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Diabetes is a pathology that has major consequences not only for those who suffer from it, but also for those around them. Relatives can play different roles in this respect, depending on the type of relationship they have with the person with diabetes. The onset of the disease is likely to modify pre-established roles within social groups such as the family sphere, with the possibility of strengthening ties, but also of damaging them., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Migraine is a disabling primary headache disorder characterized by recurrent episodes of headache. Migraine not only imposes a burden on the sufferer but also imposes a burden on their family members too. A holistic approach is more essential in the management of migraine and family members should also be included in the management of migraine. There are no published studies done in India so far to look for the impact of migraine on partners and adolescent children (IMPAC). This pilot study was done to assess the IMPAC., Objective: The objective of the study was to study the IMPAC., Materials and Methods: In this descriptive study, 130 chronic migraine patients were observed in a row during 9 months. The impact of migraine on family members as well as migraine disability and Migraine-specific Quality of Life (MSQoL) was evaluated using validated questionnaires., Results: One hundred and thirty chronic migraine patients were studied as part of this study. The mean age of the study population was 34.43 ± 9.002 years, and two-third of the participants were female. The majority of the participants had a moderate-to-severe disability due to migraine and had negatively impacted their MSQoL. The impact of migraine on family members was moderate-to-severe grade in most of the participants and affected their family life negatively both with children and spouses. The males were more significantly affected than females in terms of MSQoL, anxiety, depression, and also on migraine's impact on family members., Conclusion: Migraine not only affects the sufferers, it also significantly affects their family members., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Background: Involving family caregivers in direct care in the intensive care unit is increasingly recognized as part of best care practices. However, little is known about the factors that foster this involvement., Objective: The aim of this study was to identify the factors in the literature that promote or limit the involvement of family caregivers in direct care in adult intensive care units., Method: A rapid literature review was conducted in MEDLINE and CINAHL for English-and French-language articles published between 2010 and 2021., Results: 25 articles were selected (n=20 primary studies, n=5 literature syntheses). The results show a diversity of factors that influence the involvement of relatives in direct intensive care units. These factors can be grouped into four categories : relational, informal, clinical, and political., Conclusion: This review identifies the organizational, clinical and human issues relating to the involvement of family caregivers in direct care in order to propose recommendations to facilitate the implementation of this approach in the intensive care units.

The caregiver of a loved one suffering from a chronic pathology (Alzheimer's disease, Parkinson's disease, stroke, etc.) can be in psychological distress at all stages of the disease, including when the loved one enters an institution. We have designed and implemented a psycho-educational program for family caregivers of institutionalized patients. A preliminary study showed that this program was feasible, gave satisfaction to the caregivers and improved their understanding of the functioning of the institution, their communication with the professionals of the institution and their relationship with their relative in the institution. The program allowed caregivers to find their place within the institution by redefining their role., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Accompanying death is part of the daily life of intensive care workers. However, far from being a trivial experience, it mobilizes the teams emotionally and requires them to constantly adjust in order to carry out their mission of care for the patient and his or her loved ones. How do nurses and orderlies deal with end-of-life care and the particularities of death in an intensive care unit?, (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Résumé Définie comme la non-concordance entre la prescription médicale et sa mise en application, l’observance est un enjeu majeur de santé pour le pédiatre et l’équipe soignante prenant en charge l’enfant et l’adolescent porteurs d’une maladie chronique. Au temps de l’enfance, l’alliance avec les parents repose sur un accompagnement attentif et vigilant. L’adolescence est une période sensible, souvent problématique où le pédiatre et l’équipe soignante doivent mobiliser leur capacité d’écoute, d’empathie, pour appréhender toutes les dimensions de la non-observance : révolte, appropriation de la maladie, dépression… non seulement en direction de l’adolescent, mais vers les parents. L’éducation thérapeutique de l’enfant et de l’adolescent est ainsi essentielle pour mener l’adolescent à l’autonomie et préparer la transition vers la médecine adulte. The extend to which a patient's behaviour, in terms of taking medication, coincide with medical prescription define the adherence. Adherence is a major challenge for the paediatrician and medical staff taking care of chronic conditions patients. During childhood greater attention should be given to alliance with parents. During adolescence, various reasons for poor adherence should be analysed to be understood: rebellion, consciousness of disease, depression… Parents must be included in the analysis because they are very concerned by the illness experience of their child from the announcement until the autonomy. Patient education program should be based on an appraisal of each adolescent's need and must lead to autonomy and prepare to adult transition. [ABSTRACT FROM AUTHOR]

