38, P29, DOI 10.1183-09031936.00177210; Jones PW, 2009, EUR RESPIR J, V34, P648, DOI 10.1183-09031936.00102509; Jordan RE, 2010, THORAX, V65, P492, DOI 10.1136-thx.2009.129395; Knishkowy B., 2005, PEDIATRICS, V116, P113; Mannino DM, 2007, LANCET, V370, P765, DOI 10.1016-S0140-6736(07)61380-4; Oh EG, 2009, INT J TUBERC LUNG D, V13, P580; Puhan MA, 2004, RESP MED, V98, P342, DOI 10.1016-j.rmed.2003.10.013; Raherison C, 2009, Eur Respir Rev, V18, P213, DOI 10.1183-09059180.00003609; Rodriguez-Roisin R, 2012, ARCH BRONCONEUMOL, V48, P286, DOI 10.1016-j.arbres.2012.02.018; Schunemann HJ, 2003, CHEST, V124, P1421, DOI 10.1378-chest.124.4.1421; Schunemann HJ, 2005, EUR RESPIR J, V25, P31, DOI 10.1183-09031936.04.00029704; Williams JEA, 2001, THORAX, V56, P954, DOI 10.1136-thorax.56.12.95433
Quality of life of patients with chronic obstructive pulmonary disease in the Gulf Cooperation Council countries
No full textObjective: To assess the health-related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD) in 4 Gulf Council Cooperation (GCC) countries. Methods: We conducted a cross-sectional survey between December 2011 and March 2012 in the following countries: Kingdom of Saudi Arabia (Riyadh, Dammam, and Jeddah), Kuwait, Bahrain, and the United Arab Emirates. The HRQL was measured using the COPD Assessment Test (CAT) and the Chronic Respiratory Disease Questionnaire-Self-Administered Standardized questionnaire (CRQ-SAS). Results: We recruited 120 patients from 6 centers in 4 countries. Their average forced expiratory volume (FEV)1 was 49.3percent (± 13.4) of predicted, and the ratio of FEV1 to forced vital capacity was 0.58 (± 0.11). The average COPD Assessment Test (CAT) score was 20.4 ± 7.6; CAT scores were highest for Riyadh (24.1 ± 7.7); and lowest for Kuwait (18.5 ± 9.2), with no significant difference between the centers. For the CRQ-SAS, the dyspnea domain score was 4.6 ± 1.6, the fatigue domain score was 4.3 ± 1.3, the emotional domain was 4.6 ± 1.2, and the mastery domain was 4.8 ± 1.4. The correlation coefficients of the association between the CAT score and the 4 domains of the CRQ-SAS for all of the centers combined was statistically significant. Conclusion: The CAT and CRQ-SAS revealed that the patients with COPD experienced a moderate to severe impact from the disease, and a considerably compromised quality of life in the GCC countries.Al Moamary Mohamed S, 2012, J Infect Public Health, V5, P159, DOI 10.1016-j.jiph.2012.01.002; Al Moamary MS, 2011, BMC PULM MED, V11, DOI 10.1186-1471-2466-11-21; Al Ghobain M, 2011, ANN SAUDI MED, V31, P129, DOI 10.4103-0256-4947.77485; Al-Haqwi AI, 2010, ANN THORAC MED, V5, P145, DOI 10.4103-1817-1737.65044; Al-Hazzaa HM, 2012, SAUDI MED J, V33, P459; Al-Moamary MS, 2011, SAUDI MED J, V32, P1028; Al-Moamary MS, 2008, SAUDI MED J, V29, P271; Al Moamary MS, 2010, MED PRIN PRACT, V19, P373, DOI 10.1159-000316376; Al Mutairi SS, 2006, RESPIROLOGY, V11, P449, DOI 10.1111-j.1400-1843.2006.00873.x; Al-Riyami AA, 2003, SAUDI MED J, V24, P875; Al-Turki YA, 2006, SAUDI MED J, V27, P700; [Anonymous], 1995, AM J RESP CRIT CARE, V152, P1107; Bednarek M, 2008, THORAX, V63, P402, DOI 10.1136-thx.2007.085456; Behbehani NN, 2004, SAUDI MED J, V25, P585; Bullinger M, 2003, ADV EXP MED BIOL, V528, P113; Chaouachi K, 2009, MED HYPOTHESES, V73, P623, DOI 10.1016-j.mehy.2009.06.016; De Civita M, 2005, PHARMACOECONOMICS, V23, P659, DOI 10.2165-00019053-200523070-00003; Gershon AS, 2010, ARCH INTERN MED, V170, P560, DOI 10.1001-archinternmed.2010.17; Global Initiative for Chronic Obstructive Lung Disease (GOLD), GLOB STRAT DIAGN MAN; Halbert RJ, 2006, EUR RESPIR J, V28, P523, DOI 10.1183-09031936.06.00124605; IBM Corp. Released, 2010, IBM SPSS STAT WIND V; Jones PW, 2011, EUR RESPIR J, V38, P29, DOI 10.1183-09031936.00177210; Jones PW, 2009, EUR RESPIR J, V34, P648, DOI 10.1183-09031936.00102509; Jordan RE, 2010, THORAX, V65, P492, DOI 10.1136-thx.2009.129395; Knishkowy B., 2005, PEDIATRICS, V116, P113; Mannino DM, 2007, LANCET, V370, P765, DOI 10.1016-S0140-6736(07)61380-4; Oh EG, 2009, INT J TUBERC LUNG D, V13, P580; Puhan MA, 2004, RESP MED, V98, P342, DOI 10.1016-j.rmed.2003.10.013; Raherison C, 2009, Eur Respir Rev, V18, P213, DOI 10.1183-09059180.00003609; Rodriguez-Roisin R, 2012, ARCH BRONCONEUMOL, V48, P286, DOI 10.1016-j.arbres.2012.02.018; Schunemann HJ, 2003, CHEST, V124, P1421, DOI 10.1378-chest.124.4.1421; Schunemann HJ, 2005, EUR RESPIR J, V25, P31, DOI 10.1183-09031936.04.00029704; Williams JEA, 2001, THORAX, V56, P954, DOI 10.1136-thorax.56.12.95433
