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1.
Rech Soins Infirm ; 137(2): 77-90, 2019 06.
Article in French | MEDLINE | ID: mdl-31453675

ABSTRACT

Activity programs are described in institutional policies as an added benefit in the lives of residents in that such activities are assumed to maintain health through the process of socialization. The purpose of this study is to describe the determining factors in the socialization process of elderly residents in retirement homes. A qualitative study, in nursing study using anthropological methodology was carried out from April 2016 to May 2018 in ten retirement homes in the Limousin and on Reunion Island. territory. Fifty-eight semi-structured interviews have been analyzed using NVivo 11Plus® software. The socialization process of the elderly in the context of institutional regulation is complex. Attendance at social activities is often used to measure the degree of socialization and integration in the institution, but, on its own, it is not a significant indicator. Other elements involved in the complex socialization process of the elderly in retirement homes include : family, relations with other residents, and interaction with caregivers plays a major role. An elderly person can remain isolated in his or her room, never participate in activities, and yet feel perfectly integrated and socialized within the institution. Future research will focus on the relationship between residents and caregivers as a factor in the socialization process, including the knowledge and skills of the caregivers.


Subject(s)
Homes for the Aged , Nursing Homes , Socialization , Aged , Female , Humans , Male , Qualitative Research
2.
Oncotarget ; 8(33): 54640-54653, 2017 Aug 15.
Article in English | MEDLINE | ID: mdl-28903371

ABSTRACT

PURPOSE: While many cancer patients are affected by weight loss, others tend to gain weight, which may impact prognosis and risk of recurrence and of second cancer. The aim of this prospective study was to investigate weight variation between before and after cancer diagnosis and socio-demographic, economic, lifestyle and clinical factors associated with moderate-to-severe weight gain. METHODS: 1051 incident cases of first primary cancer were diagnosed in the NutriNet-Santé cohort between 2009 and 2015. Weight was prospectively collected every 6 months since subjects' inclusion (i.e. an average of 2y before diagnosis). Mean weights before and after cancer diagnosis were compared with paired Student's t-test. Factors associated with moderate-to-severe weight gain (≥5% of initial weight) were investigated by age and sex-adjusted logistic regression. RESULTS: Weight loss was observed in men (-3.54±4.39kg in those who lost weight, p=0.0002) and in colorectal cancer patients (-3.94±4.40kg, p=0.001). Weight gain was observed in breast and skin cancers (2.83±3.21kg, p=0.04, and 2.96±2.75kg, p=0.04 respectively). Women (OR=1.75[1.06-2.87],p=0.03), younger patients (2.44[1.51-3.70],p<0.0001), those with lower income (OR=1.30[1.01-1.72],p-trend=0.007), lower education (OR=1.32[1.03-2.70],p-trend=0.03), excess weight before diagnosis (OR=1.64[1.12-2.42],p=0.01), lower physical activity (OR=1.28[1.01-1.64],p=0.04) and those who stopped smoking (OR=4.31[1.99-9.35],p=0.005]) were more likely to gain weight. In breast cancer patients, induced menopause was associated with weight gain (OR=4.12[1.76-9.67]), but no association was detected for tumor characteristics or treatments. CONCLUSION: This large prospective cohort provided original results on weight variation between before and after cancer diagnosis, highlighting different weight trajectories. Socio-demographic and economic factors appeared to influence the risk of weight gain, illustrating social inequalities in health.