Introduction: expressed emotion (EE) is a concept which dates back to the sixties and refers to the attitude that relatives have toward a family member with schizophrenia. It comprises three behavioral patterns: criticism, hostility, and emotional overinvolvement. An important body of literature has shown that high expressed emotion (EE) is a factor of relapse in schizophrenia. The purpose of our study was to measure expressed emotion in the families of a Moroccan sample of patients and then to investigate factors associated with high EE., Methods: fifty (50) patients with stable schizophrenia, each with a relative involved in their care, were recruited during outpatients visits. Sociodemographic data were collected and the FAS scale was used by relatives. Data were also collected from the mental representations of relatives about the patient and disease. Statistical analysis was carried out using the SPSS software and was based on the Chi 2 tests as well as T tests for independent samples., Results: forty-eight percent (48%) of relatives had a high EE. High EE was associated with a feeling of shame toward the patient. It was also associated with cannabis addiction. Low EE was associated with the fact that the patient financially took care of his family., Conclusion: the knowledge of the determinants of high EE in our socio-cultural context is essential in order to direct any psycho-educational intervention aimed at reducing EE., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Amine Bout et al.)

The sick child legitimately focuses all the attention and concerns of his family and caregivers around him. However, the support offered to those around the child is of fundamental importance and of double interest, both for the psychological benefit of the family and for the young patient himself., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Aims: The study examines the experience of people living with mental disorders and their family during the spring 2020 confinement in France, as well as the care they received during this period. It also focuses on the experiences of caregivers and how they reorganized themselves during this same period., Method: Using both qualitative and quantitative methods, three surveys were conducted during the confinement. Data was collected through two online questionnaires and semi-direct individual interviews with service users, families, and caregivers., Results: The responses to our questionnaires from 173 family members, 68 service users and 40 caregivers show that people suffering from mental disorders adapted well to the confinement. Compared to the general population, there was no instance of psychiatric over-morbidity. However, the families suffered more from psychological difficulties. The deployment of remote consultations, responsiveness and availability of professionals were helpful for users. On the other hand, rapid adaptation that caregivers had to undergo made them experience a sense of loss of the actual meaning of their work. Families suffered from the lack of availability of caregivers., Conclusion: The mental health of people suffering from mental disorders involved in this study was not impacted by the confinement. They made use of the various protective resources. The habit of having a solitary life and the knowledge of available resources may have played a favorable role. Peer support has been particularly supportive. Further studies are needed to evaluate the hypothesis of a "second psychiatric wave" due to the global pandemic.

The Parents and Caregivers group in the face of ethics in pediatrics of the Île-de-France Ethics Area wondered about the association of the words Disability and Cancer by focusing on the study of the course of children with intellectual disability, treated for cancer. These situations are exceptional, the number of cases in France must not be more than fifty per year. We gathered the testimony of five families of children using a semi-directive survey taking up the journey from birth, announcement of the handicap, the diagnosis of cancer and its treatment. The verbatim show that each story is unique and rich in lessons, despite the feeling of "double penalty": "He did not deserve this, a handicap plus cancer is a lot for one person", "the shot moreover." A healthcare team was also interviewed and raised an additional question: "First, the double penalty… then, what's the point?" Through these testimonies, we sought to question the ethical principles of care, which can be shaken up in these extraordinary supported., (Copyright © 2021 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Deprescribing, in order to reduce both polypharmacy and the use of potentially inappropriate medications, remains a challenge, especially in nursing homes. Healthcare professionals perceive residents of these homes as wary of change and reluctant to take part in such endeavours. The results of two studies, one qualitative and the other quantitative, show that, on the contrary, nursing home residents and their relatives would be ready to consider a treatment reduction, provided that time is invested to explain the expected benefits of such changes., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The lockdown provoked by the COVID-19 pandemic has resulted in a reorganisation of the provision of care. The staff of the child psychiatry unit in Coulommiers has had to redesign the care provision in the light ofthe current constraints and requirements. New tools and methods have appeared, along with a new symptomatology which has had to be understood in its context. The health crisis has also affected the patients. Some have disappeared from view while others show signs of anxiety and panic attacks. Caregivers have managed to adapt in order to guarantee the necessary continuity of care., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

