Researches

Polypathologie dans les appartements de coordination thérapeutique (ACT)

Project overview Context: The Fédération Nationale d'Hébergement VIH et autres pathologies (FNH-VIH et autres pathologies) welcomes and accompanies, within coordination apartments (ACT) throughout the country, people in precarious situations living with one or more severe chronic pathologies. As a result of changes in the missions of the ACTs, the profile of the population has become increasingly complex, both socially and medically, prompting the FNH to adapt its action strategies to the new needs of the residents. HIV remains the most common disease in ACTs (from 1 in 4 to 2 in 3 residents depending on the region). However, there is a high prevalence of psychiatric disorders (1 in 4), hepatitis and cancer (1 in 5), as well as the presence of other co-morbidities. In 2015, more than half of the residents were affected by at least 1 co-morbidity. The difficulties in implementing therapeutic patient education (TPE) in TCAs raise questions about the nature of the health education needs of residents living with several pathologies, the evolution of these needs during their stay, and the health education interventions that can be used to respond to them, including therapeutic education for a patient with several chronic pathologies. A preliminary study made it possible to ensure the relevance and the possibility of carrying out a collaborative type of research (involving the community actors: residents and professionals) on the needs of the residents, with a view to adapting the educational interventions.
Objectives: To characterize the health education needs of ACT residents with HIV and associated diseases (hepatitis and others) at different times during their stay in an ACT (at entry, during their stay, and before discharge), with a view to proposing health education interventions that take into account their polypathology and their precarious situation.
1. to describe the priority needs of residents with HIV and associated pathologies (hepatitis and others), the place of their health needs and their evolution during their stay in an ACT
2. identify the different types of health education needs, particularly those related to polypathology
3. identify possible discrepancies between the needs expressed by the residents and the needs perceived by the ACT professionals
4. to propose strategies for health education interventions that take into account polypathology
Methods: Exploratory, qualitative, collaborative research within a naturalistic paradigm will be conducted. A collaborative research team involving residents and professionals will be formed. Its members will participate in all stages of the research (preparation, data collection, analysis and interpretation, valorization). A steering committee involving academics and members of the FNH will guarantee the conditions of the research and the use of the results.
In order to describe and analyze the health education needs of residents living with several pathologies, different sources will be solicited (residents, professionals, ACT directors). Different data collection techniques (individual interviews, focus groups, document review) will also be used. Collaborative work sessions will be organized to carry out the analyses and interpretations. Summaries will be written for each data collection technique and sent back to the participants for review, agreement and comments (credibility criteria). A phase of linking the different analyses will be carried out in order to highlight the complementarities, similarities and differences between the data (triangulation).
Perspectives: The results of the research will allow the FNH to consider the implementation of health education interventions integrating polypathology, adapted to the needs of residents with HIV and several associated pathologies, at different stages of their journey in the ACT. It will then be necessary to implement these interventions and to evaluate their effects on the development of skills and autonomy of the residents.

Collaboration FSH (Fédération Santé Habitat)

Valuation already in place Marchand C., Communier A., Maurice A., Njantou P., Vilder C., Figiel S., Malcher MF., De Andrade V., Thévenin L. Health education needs in Therapeutic Coordination Apartments. Santé Publique, 2022 Jan-Feb; 1(34):9-19

Research team

Claire MARCHAND

Maître de conférences en sciences de l'éducation et de la formation

Activités récentes :

Publications récentes : Laurendeau C. , Marchand C., Gagnayre R. Evolution en 2021 de l’enseignement de l’éducation thérapeutique du patient en formation initiale et place de la simulation dans cet enseignement : une enquête auprès de 92 instituts de formation en soins infirmiers français. Educ Ther Patient/ Patient Ther Educ. 2O22, 14, 10203

Email : Claire.marchand@univ-paris13.fr

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