3.
Int J Cancer ; 141(3): 457-470, 2017 08 01.
Article in English | MEDLINE | ID: mdl-28335085

ABSTRACT

Postdiagnosis diet and alcohol consumption may be associated with cancer prognosis, recurrence and mortality. Our aim was to investigate food, nutrient and alcohol intake variations between before and after cancer diagnosis and their determinants in a prospective cohort. Subjects (n = 696) were incident cancer cases diagnosed in the NutriNet-Santé cohort between 2009 and 2016. Food, nutrient and alcohol intakes were prospectively collected using repeated nonconsecutive 24-hr dietary records since subjects' inclusion (i.e. an average of 2 y before diagnosis). Mean number of dietary records per subject was 5.9 before and 8.1 after diagnosis. All dietary data before and after diagnosis were compared by mixed models. Factors associated with the main dietary changes observed were also investigated using multivariable logistic regressions. We observed a decrease in intakes of vegetables (mean decrease in intake in patients who decreased their intake=-102.4 ± 79.8 g/d), dairy products (-93.9 ± 82.8 g/d), meat/offal (-35.5 ± 27.8/d), soy products (-85.8 ± 104.1 g/d), sweetened soft drinks (-77.9 ± 95.4 g/d), and alcoholic drinks (-92.9 ± 119.9 g/d), and an increase in broths (42.1 ± 34.9 g/d) and fats/sauces (18.0 ± 13.4 g/d). We observed a decrease in energy intake (-377.2 ± 243.5 kcal/d) and in intakes of alcohol (-7.6 ± 9.4 g/d) proteins (-17.4 ± 12.5 g/d), and several vitamins (p < 0.05) and micronutrients (p < 0.05). Conversely, lipid (19.4 ± 14.6 g/d), SFA (9.3 ± 7.0 g/d), MUFA (8.3 ± 6.3 g/d) and vitamin E (3.9 ± 3.3 mg/d) intakes increased after diagnosis. This large prospective study suggests that cancer diagnosis is a key period for nutritional changes. It highlights some healthy behaviors such as a decrease in alcohol and sweetened drink consumption, but also less favorable trends, such as a decrease in vegetable consumption and in many vitamin and mineral intakes. These results provide insights to identify and target recommendations to put forward for better nutritional care of cancer survivors.


Subject(s)
Alcohol Drinking , Diet , Energy Intake , Food Preferences , Neoplasms/diagnosis , Neoplasms/prevention & control , Dietary Fats , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Prospective Studies , Vegetables
4.
Medicine (Baltimore) ; 95(40): e4629, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27749527

ABSTRACT

Physical activity (PA) but also reduced sedentary behavior may be associated with better prognosis and lower risk of recurrence in cancer patients. Our aim was to quantify the variations in PA and time spent sedentary between before and after diagnosis, relying on prospective data in French adults. We also investigated sociodemographic and lifestyle factors associated with these variations.Subjects (n = 942) were incident cancer cases diagnosed in the NutriNet-Santé cohort between 2009 and 2015. PA and sedentary behavior were prospectively collected with the 7-day short version of the IPAQ questionnaire every year since subjects' inclusion (i.e., an average of 2 year before diagnosis). All PA and sitting time points before and after diagnosis was compared by mixed model. Factors associated with decrease in PA and increase in sitting time were investigated using logistic regressions.Overall and vigorous PA decreased after diagnosis (P = 0.006, -32.8 ±â€Š36.8 MET-hour/week on average, in those who decreased their overall PA and P = 0.005, -21.1 ±â€Š36.8 MET-hour/week for vigorous PA, respectively), especially in prostate (-39.5 ±â€Š36.3 MET-hour/week) and skin (-35.9 ±â€Š38 MET-hour/week) cancers, in men (-40.8 ±â€Š46.3MET-hour/week), and in those professionally inactive (-34.2 ±â€Š37.1 MET-hour/week) (all P < 0.05). Patients with higher PA level before diagnosis were more likely to decrease their PA (odds ratio [OR]: 4.67 [3.21-6.81], P < 0.0001). Overweight patients more likely to decrease moderate PA (OR: 1.45 [1.11-1.89], P = 0.006) and walking (OR: 1.30 [1.10-1.70], P = 0.04). Sitting time increased (P = 0.02, +2.44 ±â€Š2.43 hour/day on average, in those who increased their sitting time), especially in women (+2.48 ±â€Š2.48 hour/day), older patients (+2.48 ±â€Š2.57 hour/day), and those professionally inactive (2.41 ±â€Š2.40 hour/day) (all P < 0.05). Patients less sedentary before diagnosis were more likely to increase their sitting time (OR: 3.29 [2.45-4.42], P < 0.0001).This large prospective study suggests that cancer diagnosis is a key period for change in PA and sedentary behavior. It provides insights to target the subgroups of patients who are at higher risk of decreasing PA and increasing sedentary behavior after cancer diagnosis.


Subject(s)
Breast Neoplasms/psychology , Colorectal Neoplasms/psychology , Exercise , Prostatic Neoplasms/psychology , Sedentary Behavior , Skin Neoplasms/psychology , Adult , Aged , Breast Neoplasms/diagnosis , Colorectal Neoplasms/diagnosis , Female , France , Humans , Logistic Models , Male , Middle Aged , Prospective Studies , Prostatic Neoplasms/diagnosis , Sex Factors , Skin Neoplasms/diagnosis , Socioeconomic Factors , Surveys and Questionnaires
5.
Bull Cancer ; 99(4): 479-98, 2012 Apr 01.
Article in French | MEDLINE | ID: mdl-22469552