For serious cases of COVID-19, with severe respiratory failure due to damage to the lungs by SARS-CoV-2, hospitalisation in intensive care with intubation is often essential. What psychotraumatic risks does this episode present for these patients? Are these sudden, complex treatments, sometimes with fatal outcomes and frequently reported in the media, also a factor in the appearance of psychological trauma for families? These questions are the subject of this clinical reflection., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Objectives: Schizophrenia is a long-term, stigmatized disease which often leads to social impairment, unemployment and isolation, with heavy negative social and psychological consequences both on patients and their families. Close relatives' perceptions of the illness have an impact on their mood, and then on the course of the patient's disease itself. In this context, our objective is to evaluate the perceptions of French close relatives of people with schizophrenia or schizophrenia spectrum disorders, about the disease itself, as well as their experience within the mental healthcare system., Methods: Our population is constituted of close relatives of people experiencing schizophrenia or schizophrenia spectrum disorders, recruited through an active patient and families association. We used a French translation of a standardized questionnaire, the Brief Illness Perception Questionnaire, as well as an extensive semi-structured interview assessing the experience of the mental healthcare system (diagnosis divulgation, information about disease and treatment, family psychoeducation, hospitalization experience, and access to health professionals). Some questions in the last were open-ended questions, which allowed us to gather detailed and personal responses, in order to be able to illustrate our quantitative findings with brief clinical cases., Results: Among the 27 close relatives included in our research, results to the standardized questionnaires show threatening perceptions of the disease, in particular regarding the probable duration of the disease and the frequency of symptoms. In our study, a better access to diagnosis is associated with a shorter perceived probable duration of the disease, while an easier communication with healthcare professionals (in particular nurses) is associated with the perception of a better efficiency of the treatment. Family psychoeducation seems to be associated with the perception of less frequent symptoms. When the patient lives independently or is older, close relatives of our sample perceive a higher risk of chronicity of the disease. Our results tend to confirm the available literature on the subject of information towards families in psychiatric services: indeed, studies, especially in the field of nursing research, have shown that families tend to feel excluded from care processes and from useful information exchanges about the patient's illness. Our study also confirms the fact that family psychoeducation seems to reduce the frequency of present symptoms in the patient as perceived by the close relative. This effect could be caused by a better understanding of the real symptoms or by an enhancement of the family mood and functioning. Even if the patient's hospitalization was a difficult or very difficult experience for close relatives, it showed no relationship with their illness negative perceptions. Sociodemographic variables of the patient, such as age or the fact of living in an independent household, were associated in our research with the close relatives' view of a higher potential chronicity of the illness; this could be explained by a different stage of acceptation of the illness when compared to close relatives taking care of a younger or still dependent patient., Conclusions: Our results plead for further research on a larger and less homogeneous sample. Confirming our findings could help build useful recommendations leading to better integrated families who currently seem to feel relatively isolated and exclused in the healthcare process, despite the strategic role they could play and despite the many recommendations of public health policies in that matter. Efforts should continue to be made to reach the goal of a better inclusion of families and close relatives of people experiencing schizophrenia or schizophrenia spectrum disorders, in particular in the field of information and communication with health professionals, both areas which seem to have a potential effect on close relatives' illness negative perceptions. Family psychoeducation deserves more attention and should be more systematically proposed to French families with an easier and free access., (Copyright © 2019 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Cystic fibrosis, a rare, hereditary and chronic disease, affects the psychic functioning of children and their families. Since it is incurable, constant adjustments are essential to make sense of the inevitable evolution of the disease. The psychologists support the families and the patients so that all live as well as possible with cystic fibrosis., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Type 1 diabetes in children in Switzerland is becoming increasingly prevalent. The coordination of care seems to be a determining element and is essential for effective and efficient care., Objective: Identify the difficulties and the levers of coordination faced by healthcare workers and families during the discovery of type 1 diabetes in children aged from birth to fifteen., Method: Qualitative analysis using semi-directed interviews., Results: Three families and five healthcare workers participated in the study. Confirmation of the diagnosis was received badly and was a shock for the families. Nurses specializing in pediatric diabetes are recognized for being experts in diabetes care and education. Non-specialist nurses consider diabetes care to be stressful and complex. Collaboration between units is described as compartmentalized. ICT tools are not shared between units. Psychological support is considered to be unsatisfactory by the families., Discussion: Interdisciplinary nurses need to work together and with a structured coordination of care.

