The psychopathological repercussions on patients faced with pain: A focus on endometriosis.

OBJECTIVES: Endometriosis is a chronic and progressive gynecological disease that affects 1 to 2 out of 10 women of childbearing age in France. The objective of this research was to understand the factors determining the quality of life of the patients who experience significant pain symptoms (75%), distinguished by the extent and depth of the lesions. The second objective was to evaluate the psychological repercussions of this pain. We will therefore assess the various psychological processes involved in explaining quality of life. METHOD: In total, 1039 women aged 18-55 years completed a self-administered questionnaire, assessing different types of pain and intensity, body image (BIS), self-esteem (Rosenberg), anxiety-depressive symptomatology (HAD), and quality of life (SF-36). Socio-biographical and medical characteristics of the patients were also assessed. RESULTS: Analyses of variance showed that patients with chronic pain had lower self-esteem and body image, more anxiety-depressive symptoms, and a poorer quality of life than women with cyclic pain and those without pain. Regression analyses showed that the determinants of physical and mental quality of life differed significantly according to the type of pain experienced. CONCLUSION: The consequences of the pain associated with endometriosis reveal multiple problems that can be considered from a new perspective. Although psychological disorders can be a response to pain phenomena they can also contribute to their increase. This is where the challenge lies in providing comprehensive care.

The level of education is associated with an anxiety-depressive state among men and women - findings from France during the first quarter of the COVID-19 pandemic.

CONTEXT: It is widely recognised that the COVID-19 pandemic has negatively impacted individuals' mental health. However, little emphasis has been put on the possible influence of socio-economic factors in the relationship. In the context of the COVID-19 pandemic, our objectives were (i) to assess the relationship between education level and mental health in French adults, and (ii) to study the influence of the economic, social, health and the COVID-19-related factors in men and women respectively. METHOD: Data are from 32,581 individuals representative of the French population who responded to the weekly survey "Baromètre COVID-19" between April 7th and May 31st 2020. Education level was self-reported (university degree, high school qualification, vocational certificate/qualification, no diploma). Anxiety-depressive state was derived from four items related to the frequency of occurrence of depressive and anxiety symptoms, and summarized in an overall validated anxiety-depressive score. Multivariate linear regression analyses were carried out with nested adjustments of variables related to economic, social, health and COVID-19 contexts to assess the relationship between education and anxiety-depressive state. RESULTS: In total, 45% of individuals reported symptoms of anxiety-depressive state (53% in women versus 36% in men). Among men, those with a vocational certificate/qualification and those with no diploma had a greater risk of having a higher anxiety-depressive state compared to those with a university degree (ßVocational certificate/qualification = 0.16 [0.04; 0.27]; ßNo diploma = 0.75 [0.43; 1.07]) while among women, the risk of anxiety-depressive state increased as education level decreased (ßBaccalaureate = 0.37 [0.25; 0.49]; ßVocational certificate/qualification = 0.41 [0.28; 0.54]; ßNo diploma = 0.8 [0.49; 1.12]). For both men and women, economic, health, and COVID-19 factors partly attenuate these associations while social factors marginally modified the relationship. After accounting for confounders and intermediate variables, the absence of a diploma remained associated with anxiety-depressive state among men, while the whole educational gradient of anxiety-depressive state persisted among women. CONCLUSION: In France, at the end of the first wave of COVID-19, individuals with a lower level of education had a higher risk of anxiety-depressive state. This association was more pronounced for women, highlighting a process of social inequality in health possibly related to gender. This should be considered in future prevention and public health interventions.

Development and Preliminary Validation of the Questionnaire "Evaluation of the Constitution of Social Circles" in Patients Treated for Cancer of the Upper Aerodigestive Tract.

