French national survey on breast cancer care: caregiver and patient views.

PURPOSE: To improve the quality of care for patients with breast cancer, an analysis of the health-care pathway, considering feedback from both health-care practitioners (HCPs) and patients, is needed. METHODS: Between 2020 and 2022, we conducted a survey at French breast cancer centers and analyzed information from questionnaires completed by HCPs and patients. We collected information on center organization, diagnostic processes, treatment decisions and modalities, supportive care, patient advocacy groups, and work issues. RESULTS: Twenty-three breast cancer centers were included and questionnaires completed by 247 HCPs and 249 patients were analyzed. The centers closely followed the legal French framework for cancer treatments, which includes formal diagnostic announcements, multidisciplinary tumor boards, personalized treatment summaries, and supportive care access. HCPs and patients were satisfied with the time to diagnosis (≤ 2 weeks as evaluated by 75% of patients), time to surgery (mean 61 days), time between surgery and chemotherapy (mean 47 days), and time between surgery and radiotherapy (mean 81 days). Fertility preservation counseling for women under 40 years of age was systematically offered by 67% of the HCPs. The majority (67%) of the patients indicated that they had received a personalized treatment summary; the topics discussed included treatments (92%), tumor characteristics (84%), care pathways (79%), supportive care (52%), and breast reconstruction (33%). Among HCPs, 44% stated that reconstructive surgery was offered to all eligible patients and 57% and 45% indicated coordination between centers and primary care physicians for adverse effects management and access to supportive care should be improved, for chemotherapy and radiotherapy, respectively. Regarding patient advocacy groups, 34% of HCPs did not know whether patients had contact and only 23% of patients declared that they had such contact. For one-third of working patients, work issues were not discussed. Twenty-eight percent of patients claimed that they had faced difficulties for supportive care access. Among HCPs, 13% stated that a formal personalized survivorship treatment program was administered to almost all patients and 37% almost never introduced the program to their patients. Compliance to oral treatments was considered very good for 75-100% of patients by 62% of HCPs. CONCLUSIONS: This study provides an updated analysis of breast cancer care pathways in France. Overall, the initial processes of diagnosis, announcement, and treatment were swift and were in agreement with the best care standards. No barriers to accessing care were identified. Based on the study findings, we proposed several strategies to improve the quality of care for patients in supportive care, coordination with primary care physicians, reconstructive surgery, and fertility preservation access.

Self-compassion and psychological well-being of radiographers at work.

OBJECTIVES: The aim of this study was to assess how self-compassion affects the psychological well-being of radiographers at work. METHODS: An online survey was sent to radiology and radiotherapy departments in Rhône-Alpes, a region of France (from October 2021 to February 2022). The study is mixed: quantitative data, with closed questions and two validated scales, and qualitative data, with open questions aimed at assessing perceptions among radiologists as regards self-compassion. RESULTS: A total of 253 radiographers (mean age 32.9 years), took part in this survey. Radiographers reported a poor level of well-being and a moderate level of self-compassion. We found a link between well-being at work and self-compassion. Gender, age, number of years of experience and the desire to receive training on well-being appear to have an impact on the level of self-compassion. The perception of self-compassion by radiologists is essentially positive. CONCLUSION: Particular attention should be paid to radiologists who are female, young, and with only a few years of experience. Self-compassion is a protective factor for radiologists and may help them take care of themselves to continue caring for others. Training related to self-compassion should be promoted in medical imaging departments.

Perceptions and feelings of a French sample regarding lung cancer screening.

INTRODUCTION: This study investigated the perceptions and feelings of a French sample about the possible introduction of lung cancer screening. METHODS: A total of 146 individuals, aged between 19- and 64-years, participated in this study conducted between November 2020 and January 2021. Participants were divided into three groups according to their smoking status: (i) active smokers (G1); former smokers (G2); and non-smokers (G3). Each individual completed an online questionnaire evaluating their perceptions and feelings about lung cancer, screening and scans. RESULTS: Overall, a higher percentage of former smokers (47%) indicated a greater willingness to participate in lung cancer screening compared to active smokers (19%) and non-smokers (32%). Active smokers and former smokers reported anxiety about the development of lung cancer. Active smokers who wished to participate in screening reported a greater motivation to reduce their tobacco consumption. The perception of lung cancer risk had less influence than age and socio-economic category on the participation in screening. Finally, stigma did not appear to be a barrier to undergoing screening. CONCLUSION: Active and former smokers were generally optimistic about screening; however, active smokers showed less inclination to participate in screening compared to former smokers and non-smokers. Three main factors appeared to influence this participation: the perception of the risk of developing cancer, age and socio-economic category.

A qualitative study of teleconsultation practices among French oncologists in a post-COVID-19 period.