ABSTRACT

Each year, 13,000 newly gynecologic cancers are diagnosed in France. Gynecologic cancers were specifically heterogeneous (localisations, histologic subgroups, age class, etc). This work was delineated for a national call dedicated to gynecologic cancers. This review reports the major needs in terms of scientific research dedicated to gynecologic cancers in the biologic, epidemiology, human and sociologic fields. For example, medico-economic strategies adapted to ethnosociologic context, specifically for cervix cancer, took important part of the epidemiologic research. Impact of gynecologic cancer in terms of symptoms and late effects, quality of life after treatments and fertility needs to be specifically explored. For fundamental research, molecular characterisation, biologic markers, impact of immunology and genetics represent the major part of the field need to be explored. Finally, therapeutic and diagnosis innovations, optimization of treatments strategies and development of predictive models in order to perform individual prediction taking into account several risk factors (clinical and molecular) to offer help in management of gynecologic cancers are required.


Subject(s)
Genital Neoplasms, Female , Biomarkers, Tumor/blood , Biomedical Research , DNA, Neoplasm/blood , Early Detection of Cancer , Endometrial Neoplasms/pathology , Female , Fertility , France/epidemiology , Genital Neoplasms, Female/diagnosis , Genital Neoplasms, Female/epidemiology , Genital Neoplasms, Female/genetics , Genital Neoplasms, Female/immunology , Genital Neoplasms, Female/psychology , Genital Neoplasms, Female/therapy , Humans , Immunologic Surveillance/immunology , MicroRNAs/analysis , Ovarian Neoplasms/epidemiology , Ovarian Neoplasms/genetics , Ovarian Neoplasms/immunology , Ovarian Neoplasms/pathology , Ovarian Neoplasms/psychology , Ovarian Neoplasms/therapy , Quality of Life , Risk Factors , Sexuality , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/immunology , Uterine Cervical Neoplasms/psychology , Uterine Cervical Neoplasms/therapy
6.
J Healthc Risk Manag ; 30(4): 42-7, 2011.
Article in English | MEDLINE | ID: mdl-21506201

ABSTRACT

A cross-sectional and descriptive survey of a safety culture (SC) was conducted in 20 clinical units in France. A self-administered questionnaire measuring 12 dimensions of safety culture was given to healthcare professionals. The overall response rate was 65%. The poorly developed dimensions of safety culture that were identified were nonpunitive response to error, staffing, management support for patient safety, handoffs, and transitions.


Subject(s)
Hospital Administration/methods , Organizational Culture , Quality Assurance, Health Care/organization & administration , Safety Management/organization & administration , Cross-Sectional Studies , France , Humans , Models, Organizational
7.
Bull Cancer ; 93(2): 179-91, 2006 Feb.
Article in French | MEDLINE | ID: mdl-16517416

ABSTRACT

In response to the evolution of the information-seeking behaviour of patients and concerns from health professionals regarding cancer patient information, the French National Federation of Comprehensive Cancer Centres (FNCLCC) introduced, in 1998, an information and education program dedicated to patients and relatives, the SOR SAVOIR PATIENT program. The methodology of this program adheres to established quality criteria regarding the elaboration of patient information. Cancer patient information, developed in this program, is based on clinical practice guidelines produced by the FNCLCC and the twenty French regional cancer centres, the National League against Cancer, The National Cancer Institute, the French Hospital Federation, the National Oncology Federation of Regional and University Hospitals, the French Oncology Federation of General Hospitals, many learned societies, as well as an active participation of patients, former patients and caregivers. The handbook SOR SAVOIR PATIENT Understanding rectal cancer is an adapted version of the clinical practice guidelines (CPG) Standards, Options and Recommendations for rectal cancer. It is meant to provide a basis for the explanation of the disease and treatments and to facilitate discussions with the healthcare team. It is available from the FNCLCC (101, rue de Tolbiac, 75013 Paris, Tel. (0033) 1 44 23 04 68, www.fnclcc.fr). This document has been validated at the end of 2004 and published in 2005. SOR SAVOIR PATIENT guides are systematically updated when new research becomes available. Information leaflets, extracted from the handbook SOR SAVOIR PATIENT Understanding rectal cancer and published in this edition of the Bulletin du cancer, allow patients to better understand colonoscopy and colostomy, which represent an important patient information need. These articles are meant to inform patients and relatives about the disease and its treatments. It also offers health professionals a synthetic evidence-based patient information source which facilitates discussions with the patient.


Subject(s)
Rectal Neoplasms , Colonoscopy , Colostomy , Family , Humans , Rectal Neoplasms/diagnosis , Rectal Neoplasms/therapy
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