Introduction: Based on self-determination theory, the Children's Intrinsic Needs Satisfaction Scale (CINSS) measures autonomy, competence and relatedness at school, home and with peers. The factor structure and criterion-related validity of the CINSS in the Canadian youth population are tested using data from the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS)., Methods: Data from the 2014/2015 CSTADS were analyzed for evidence of convergent and discriminant validity and for method variance. A multitrait multimethod (MTMM) confirmatory factor analysis (CFA) was conducted to account for the conceptual structure of the measure. Criterion-related validity was demonstrated through correlations between related constructs, prosocial behaviours and behavioural problems, and the CINSS subscale scores. Mean differences on CINSS subscale scores between those who reported and did not report being bullied or bullying others were also examined., Results: Correlation analyses demonstrated that, in general, correlations were higher between concept/context item pairs and lowest between items measuring different concepts and contexts. Cronbach's alpha for concept and context subscales were high: α = 0.77 for autonomy, α = 0.85 for competence and α = 0.79 for relatedness. A MTMM CFA demonstrated that the model fit the data well, with no modifications. Criterion-related validity was demonstrated through correlations between CINSS subscales and related concepts or mean differences on CINSS subscales between groups., Conclusion: The CINSS demonstrates good internal consistency, factorial validity and criterion-related validity in this sample of Canadian students. The measurement of positive mental health among Canadian youth is central to surveillance efforts which will help inform mental health promotion activities across Canada., Competing Interests: There are no conflicts of interest to report.

Childhood cancer causes immense upheaval for the child and his or her family. The end of the treatments constitutes a transition period which brings with it numerous other problems. It is essential to take into account the difficulties expressed by families and to envisage areas of action to help and support them., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

The participation of families in intensive care is a practice which is still insufficiently developed. However, it is something which patients and their families would like to see implemented. The nurses are on the front line in this innovative form of care., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: Mental illness such as schizophrenia is a major public health concern. In France, the economic cost of schizophrenia represents 2% of total medical expenditures. Schizophrenia has an impact on health and quality of life not only for patients but also for relatives. Family psychoeducation is a complementary therapeutic intervention to ordinary clinical care deigned to alleviate the burden of care among relatives of patients with schizophrenia. Literature suggests such programs including the patients' family members reduce the risk of relapse. Current studies also suggest that negative emotions expressed by family members have negative consequences on patients' mental health and need to be addressed. However, family psychoeducation is still underdeveloped in France. The objective of this study was to assess the longitudinal outcome on depression level of a psychoeducation program for relatives of schizophrenic patients. The program was held in Paris and Région Île-de-France "Cluster ProFramille Île-de-France" between 2012 and 2014., Methods: Level of participant's depression was assessed by the Center for Epidemiologic Studies - Depression Scale (CES-D). Measures of depression were made for four time points: 2 months before joining the program (T1), at the beginning of the program (T2), at midpoint of the first program module (3 months, T3) and at the end of the first program module (6 months, T4). Repeated-measures ANOVA were performed to assess longitudinal change in a participant's level of depression. Type of coping strategies, knowledge about the disease, dominant thoughts and emotional progress are assessed by the program. Univariate correlation with CES-D differences between T1 and T4 were assessed. Variables with a significant association were included in a multivariate linear model to explain CES-D difference., Results: Sixty-five relatives participated to the "Cluster ProFramille Île-de-France" between 2012 and 2014 and terminated with the first module of the program. Repeated-measures ANOVA on CES-D scores between T1 and T4 (8 months) showed a significant decrease in average scores for all participants. The mean of decrease was 7 points, equivalent to a 26.6% pre-post decrease level of depression. Significant univariate correlations with depression decrease over 8 months were with "psychomotor tiredness", "frequent worries" and "dealing with worries". Multivariate linear regression only confirmed the significant role of diminishing fatigue in relation to the decrease of depression., Conclusion: Our study's results showed that the ProFamille program was efficient in reducing the level of depression for its participants over an 8 month period. As the participants progressed on managing their fatigue, their depressed moods improved., (Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

The complexity of depressive diagnosis and other forms of expression of psychological suffering during adolescence explain why particular caution is required. The medico-psycho-social determinants of teenager's mental health enjoin us to support a holistic analysis of these situations. Different analysis spectra - symptomatic, environnemental, anthropological, cultural - allow us to understand a situation at different levels of interpretation. As we will see through a clinical case examination, the difficulty of depressive diagnosis in a multicultural background is increased by the ethnocentrical aspect of this category.

