[Nursing care and personalised care and prevention of a vulnerable public]. / Parcours personnalisés soins et prévention d'un public précaire.

For two years, the association Rhéso, which works in social reintegration in the Vaucluse (84), has been testing a Personalised care and prevention pathway (PCPP) on all of its systems. Quantitative and qualitative analyses of nursing interventions carried out on the basis of care and prevention defined in this PPCP indicates that it is possible to offer a care pathway adapted to all users integrating a medico-social assistance structure.

Lack of information received by a French female cohort regarding prevention against exposure to reprotoxic agents during pregnancy.

OBJECTIVE: The aim of this study was to evaluate the information pregnant women received regarding possible exposures to five recognized reprotoxic agents during their pregnancy. STUDY DESIGN: A cohort study was conducted using two postnatal units in France. Women hospitalized in postnatal units were requested to complete a self-administered two part questionnaire. The first part gathered information about the patient's socio-professional level and the type of pregnancy follow-up. The second part examined the information the patient received regarding daily products containing the following known reprotoxic agents: bisphenol A, toluene, n-hexane, cis-chloroallyl-triaza-azonia-adamantane-chloride and O-phenyl-phenol. The women cited the sources of information. We combined the employment status and educational level to separate the women into two groups. The groups were then compared using the Chi Square test or Fisher's exact test. RESULT(S): There were 390 women in this study. Our results showed the women received information regarding the following: 21.6% (n=84) regarding tin cans, 21.9% (n=85) concerning plastic meal boxes when heated in microwave ovens, 8.8% (n=32) about water in gas-bottles, 27.4% (n=106) about non-organic foods, 39.3% (n=152) about hair dyes, 17% (n=66) about nail polishes, 23.4% (n=103) about insect repellents, 34.4% (n=133) about "do-it-yourself" products, 2.1% (n=8) about gardening products, 26.7% (n=103) about electric plug-in repellents, 21.1% (n=81) about housekeeping products, and 6.8% (n=26) about register receipts. Women with a higher level of education and a qualified occupation were better informed about these daily products. These women were more likely to learn the information on their own (internet, media). CONCLUSION(S): Our study showed French women did not receive sufficient information regarding potential exposures to reprotoxic agents during pregnancy.

A pilot study about infertile men's awareness of their reprotoxic exposures and the intervention of occupational medicine to assess them.

BACKGROUND: Male infertility related to professional reprotoxic exposure has been assessed in several studies. Collaboration between occupational physicians and patients can yield information about the preventive measures that can be taken to avoid such exposure. The use of preventive measures is determined by the collaboration between reproductive medicine and occupational medicine and also by the patient's awareness of reprotoxic occupational exposures. Our andrology laboratory developed a systematic environmental interview that an occupational physician administers before semen analysis to assess patients' occupational reprotoxic chemical and physical exposures. This observational prospective study evaluated patients' feelings regarding this interview. The main outcome measure was the participants' score to determine their general reprotoxicant knowledge. The study also evaluated the patients' satisfaction about the interview with occupational physician and their attitude about reproductive toxicants. RESULTS: The mean score for general knowledge of reprotoxicants was 9.6 ± 2.7/16. The most frequently underestimated reprotoxic factor was excessive heat (34.7 % correct responses). In cases of semen parameter abnormalities AND recognized occupational reprotoxic exposure, 63.2 % of the patients said they would use individual protective devices, and 55.1 % said they would temporarily adapt their workstation. Regarding the interview with the laboratory's occupational physician, 80.7 % considered it moderately or very useful. Of the interviewed patients, 46.2 % reported having changed their living habits 2 months after the interview, and 88.5 % were satisfied or very satisfied with the care they received. All of the respondents said it would be useful to extend the interview to include their wives. CONCLUSIONS: The data suggest that patients' knowledge about reprotoxic exposures can be improved, particularly knowledge related to physical exposure. The vast majority of patients were satisfied with the introduction of this new collaboration between reproductive and occupational medicine.

CONTEXTE: Plusieurs études ont mis en évidence des infertilités masculines en lien avec une exposition reprotoxique professionnelle. L'interaction entre médecin du travail et patient peut faire émerger des informations sur les mesures preventives à mettre en place pour éviter ces expositions. L'utilisation de ces mesures préventives est déterminée par la collaboration entre médecin de la reproduction et médecin du travail et également par la conscience du patient de subir une exposition professionnelle reprotoxique. Notre laboratoire de spermiologie a mis en place un entretien systématique environnemental, assuré par un médecin du travail avant l'analyse de sperme, dans le but d'établir les expositions professionnelles reprotoxiques chimiques et physiques de chaque patient. Cette étude observationnelle prospective évalue la perception des patients de cet entretien. Le critère d'évaluation principal est le score de chaque patient évaluant ses connaissances générales sur les reprotoxiques. L'étude évalue également la satisfaction des patients à propos de cet entretien avec le médecin du travail et leur attitude vis à vis des reprotoxiques. RESULTATS: Le score moyen de connaissances générales sur les reprotoxiques était de 9.6 ± 2.7/16. Le facteur reprotoxique le plus fréquemment sous estimé était la chaleur excessive (34.7 % de bonnes réponses). En cas d'altération des paramètres spermatiques associée à des expositions professionnelles reprotoxiques, 63.2 % des patients se disaient prêts à utiliser des dispositifs de protection individuelle, et 55.1 % à accepter une adaptation temporaire de leur poste de travail. Concernant l'entretien avec le médecin du travail du laboratoire de spermiologie, 80.7 % le considéraient modérément ou très utile. Parmi les participants, 46.2 % rapportaient un changement dans leurs habitudes de vie 2 mois après l'entretien, et 88.5 % étaient satisfaits ou très satisfaits des soins reçus. Tous les participants trouveraient utile d'étendre cet entretien à leur compagne. CONCLUSIONS: Nos résultats suggèrent que les connaissances des patients sur les expositions reprotoxiques peuvent être améliorées, particulièrement en ce qui concerne les expositions physiques. La grande majorité des patients était satisfaite de l'introduction de cette nouvelle collaboration entre médecine de la reproduction et médecine du travail.