Actualités du laboratoire Hesper

- Corinne Dupont et Laurent Gaucher : « Women’s dissatisfaction with inappropriate behavior by health care workers during childbirth care in France: A survey study »

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.

Noël V, Mouchoux C, Krolak-Salmon P, Novais T.

No abstract available.

https://pubmed.ncbi.nlm.nih.gov/33818771/

Guillon A, Laurent E, Duclos A, Godillon L, Dequin PF, Agrinier N, Kimmoun A, Grammatico-Guillon L.

Abstract:

Background: The COVID-19 sanitary crisis inflicted different challenges regarding the reorganization of the human and logistic resources, particularly in intensive care unit (ICU). Interdependence between regional pandemic burden and individual outcome remains unknown. The study aimed to assess the association between ICU bed occupancy and case fatality rate of critically ill COVID-19 patients.

Methods: A cross-sectional study was performed in France, using the national hospital discharge database from March to May, 2020. All patients admitted to ICU for COVID-19 were included. Case fatality was described according to: (i) patient's characteristics (age, sex, comorbid conditions, ICU interventions); (ii) hospital's characteristics (baseline ICU experience assessed by the number of ICU stays in 2019, number of ICU physicians per bed), and (iii) the regional outbreak-related profiles (workload indicator based on ICU bed occupancy). The determinants of lethal outcome were identified using a logistic regression model.

Results: 14,513 COVID-19 patients were admitted to ICU; 4256 died (29.3%), with important regional inequalities in case fatality (from 17.6 to 33.5%). Older age, multimorbidity and clinical severity were associated with higher mortality, as well as a lower baseline ICU experience of the health structure. Regions with more than 10 days with ≥ 75% of ICU occupancy by COVID-19 patients experienced an excess of mortality (up to adjusted OR = 2.2 [1.9-2.6] for region with the highest occupancy rate of ICU beds).

Conclusions: The regions with the highest burden of care in ICU were associated with up to 2.2-fold increase of death rate.

https://pubmed.ncbi.nlm.nih.gov/34410543/

- Alexandra Dima, Julie Haesebaert, Adèle Perrin, Luiza Siqueira Do Prado, Anne-Marie Schott-Pethelaz : « What is Patient and Public Involvement in Research and how to do it? »

Patient oriented research – Key features and RESHAPE guidelines

Nowadays, partnering with patients in health research is strongly recommended. Patient and Public Involvement (PPI) in research is defined as research actively carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’, or ‘for’ them (INVOLVE group UK). In 2015, as part of the patient partnership strategy,

The BMJ began requiring authors to include a PPI statement in all research articles. In the year before the PPI reporting requirement, 0.5% of research articles reported PPI activity. In the year following the requirement, 11% of research articles reported PPI activity (Price A, BMJ 2018). In France, researchers awareness about PPI in research is less developed. Our presentation aims to disseminate these approaches within RESHAPE projects. After presenting the foundations and benefits of partnership in research, we will propose a guide and tools designed to support RESHAPE researchers and patients to engage in partnership in research.