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disease that usually occurs in adulthood. The majority of affected patients will develop renal complications related to cysts during their life, but may sometimes also develop severe extrarenal complications. The aim of this study is to review quantitative and qualitative results of researches that have investigated quality of life of patients suffering ADPKD. The results obtained with health-relative quality of life scales are contradictory and lack of sensibility according to the special features of ADPKD, for psychological impact for instance. Quality of life is decreased according to the quality of life scales specific to the ADPKD and qualitative studies from the early stages of the kidney failure with respect to physical (pain) and psychological impact of the disease. Untreated anxiety and depression are diagnosed for a significant part of patients. Uncertainty of prognosis, genetic guilt, precariousness of parental future, feelings of powerlessness and hopelessness are responsible at least in part of these disorders. According to the patients, pain remains underestimated by physicians and treatments are considered as insufficiently effective., (Copyright © 2017 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)

Shared psychotic disorder is a rare entity characterized by the transmission of delusional symptoms from one patient ("inducer") to another ("induced" partner). We here report a clinical observation of atypical shared psychotic disorder involving delusion of persecution and of grandeur in a teenager induced by two subjects (grand-father and paternal uncle) with two different types of psychiatric disorders, all of which present in the same subject (third-party). The nature of the content transmitted to the third subject was the sum of the ideas of the first two subjects. These three subjects had a close relationship and lived in a closed environment, without access to the outside world.

The occurrence of an unexpected sudden death puts the witnesses of this event in a situation of high emotional impact. The benefit to allow the families of victims to dispense the first resuscitation techniques has been emphasized. However, little data exist on the emotional impact of a cardio-respiratory arrest outside the hospital on the witness, who is often a close family member. Recently, we investigated the presence of psychological distress and the factors influencing it, in the active practice of basic resuscitation gestures by the witnesses guided by the operator 112. Resuscitation by a person not belonging to the medical corps seems not to be devoid of psychological impact. Indeed, the presence of psychological distress is observed for most of witnesses questioned 6 to 10 days after the call but also 3 months later. This work highlights therefore the importance of identifying the coping strategies involved, in order to promote potentially beneficial strategies and limit the trauma associated with this type of event.

For several years, the Deux-Sèvres department has been providing psychological support to people bereaved after the suicide of a loved one. The care provision is collaborative and coordinated., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Transferring a patient undergoing an allogeneic stem cell transplantation to the intensive care unit (ICU) is always a challenging situation on a medical and psychological point of view for the patient and his relatives as well as for the medical staff. Despite the progress in hematology and intensive care during the last decade, the prognosis of these patients admitted to the ICU remains poor and mortality is around 50 %. The harmonization working party of the SFGM-TC assembled hematologists and intensive care specialist in order to improve conditions and modalities of the transfer of a patient after allogeneic stem cell transplantation to the ICU. We propose a structured medical form comprising all essential information necessary for optimal medical care on ICU., (Copyright © 2016. Published by Elsevier Masson SAS.)

In end-of-life situations it is important to avoid futile transfers to intensive care and to respect the wishes of the patient. To this end, it is possible to talk about the approaching death and organ donation with the family, in an 'anticipated' support approach., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

A protocol for the provision of psychological support for family members has been put in place by a hospital coordination team, in the framework of organ donation after the limitation or cessation of treatment. The support takes into account the needs of the families in terms of information, listening and follow-up. The unit psychologist plays an important role in this approach., (Copyright © 2016. Published by Elsevier Masson SAS.)

Objectives: Report the reasons that lead families to refuse organ donation during their close solicitation by hospital coordination., Material and Methods: A retrospective study was conducted between 2012 and 2015, including 148 (34%) refusal of organ donation among 426 patients identified in a state of brain death. A questionnaire of the family was completed for each interview. Collected data concerned patient characteristics, cause of death, description of the interview and reasons for refusal. A descriptive statistical analysis was performed., Results: The median age of patients was 50 years with a sex ratio of 1.4 men to 1 woman. The most common reason for non-donor family was the desire to maintain the integrity of the body of the patient (28%) followed by a religious order pattern (11%), brutality and suddenness of death (9%), the denial of death (6%) and early age of the donor (5%). In 39% of cases, the family said that the donor had expressed a written or oral refusal in his lifetime., Conclusion: A better understanding of the reasons leading to the refusal of non-donor family could provide assistance to the medical team on actions to general public with the aim to reduce the refusal rate., Level of Evidence: 4., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

