[How do general practitioners promote a more equitable access for patient education?]. / Comment les médecins généralistes favorisent-ils l'équité d'accès à l'éducation thérapeutique pour leurs patients.

Our research is designed to understand how and under what conditions general practitioners contribute to equitable access to patient education (PE).We conducted a survey based on interactionist sociology in a sample of 32 doctors. These practitioners worked in the context of health networks and health care centres and were also involved in the PE resource centre for the Île-de-France region, thereby providing a favourable setting for our study, also reflected by the fact that one-half of practitioners were aware of the importance of or had been trained in PE.Doctors stress that their engagement in the patient-doctor relationship does not depend on the patient's psycho-social characteristics. Their educational practice nevertheless appears to be influenced by their a priori judgement of these characteristics. Based on their judgement, some clinicians develop practices that seem to promote better access for their socially underprivileged patients. This process is facilitated by several dynamics described in this article.The results of this research open up opportunities for office-based physicians and PE development structures to facilitate better access to PE for all patients.

[Coordination of support to general practitioners to facilitate the patient's care pathway]. / Coordination d'appui au médecin traitant pour faciliter les parcours de ses patients.

BACKGROUND: In France, the referring GP is responsible for coordination of the patient's care pathway, but GPs appear to have few resources to achieve this task A general practitioner support network (Arespa) was developed in the Franche-Comté region (Arespa)for complex patients. OBJECTIVE: To analyse the functioning and effects, of this network on the GP's practices. METHODS: Qualitative research. Material based on individual semistructured interviews of members of Arespa staff and regulatory bodies; collective interviews of all coordinators (12; 4 groups) and general practitioners (37, 7 groups). Clinical vignettes were used to determine the nature of the coordinators' work; the doctor's perception of the network and how and why they used it; the perceived impact of the network; but also regulation byfunding bodies. RESULTS: This coordinating network can be considered to be an original case management organisation, as it addresses the consequences of the disease on the patient's everyday life in order to facilitate the care pathway and life. The main differences are that it is primarily directed to GPs and coordinator interventions may therefore focus on treatment the consequences of disease rather than the patient's expectations. Secondly, there are no eligibility criteriafora patient's entitlement toArespa intervention, which depends exclusively on each doctor's assessment. DISCUSSION: This approach is part of a specific institutional and regulatoryframework designed to ensure the use and individual and collective efficacy of the Arespa network. The authors discuss the results in the light of the literature on case management.

[Benchmarks for interdisciplinary health and social sciences research: contributions of a research seminar]. / Jalons pour une recherche interdisciplinaire en santé et en sciences humaines et sociales: apports d'un séminaire de recherche.

This article proposes a reflection on an interdisciplinary seminar, initiated by philosophy and sociology researchers and public health professionals. The objective of this seminar was to explore the mechanisms involved in setting up and conducting interdisciplinary research, by investigating the practical modalities of articulating health and human and social sciences research in order to more clearly understand the conditions, tensions and contributions of collaborative research. These questions were discussed on the basis of detailed analysis of four recent or current research projects. Case studies identified four typical epistemological or methodological issues faced by researchers in the fields of health and human and social sciences: institutional conditions and their effects on research; deconstruction of the object; the researcher's commitment in his/her field; the articulation of research methods. Three prerequisites for interdisciplinary research in social and human sciences and in health were identified: mutual questioning of research positions and fields of study; awareness of the tensions related to institutional positions and disciplinary affiliation; joint elaboration and exchanges between various types of knowledge to ensure an interdisciplinary approach throughout all of the research process.

[The main missions of the National Palliative Care Resource Centre]. / Diffusion de la démarche palliative, une mission phare du Centre national de ressources soin palliatif.

The French National Palliative Care Resource Centre (CNDR) provides people impacted by the end of life, death and bereavement with a range of constantly evolving services. Spreading the palliative approach in order to enable everyone to benefit from it and appropriate it constitutes the main mission of the CNDR.

Chronic palliative care: specific practices for Alzheimer's disease sufferers.

INTRODUCTION: In France, the government's plan to combat Alzheimer's disease takes into consideration mostly the beginnings of the disease; it does not deal with the sufferers' end of life. For this pathology, the very idea of a palliative care phase and its definition are not straightforward. METHOD: The object of this qualitative study was to clarify this idea through a series of interviews with 44 professionals. RESULTS: The study describes three successive phases in the disease trajectory, revealed by changes in the logic of care: the stimulation phase, the chronic palliative care phase, and the terminal palliative phase. CONCLUSION: Alzheimer's disease has a specific phase of chronic palliative care. It presents, for professionals, several types of problems related to communication, pain, and feeding.