La recherche au service de la performance en Santé
U.INSERM 1290 - La recherche au service de la performance en Santé
Université Claude Bernard Lyon 1
U.INSERM 1290 - La recherche au service de la performance en Santé

Actualités du laboratoire Hesper

Perceptions and Experiences of Older Persons in Two Types of Institution in France: Foster Care Family Institution and Medico-Social One.

Chammem R, Domi S, Schott AM


Background: The rapid increase in the number of older people with loss of autonomy and requiring human support, medical services, and adapted accommodation is a challenge in many countries. Beside institutions for older people, foster care families may offer an interesting innovative and affordable alternative that should to be evaluated. As the place of living has a major impact on the quality of life, our objective was to compare the perceptions and experience of older adults depending on the type of accommodation in which they live in.

Rita Chammem, Serge Domi and Anne-Marie Schott

Methods: This study was based on a mixed method approach, with a quantitative assessment and a qualitative study with semi-structured interviews conducted with older people living in two different types of institutions: medico-social institution and foster care families. We explored the perceptions and the quality of life of the participants.

Results: Institutionalization, chosen or not, can represent a trauma for older people as it disrupts their personal habits. Participants described medico-social institutions as an institutional framework supported by a strict professional team and rules, as impersonal structures (i.e., somewhat neutral), and as offering a very present, prepared, and respected reception protocol on the first day of arrival, which remained marked in memories. On the other hand, foster care families were considered as more spontaneous and family-oriented structures relying on internal and negotiable rules, offering personalized and close support in the face of loss of autonomy, but in which the reception protocol on the first day of arrival was almost absent.

Conclusions: Foster care families and medico-social institutions presented different advantages and disadvantages from the point of view of the participants. This can help health policy makers to rethink the way seniors are housed by taking into consideration their perception and quality of life.

Women's dissatisfaction with inappropriate behavior by health care workers during childbirth care in France: A survey study.

Gaucher L, Huissoud C, Ecochard R, Rudigoz RC, Cortet M, Bouvet L, Bouveret L, Touzet S, Gonnaud F, Colin C, Gaucherand P, Dupont C ; AURORE Group.


Background: Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units.

Methods: This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self-reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self-reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision-making, or deficient consideration of pain).

Results: Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94-7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57-12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision-making.

Conclusions: Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions.


Le laboratoire RESHAPE participe à l'organisation de la première formation interprofessionnelle francophone promouvant le soutien à l’adhésion thérapeutique des patients : "SOUTENIR L’ADHÉSION THÉRAPEUTIQUE DES PATIENTS".

Cette formation, soutenue par la Région Auvergne-Rhône-Alpes et l’ESPACOMP (Société Internationale pour l’Adhésion Médicamenteuse), est le résultat de la collaboration entre le laboratoire RESHAPE (INSERM-UCBL U1290) et les Universités de Genève et de Lausanne.

Au sein de cette formation, interviennent des enseignants chercheurs de Lyon : Teddy NOVAIS, Pharmacien enseignant-chercheur, Docteur en santé publique et Marie Viprey, Pharmacienne, Docteur en santé publique. Des enseignants-chercheurs suisses interviennent également : Marie SCHNEIDER, Professeure titulaire d’adhésion thérapeutique et d’inter-professionnalité à l’Université de Genève et Cristiana FORTINI, Psychologue au CHUV de Lausanne et chargée de cours à l’Université de Lausanne, spécialisées et reconnues dans le développement et l’animation de formations à l’entretien motivationnel pour les professionnels de la santé.

L’objectif de cette formation courte interprofessionnelle est de permettre aux participants d’acquérir les connaissances fondamentales en adhésion thérapeutique et les compétences en entretien motivationnel. Cette formation vise à la mise en œuvre d’une approche semi-structurée de l’adhésion médicamenteuse mettant le patient au centre de l’entretien afin de l’accompagner (approche motivationnelle).

La formation est organisée autour de 3 composantes :

  • Webinaires introductifs, 2 sessions d’une heure : connaissances théoriques sur l’adhésion (comportement et déterminants), méthodes d’évaluation de l’adhésion ;
  • Séminaire / école d’été en présentiel, 3 journées de 7 heures : formation de base à l’entretien motivationnel appliquée à l’adhésion thérapeutique, avec la participation de patients partenaires pour la formation ;
  • Webinaires de suivi, 2 sessions d’une heure : suivi de l’implémentation d’une approche structurée personnalisée de soutien à l’adhésion thérapeutique dans sa pratique professionnelle (suivi individuel 1 & en binôme, discussion des étapes de l’implémentation de l’intervention dans les différents milieux de santé).