Background: The Covid-19 pandemic has prompted healthcare professionals to adapt and implement new tools to ensure continuity of patient care. Teleconsultation became the only option for some practitioners who had never used it previously and boosted its use for others who already used it. Several studies have reviewed the use of teleconsultation in oncology during the epidemic, but few have addressed its continued use and how practitioners view it in a post-epidemic period. The aim of this survey was to conduct a qualitative exploration of how oncologists use teleconsultation in their daily practice in a post-COVID 19 period. Materials and Methods: For this qualitative study, semi-structured interviews were conducted with oncologists in France who utilized teleconsultation in the field of oncology during the COVID-19 period. The interview guide included questions on the interests and limitations of using teleconsultation in oncology, on reluctance to use it among oncologists, and invited participants to formulate proposals for more optimal use. Results: Fourteen oncologists participated in the survey. Currently, 12% of the consultations of the surveyed practitioners are conducted via teleconsultation. Seven themes were identified in the analysis of the interviews: (a) The oncologist and teleconsultation; (b) Clinical motivations for using teleconsultation; (c) Comparison between teleconsultation and in-person consultation; (d) Advantages and disadvantages of teleconsultation; (e) Technical modalities of teleconsultation; (f) Role of Covid and confinement in the use of teleconsultation; (h) Epistemic judgments about teleconsultation. Optimal teleconsultation occurs when seamlessly incorporated into patient care, offering reduced patient inconvenience, and providing economic and environmental benefits. Although there's a lack of unified agreement in research literature regarding time efficiency, teleconsultation facilitates more customized patient monitoring and addresses the challenge of "medical deserts" nationally. Considering patient preferences is crucial when contemplating the use of teleconsultation. Predominantly, technical issues stand as the principal barriers to teleconsultation implementation. Conclusion: Even after the end of the health crisis, teleconsultation is still used in clinical practice. Recommendations for effective use are suggested.

[Survey on the practice of medical teleconsultation in oncology in Auvergne Rhône Alpes]. / Enquête sur la pratique de la téléconsultation médicale en oncologie en Auvergne Rhône Alpes.

RATIONAL: Teleconsultation (TLC) practice, which suddenly arrived in the cancer patients care, has experienced an undeniable quantitative boom given the health context. A quantitative and qualitative assessment of this practice now seems necessary. This study aims to describe the use of TLC by oncologists in the Auvergne-Rhône-Alpes region during the pandemic in order to assess its advantages and limits, and to estimate the barriers encountered and the possible levers for its promotion in oncology. METHOD: The use of TLC in daily medical practice was evaluated using a descriptive observational survey from October to December 2021. Health's professionals were invited to answer an online survey composed of around thirty questions. RESULTS: Of the 200 oncologists contacted, 72 took part in the survey. Among them, 64 have already made at least one TLC. TLCs represented 25 % of consultations during the confinement period. New cancer patients, the fact of not seeing the patient physically and the absence of the possibility of carrying out a physical examination are the 3 main obstacles to TLC. The mastery of computer tools is one of the main levers. All cancer patients appear eligible for TLC ; the professionals surveyed prefer this solution for certain socio-demographic and medical characteristics of the patients (the fact of living far from the cancer centre, of having a stable clinical situation, of being under surveillance or being treated with oral anti-cancer drugs…). Despite a median level of satisfaction of 63 % estimated by doctors, less than 10 % of medical consultations are currently kept in TLC. CONCLUSION: TLC is now an integrated practice in oncology but seems more relevant for a specific patient profile and clinical situation. In addition, technical and training constraints still limit its use in clinical practice today.

Well-being treatments in cancer care: patient benefits.

OBJECTIVES: Well-being care is widely offered and delivered in patients with cancer. However, very few studies have rigorously evaluated its benefits. The objective of this study was to evaluate the impact of four well-being treatments (foot reflexology, socio-aesthetics, sophrology and singing) provided in a healthcare facility. METHODS: Three hundred and seventy-four patients with cancer were offered a well-being treatment and agreed to evaluate the type of treatment received, the benefits felt as a result, and numerical evaluation scales for pain and well-being before and after the session. RESULTS: The distribution of well-being treatments provided was as follows: foot reflexology: 19.0%, socio-aesthetics: 63.9%, sophrology: 6.7%, singing: 10.4%. The average gain in pain relief was 1.01 on a scale of 0-10 (p<10-5) and on well-being 6.97 on a scale of -10 to +10 (p<10-5). One patient (0.3%) experienced pain induced by a foot reflexology session and one patient (0.3%) experienced a deterioration in well-being following a singing session. CONCLUSION: The well-being treatments studied provided significant pain relief and increased well-being in patients with cancer after their completion.

Removing the language barrier in the medical care of allophone patients / Lever de la barrière linguistique dans la prise en charge médicale de patients allophones

INTRODUCTION: Non-French speaking patients have difficulty communicating with professionals when they come to a health care service. The role of the nursing staff is thus to find solutions to communicate effectively with them and facilitate patient care. PURPOSE OF RESEARCH: A systematic search of medical and allied health databases was conducted (EM Premium, BDSP, PubMed, Cairn.info). Articles identified during the search process that met the inclusion criteria were then critically appraised. RESULTS: During the search and inclusion process, 13 articles, 3 systematic review and 2 randomized control trials were found that were deemed of suitable quality to be included in the review. These were analyzed in more detail to observe common themes and then grouped into three categories. CONCLUSIONS: The results of the review demonstrate the different techniques used in care to overcome the language barrier and their effectiveness. All health care professionals involved in care must be familiar with the different techniques used and their usefulness.