PURPOSE: The constitution of social circles around patients treated for cancer of the upper aerodigestive tract (UADT) has a major influence on factors that affect quality of life (QOL) but is poorly assessed, mainly due to a lack of tools. The objective of this study is to develop a questionnaire that assesses the constitution of social circles in a population treated for UADT cancer and to analyze the construct (structural and clinical validity) and criterion validity. METHODS: The Evaluation of the Constitution of Social Circles (ECSC) questionnaire was developed in French by a committee of experts. Structural validity was analyzed using inter-item correlations. The scores of a group of patients treated for UADT cancer were compared with those of a group of healthy subjects (clinical validity). For criterion validity, the ECSC scores were compared to those from various questionnaires that assess social functioning (QFS), psychological status (HAD), perceived speech impairment (PHI), and QOL (EORTC QLQ-H&N35) in patients. RESULTS: Structural validity shows low to moderate inter-item correlations which is consistent with the construction of the questionnaire not assessing underlying concepts. Clinical validity was satisfactory regarding the frequency of contact (p = 0.01), satisfaction with the frequency of contact in the private circle (p = 0.03), and the size of the social circles of family and friends (p ≤ 0.01). Criterion validity was adequate with moderate correlations between the ECSC scores and the QFS sub-scores of interest (rs > 0.56, p < 0.05). Anxiety (HAD) had a low correlation (|rs| = 0.46, p < 0.05) with satisfaction with exchanges and the frequency of contact with family. Satisfaction with exchanges with the private circle was moderately correlated with the EORTC QLQ-H&N35 score (rs = 0.56, p = 0.01) and showed a negative trend on the PHI (rs < -0.39, p ≥ 0.05). CONCLUSION: While the test-retest reliability is yet to be evaluated and the sample size should be increased, this preliminary study shows that the ECSC is a valid tool for assessing the constitution of social circles in patients treated for UADT cancer. It highlights the links between social circles and their functional impact on communication and QOL.

Determinants of sanitary measures and lockdown compliance among health professionals during the COVID-19 pandemic.

Introduction: COVID-19 pandemic forced several countries to establish sanitary and lockdown measures to prevent the spreading of the virus. Only necessary workers were allowed to work, including health workers in hospitals. Objectives: This study explores the association between some variables and sanitary measures compliance among health workers during a pandemic. Method: A total of 299 Health workers were recruited online using social networks. Participants completed questionnaires evaluating personality, coping, Anxiety and depression, psychological flexibility and sanitary measures compliance. Results: Correlations indicated most observant participants were more likely to present efficient coping and more based on problem solving. Also, Honesty-Humility as a personality trait was positively correlated to a better compliance. Regressions indicated the perceived utility of sanitary measures was the strongest predictor for compliance among health workers. Honesty-Humility and sanitary risks perception were predictors for compliance. Conclusions: This study conducted among health workers points indicates variables associated with higher compliance. Our results suggest compliance and non-compliance as health behaviours or risk behaviours are linked to perceived threats. This perception is linked to health workers' knowledges, their coping strategies, and personality.

Introduction: La pandémie COVID-19 a obligé de nombreux pays à mettre en place des mesures sanitaires et de confinement afin d'en ralentir la propagation. Seules les professions nécessaires ont poursuivi leurs activités, dont les professionnels de santé en milieu hospitalier. Objectif: Cette étude a pour but l'exploration de facteurs en jeu dans l'observance des mesures sanitaires auprès du personnel médical hospitalier en période de pandémie. Méthode: Un total de 299 professionnels de santé a été recruté via les réseaux sociaux. Les participants ont complété des questionnaires évaluant la personnalité, le coping, l'anxiété et la dépression, la flexibilité psychologique et l'observance des mesures sanitaires. Résultats: Les corrélations effectuées ont montré que les participants les plus observants sont ceux qui présentaient un coping efficace, et principalement axé sur la résolution de problèmes. De plus, l'honnêteté comme trait de personnalité était corrélée positivement à une meilleure observance. Nos régressions ont indiqué que l'utilité perçue des mesures sanitaires est le plus solide prédicteur de l'observance chez les professionnels de santé. L'honnêteté et la perception des risques sanitaires sont apparues comme des facteurs prédicteurs de l'observance. Conclusion: Cette étude menée auprès de professionnels de santé a permis de mettre en évidence certains facteurs associés à une meilleure observance. Nos résultats suggèrent que l'observance et la non-observance en tant que comportements de santé ou à risques est influencée par la perception des menaces. Cette perception est liée aux connaissances des professionnels de santé, le coping à l'œuvre et la personnalité.

Détresse psychologique et sentiment de solitude : quels impacts du confinement lié à la Covid-19 dans la population française ?