A geriatric inpatient may learn of the death of a loved one. The medical team must assess what is the kindest way to announce it to the patient who is already fragile. It will address the patient's relationship with the loved one, the right to information, and the position of the family. Accompanying the patient through this ordeal is also important. This delicate issue needs the reflection of the team., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Anorexia nervosa affects mainly young adults. During care, caregivers seek alliance with patients' friends and family to be able to relate to the patients' symptoms and also their environment. Collaborative work with families helps build confidence. The "family group" is an example of well-intended partnership., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

To accompany the individual diagnosed with cancer along the care continuum, teams of professionals have been created based on integrating an interprofessional patient-centred (IPPC) practice. The goal of this article is to present some of the results of a case study documenting IPPC practice carried on by teams within the oncology care continuum. Observations and interviews with patients and their family were conducted. The results suggest that IPPC practice is variable within teams, but optimal at the beginning of treatments or cancer recurrence. However, patients can experience breakdowns in the continuity of care and more difficult transitions between oncology continuum periods (diagnosis, treatment, follow-up).

In the current healthcare environment, there is an increasing consensus for a holistic approach to the patient by means of a bio-psychosocial and spiritual model. The first part of this article describes how, in the context of a laic healthcare environment, physicians, nurses and spiritual caregivers are asked to change their way to communicate and to take into account this spiritual dimension. In the second part we will discuss some of the challenges of this interdisciplinary approach of the spiritual dimension in the hospital and the community. We will describe potential benefits for the patients, their family members and the caregivers. At the end, taking into account the spiritual dimension of the patient without proselytism will depend on the capacity of each caregiver to speak about it and to share this information in multidisciplinary team.

Communication around a comatose patient is a touchy subject. In the event of a breakdown in this interaction, there is a risk of a strained relationship being established between the nurses, the patient and their family, a source of conflicts or value judge ments. The objective of appropriate communication is to place the patient back at the centre of the relationship., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Cédric de Linage experienced coma through his wife, Amélie, after she suffered cardiopulmonary arrest. Here he describes the crucial role, during this period of uncertainty and fear, played by the nursing team. Through their care and day-to-day compassion, the team was able to treat the patient as a fragile but living patient., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Purpose, Objective: The aim of our study was to investigate the quality of life of patients undergoing cleft lip or cleft lip and palate as well as the perception of quality of life of patients perceived by their parents slot., Patients and Methods: Fifty-one adolescents and young adults (29 boys and 22 girls) who underwent cleft lip (FL 22) or lip and palate (CLP 29) and their parents have received psychological and surgical joint consultation. The minimum age for inclusion was 10 years (mean age 15.5 years). A quality of life questionnaire (VSP-A) "children" was given between 10 and 11 years and a questionnaire "adolescents" beyond. Parents have them answered a questionnaire of perceived quality of life of their children. The results were analyzed and compared to a control population (Statistics Student test). Perceived parents lived in relation to their children was obtained through the study of linear regression curves., Results: The response rate to the questionnaires was 66.7% for parents, 85.7% for children and 63.6% for teenagers. The quality of life of the patients was assessed by the patients to 65.1/100 on average. The index of overall quality of life was superimposed on the control population (p=0.66). Perceived quality of life of patients by their parents was fairly close to the quality of life described by patients (66.5). On the areas of family, education, recreation, quality index was proportionately less than for other areas. For each of these areas, parents overestimated the quality of life of their child. Compared to the control group the fields of education, leisure, vitality quality index were significantly lower in the/FL population P., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Background: To date, we do not know how home adaptations transform the residential experience of people with disabilities and their families., Purpose: This study aimed to describe the residential reappropriation process of people with spinal cord injury and their families., Method: Interviews with 31 people with spinal cord injuries and 31 family members focused on the adaptations, satisfaction with the adaptations, territorial behaviour at home, and family functioning., Findings: Adaptations aimed to sustain the disabled person's autonomy and mobility. Participants were satisfied with the physical adaptations, particularly in regard to convenience and feeling safe. Territorial behaviour supported the need for control and freedom. A more successful reappropriation process was associated with more effective family functioning., Implications: Territorial behaviours and effective family functioning should be considered by occupational therapists working with families.