Introduction: Lorsque les patients allophones se présentent dans un service de soins, le rôle du personnel soignant est de trouver des solutions pour communiquer efficacement avec eux. But de l'étude: Cette scoping review a pour but de retranscrire les différentes techniques utilisées dans les soins pour pallier la barrière linguistique, de les comparer et d'évaluer leur efficacité. Une recherche systématique de la littérature a été effectuée à l'aide de bases de données (EM Premium, BDSP, PubMed, Cairn.info) pour des publications comprises entre 2005 à 2021 en utilisant des termes de recherche pertinents. Résultats: Au total, 13 articles ont pu être étudiés et confrontés entre eux. Ils ont été regroupés en trois catégories différentes : 1) interprètes professionnels, 2) interprètes non professionnels, 3) autres méthodes. La plupart des articles ont relevé certains avantages au fait que les professionnels médicaux utilisent une technique pour pallier la barrière de la langue. Conclusions: Malgré la faible quantité de publications sur le sujet et le manque de mesures standardisées dans les articles inclus, cette revue établit suffisamment de données pour conclure que les stratégies mises en place pour pallier la barrière linguistique dans les soins sont efficaces.

Quality of life in patients with non-metastatic breast cancer: evolution during follow-up and vulnerability factors.

OBJECTIVE: In women with breast cancer, many disease-related psychosocial factors directly affect quality of life (QoL) during and after treatment. The aims of this prospective study were to evaluate the psychosocial factors affecting QoL and its dimensions, to study their evolution over time, and to determine the factors associated with this evolution. METHODS: Thirty women with non-metastatic breast cancer were asked to complete a number of questionnaires evaluating QoL and its dimensions, symptoms of anxiety and depression, body image, social support, and coping strategies immediately after their diagnosis of breast cancer (T1), at the end of treatment (T2), and 6 months after the end of treatment (T3). RESULTS: Level of education, mastectomy, and hormonotherapy all had an impact on QoL. QoL and its dimensions changed over time. Coping strategies, social support, body image, and symptoms of anxiety and depression were predictive factors for QoL. CONCLUSION: The identification of these predictive factors should help medical teams to identify the patients who are most vulnerable and susceptible to poor QoL. In women with breast cancer, it is essential to identify and treat any changes in patients' need for support in an appropriate manner, both during the course of therapy and particularly during remission.

[Antalgic effects of socio-aesthetics in cancer patients]. / Effets antalgiques de la socio-esthétique chez les patients atteints de cancer.

INTRODUCTION: Socio-aesthetics is the delivery appropriate beauty care in a population weakened by a physical, psychological and/or social attack. It has found its place in indications in both medical (especially in oncology) and social settings. It offers many types of treatments including facials, foot beauty, make-up, wig tips, body massage, product advice, cosmetic manicure, varnishing… The main purpose of this study was to evaluate pain reduction as a result of socio-aesthetics. METHODS: One hundred and eighty patients were offered a socio-aesthetic session between 12/01/2018 and 11/30/2019. One hundred and fifty-seven (87,2%) accepted the care (56.7% of women/43.3% of men, regardless of the type of cancer) and all agreed to complete a questionnaire on the type of treatment received, the benefits felt and a Likert pain assessment scale before and after the treatment. RESULTS: No patient experienced an increase in pain after the socio-aesthetic care. In the general population, the mean pain evaluation was rated at 1.31/10 and 0.78/10 before and after the session respectively, p<10-5. By selecting patients experiencing pain before treatment (40 patients, 28.0% of the total population), the mean pain evaluation was 4.27/10 and 2.52/10 before and after the treatment respectively, p<10-5. Pain was significantly reduced by massage. No patient found the socio-aesthetic treatment unnecessary. CONCLUSION: Socio-aesthetics is definitely a supportive care in oncology as it is significantly analgesic. It is easily accepted by men and regardless of the type of cancer. Researchers should conduct more studies on its impact on the quality of life.

Mindfulness-Based Programs Improve Psychological Flexibility, Mental Health, Well-Being, and Time Management in Academics.

(1) Background: Occupational stress is high in academia, and is partly related to time pressure. Mindfulness-based programs are known to be effective in reducing stress and increasing well-being. Recent work suggested that these programs may also improve time management. This study tested the effects of a mindfulness-based program on academics' psychological flexibility, mental health, well-being, and time management. (2) Methods: The study was conducted in a French research department. Participants were offered to join a mindfulness-based program (n = 21) or to be on a wait-list control group (n = 22). Self-reported measures of psychological flexibility, mental health (stress, anxiety, and depression symptoms), well-being, and time use were collected before and after the eight week program. (3) Results: Results showed that psychological flexibility, mental health, well-being, and efficient time use significantly increased in the intervention group compared to the control condition. (4) Conclusions: The results suggested that the mindfulness-based programs were effective in improving adaptive functioning, well-being, and optimal time use in academia, thus underlining potential useful perspectives to help academics improve mental health and time management.