The COVID-19 pandemic created a worldwide health crisis. This crisis resulted in an almost two-month lockdown in France - lockdown that has serious impacts on physical and mental health. This unprecedented situation resulted in an important reflection about the mental health of the persons experiencing this crisis. The aim of our study was to apprehend the emotional state of the persons experiencing this lockdown, taking into account day-to-day life and feelings of loneliness. In order to develop a good comprehension of the impact of this situation on mental health, we recruited 4689 persons through an online survey between March 17th and May 11th of 2020 in France. We used several psychometric tools that gave us access to various data, such as socio-biographical information, situational variables - place of living, work context, etc. - and psychological state - depressive symptoms, anxiety, loneliness, etc. This paper focuses mostly on the UCLA loneliness scale, and the French Canadian version of the Psychiatric Symptoms Index (PSI), which measures psychological distress, as well as depressive symptoms, anxiety and cognitive impairment. Results show a moderate psychological distress for 27.5% of our sample, with depressive symptomatology, irritability or cognitive impairment. There is also a high loneliness feeling in 21.8% of the sample. Psychological distress is explained by sociodemographic variables - such as gender and age - but also by situational information - type of housing and persistence of income - and the loneliness feeling. If this pandemic and this lockdown show a clear impact on the emotional life of the French population, these results need to be taken into account with a broader range of situational and psychological variables. These additional data would help us have a more thorough understanding of the underlying factors explaining this difficult experience of the crisis. This comprehension also needs to go further in time and think about the repercussions beyond the end of the lockdown, in order to observe the evolution of these emotions and the potential persistence of psychological distress.

[Quality of life in home-based cancer patients: A comparative study of chemotherapy administration route]. / Qualité de vie des patients atteints de cancer traités à domicile : étude comparative des différentes voies d'administration de la chimiothérapie.

INTRODUCTION: Home healthcare can be totally different depending on the route of treatment: intravenous anticancer drugs involve regular contact with the health caregiver while the oral route leaves the patient completely autonomous. This cross-sectional research has a comparative purpose between the representations of disease and treatments, the self-efficacy and the quality of life of patients treated with oral anticancer drugs and those treated by intravenous route. METHODS: The sample include 130 patients with cancer. Seventy-two are treated with intravenous chemotherapy and 48 by oral route. The protocol includes a questionnaire of disease representations (IPQ-r), treatment representations (BMQ), self-efficacy (GSES 10) and quality of life (QLQ-C30). RESULTS: The administration route of anticancer treatment impacts the illness representations with the normalization of cancer. The intravenous route, by its invasive and time-consuming nature, increases difficulties in fulfilling family and professional roles. Moreover, side effects are correlated with the perceived dangerousness of the treatment and self-efficacy. Age and the length of time since the diagnosis affect respectively the understanding of the disease and the cognitive dimension of quality of life. DISCUSSION: More than a difference in form of treatment, the whole pathway of healthcare has to be taken into account since it involves different psychological consequences, in particular about therapeutic choices or in terms of patient support.

[Therapeutic education of patients taking oral chemotherapy at home]. / Éducation thérapeutique des patients sous chimiothérapie orale à domicile.

Oral cancer drugs make the patient more active and autonomous. They reduce the number of hospital appointments and the risk of infection. However, they result in new problems such as the management of side effects. In this context, therapeutic education is essential. The first French therapeutic education programme for patients taking oral cancer drugs at home has been set up.

[Psychological impact of ostomy on the quality of life of colorectal cancer patients: Role of body image, self-esteem and anxiety]. / Impact psychologique de la stomie sur la qualité de vie des patients atteints d'un cancer colorectal : rôle de l'image du corps, l'estime de soi et l'anxiété.

Surgery accounts for an important part of the therapeutic arsenal of colorectal cancer treatment. In digestive cancers, ostomy devices induce the loss of anal function and control. This medical appliance generates changes affecting all aspects of patients' lives. This study explores, on the one hand, the psychological impact of colostomy on colorectal cancer patients' quality of life and on the other hand, it analyzes the correlational links between body image, self-esteem and anxiety during the stoma. Thirty-five patients with colorectal cancer participated in the study, divided into 2 subgroups: 23 were carriers of a definitive stoma and the 12 others with a temporary stoma. All completed the Functional Assessment Cancer Therapy (FACT-C), the Body Image Scale (BIS), the State Trait Anxiety Inventory (STAI-Y) and the Self Esteem Scale (ETES). Analysis revealed the quality of life of temporary ostomates is more affected than that of the definitive ones. All three of them, body image, self-esteem and anxiety negatively affect the quality of life regardless of the type of stoma. This study highlights the prevalence of physical self-esteem for temporary ostomy; the role of a good body image and substantial emotional self-esteem for the permanent ostomy. Future studies are required to explore the underlying causes of the acceptance of this equipment and the mediating role of care devices.