[Qualitative and collaborative research with cancer patients. Experience narratives of treatments for peritoneal carcinomatosis]. / Une recherche qualitative et collaborative auprès de patients atteints de cancer. Récits d'expérience des traitements de la carcinose péritonéale.

UNLABELLED: This CORCAN study is concerned with the way patients hospitalised for peritoneal carcinosis perceive surgical treatment and hyperthermic intraperitoneal chemotherapy (HIPEC). OBJECTIVES: (1) To identify and analyse, using concepts of social representation and accounts of the illness, characteristics of the way this treatment is experienced; (2) to inform doctors and healthcare workers about patients' representations, with a view to adjusting the treatment, the care and the information given to patients. METHODOLOGY: Fifty-eight directive and nondirective interviews were conducted longitudinally with 21 patients (13 women and 7 men) hospitalised for treatment by cell killing and HIPEC. RESULTS: Five important elements of concern were raised and discussed by the patients at different stages of the disease, then reported and discussed with the doctors and healthcare workers. These were patients' experiences of: the hyperthermic intraperitoneal chemotherapy (HIPEC), randomisation, intensive care, the effects of surgery on the digestive system, reorganising their diet, and returning home.

Patient and professional attitudes towards research in general practice: the RepR qualitative study.

BACKGROUND: Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the views of patients and relevant professionals on research in general practice. METHODS: Qualitative study, using the grounded theory approach according to Strauss and Corbin, conducted in 2010 in three French regions. Nine focus groups were run to data saturation, and included 57 participants in four different categories: patients, non-academic GPs, academic GPs, academics in other disciplines. RESULTS: Most of the participants in the four categories described research in general practice as specific to the population managed and relevant for health care. They considered that its grounding in day-to-day practice enabled pragmatic approaches. The influence of the pharmaceutical industry, rivalries between university disciplines and a possible gap between research and practice were considered as pitfalls. The barriers identified were representations of the medical researcher as a "laboratory worker", the lack of awareness of any research in the discipline, and lack of time and training. While the views of patients and non-academic GPs are mostly focused on professional issues and the views of academics other than GPs on technical issues, academic GPs are in a position to play a role of interface between the universities and general practices. CONCLUSIONS: Although the role of GPs in research is perceived differently by the various protagonists, research in general practice has an undisputed legitimacy in France. Solutions for overcoming the identified barriers include research networks with appropriate resources and training and scientifically sound collaborative research projects, as already implemented in leading countries.

When the group practice breaks up: a qualitative study.

BACKGROUND: Group practices are increasingly common for primary care physicians worldwide. Although breakups are likely to happen frequently within group practices, their process has not been studied to date. The aims of this study were therefore to explore the reasons for breakups of group practices of general practitioners and to describe the associated feelings. METHODS: We conducted a qualitative study consisting of in-depth interviews of 21 general practitioners and one secretary from past group practices in the Rhône-Alpes region, France, who experienced a breakup. RESULTS: When getting started in group practice for the first time, young doctors did not feel ready and supported, and did not necessarily share the same expectations as their partners. The reasons for the breakups involved imbalances within the groups, contrasting working and management styles, and breakdowns in communication. The breakup process often generated long-persistent feelings of suffering and failure for almost every partner who experienced a breakup, particularly for the partner who was leaving. CONCLUSIONS: Weakening factors exist from the very beginning of a partnership, and problems are likely to increase at every change or event occurring in the group. We provide several recommendations, including fair management, a shared project based on a precise contract, the consultation of third parties as necessary and, in the worst case scenario, leaving the group practice in time.

[Social representations of vaccination among patients and general practitioners: a study based on hierarchized evocation]. / Représentations sociales de la vaccination chez les patients et les médecins généralistes : une étude basée sur l'évocation hiérarchisée.

In France, there is a discrepancy between perceptions and practices related to vaccination, the causes of which are poorly understood. The purpose of this study was to examine and compare patients' and physicians' social representations of vaccination. A qualitative study based on hierarchized evocation was conducted on a sample of 30 patients and 30 general practitioners. The participants were asked to write down seven words or word groups (word associations) induced by the concept of "vaccination" and to rank them in order of importance. The associations were grouped by theme and sub-theme. Their frequency, connotations and importance were compared between the two groups. The results show that, overall, the physicians had a positive view of vaccination, while the patients had a more neutral view (polarity index: + 0.38 vs + 0.07, p < 0.01). Among both patients and general practitioners, vaccination tends to be perceived as a form of medical care mainly targeting children and aimed at prevention, and its effectiveness is considered to be implicit. However, the patients appeared to be more concerned about the potential side effects of certain vaccinations, while the GPs emphasized the harmlessness of vaccination. The participating GPs also tended to take a collective view of vaccination, while some patients criticized the lack of targeted vaccinations. Better communication on these key aspects of representations may help to increase confidence in vaccination and to close the gap between perception and practice.