Évaluation des besoins éducatifs des patients diabétiques de type 2 reçus en médecine physique et de réadaptation : regards croisés de patients et de soignants au Centre Hospitalier Maurice Selbonne

Abstract : The rise of chronic diseases, especially diabetes, has a particularly visible impact, because of its complications, in Physical Medicine and Rehabilitation Service (PMR). In these circumstances, the therapeutic patient education (TPE) should have a privileged position. Objective : The main objective was to assess and identify personal needs in therapeutic education of type 2 diabetic patients. The secondary objectives were to assess the knowledge of the patients concerning their pathology, the knowledge of the caregivers about the TPE and their assessement in the obtacles to its achievement. Material and method : A cross-sectional observational study has been carried out in a MPR service at Maurice Selbonne Hospital Center (MSHC) from 1st March to 30th June 2017. A preliminary phase was aimed at analyzing the medical records of all the patients included, then two surveys were designed and administered , one to 30 type 2 diabetic patients, the other to 26 caregivers. A score named NCGD was created to evaluate the level of patient’s general knowledge about diabetes. Results : The included patients had generally a very low NCGD score, participation into a TPE program increased this score (p=0,049). The glycemic balance of the patients remained correct and the women had an average Ghb lower than men (6,9 % vs 8 %, p=0,03). The referring physician was the primary source of information and, although 50 % of the patients said they were misinformed, they seemed to show some indolence in the search for information. Within the diet and lifestyle, physical activity remained a misidentified notion. Half of the healthcare workforce reported difficulties with diabetes patients and one third of them found the patients unmotivated to manage their pathology. There was a confusion between health education and TPE among the caregivers and the vision they had of their role in TPE wa sunclear and poorly defined. The barriers identified in setting up TEP in the MSCH were a lack of training and a lack of time. Discussion and conclusion : Despite the weak power of this study, due to a small staff and the presence of several biases, it made possible to highlight the needs and demands of patients and caregivers in therapeutic education. Some innovative solutions are emerging, which should be integrated into future TPE programs, to raise awareness and to help patients for a better care. Caregivers will need access to trainings to embrace the profound changes required to establish TEP programs.
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Master Thesis
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Luc Charnay. Évaluation des besoins éducatifs des patients diabétiques de type 2 reçus en médecine physique et de réadaptation : regards croisés de patients et de soignants au Centre Hospitalier Maurice Selbonne. Médecine humaine et pathologie. 2018. ⟨dumas-02071890⟩

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