Background: Transmission of oncogenetic information (TOI) by probands to their families is of major importance to organize medical prevention in his family. Little is known about the difficulties that the proband faces when he tries to endorse his "duty to warn"., Methods: To characterize the barriers to TOI, a survey was performed, previously to the bioethic law of 2011, on a representative sample of 337 counselees seen in the last 10 years at the Centre Jean-Perrin Oncogenetics Department. A questionnaire comprising 97 items was prepared by experts and validated by a group of patients and health professionals. Nineteen Lickert-scale questions specially concerned TOI., Results: Analysis found two dimensions, one of emotions and one concerning communication attitudes. Both dimensions were negatively correlated (r=-0.34, P<10(-7)): high emotional levels limited communication attitudes. The probands' history of cancer was the main factor impacting TOI. TOI was more difficult for cancer patients than for healthy counselees (P=0.025). Delay since consultation and type of cancer risk had no bearing on TOI., Conclusion: Cancer and its treatments seem to deeply affect patient's relatives and limit his capacity to involve his family into the oncogenetic inquiry. Measures are suggested to help ex-patients improve TOI., (Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Patient associations are very active in the support and defence of the rights of patients and their families. They offer training to support them and long respite breaks during which patients and carers can recharge their batteries. Digital technologies open up new approaches in the support provided.

Taking the example of a nursing situation, a nurse shares with us the clinical approach taken by the nursing teams caring for a dependent person helped by a family member. While the patient is at the centre of the approach, the family carer also benefits from the attention of the nurses. The Zarit Burden Interview is an effective toolfor identifying and assessing the carer's needs.

Situations involving people struggling with their day-to-day living activities, family carers, professionals and many other players are complex. Each is singular, evolves, and is sometimes difficult to decipher. While supporting a family member can be a wonderful human adventure, some situations generate extreme suffering.

The platforms for respite care and support for carers are recent developments. They enable support to be extended to the family members and not just the patients themselves. These services are provided by daycare centres which, through their missions, already offer a form of respite care to families supporting an elderly person at home in the process of losing their autonomy, often as a consequence of a form of dementia such as Alzheimer's.

Accompanying loved ones suffering from a mental health problem on a daily basis is an experience that profoundly transforms the identity of families. Such families must often cope with feelings such as guilt and helplessness. The psychiatric hospitalisation of a family member suffering from mental illness hardly improves the situation. In this context, existing literature recognises the benefits of including family members involved in care, as much for the afflicted person as for family and the professionals involved. However, these families inevitably feel excluded from care and unrecognised in their role, leading to important consequences. This critical review of literature was meant to analyse the obstacles to practicing a family-oriented approach by nurses working in mental health units, in order to propose recommendations aiming at the transformation of present clinical practices in this regard. A systematic study of literature was carried out on the databases CINHAL, Psychlnfo and PubMed and the analysis of literature was realised based on the Theory of Change proposed by Collerette. The results demonstrate that confidentiality, lack of abilities and expertise in addition to certain organisational problems constitute the principal barriers to the practice of nursing interventions for families on a daily basis.

Objectives: In France, organ donation refusal rates approach 32% of eligible brain deaths. Outright family refusal represents the primary barrier reason for declining organ donation. This retrospective study evaluated factors influencing this decision., Material and Methods: A retrospective chart review at Lille Hospital, France, was conducted on brain-death patients eligible for organ donation between 2010 and 2011. Data were collected regarding patient characteristics, death conditions and reasons for refusal based upon family interview. Descriptive statistic analyses were conducted to identify circumstances associated with family refusal., Results: Of 227 eligible organ donors identified, 70 families (30.8%) refused organ donation. The most frequent reason for refusal was desire to keep the body's wholeness (46.3%), followed by religion (16.4%), mistrust of the medical community (13.4%), and revolt against society (6%). The most common causes of death associated with refusal were brutality and suddenness of death (44.8%), early age (23.9%), denial of death (17.9%), and the family culpability (11.9%). In 30% of cases, the family followed the deceased's wishes before his death., Conclusion: Family refusal remains a significant factor associated with the approximately one third of declined eligible organ donations. This retrospective analysis suggested that the most important cause for refusal was a desire to keep the body's wholeness, and the brutality and suddenness of the potential donor's death. Additional research addressing these factors, and their underlying causes, paired with measures to improve professional training and public awareness are warranted to improve organ donation rates., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

A child's cancer affects the whole family and has repercussions on each member. The disease favours the creation of intense, close bonds and support strategies between the parents and child, from which it is often difficult to withdraw. A specific consultation, away from the care environment, provides support for the patients and their family.