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Résumé But de l'étude En prévention primaire des maladies cardiovasculaires, l'éducation thérapeutique du patient aide à la mise en place d'une hygiène de vie protectrice, dans un contexte sociétal où les facteurs de risque abondent. Patients et méthodes L'éducation thérapeutique du patient propose aux personnes désireuses de préserver leur santé cardiovasculaire un programme comportant actuellement six thèmes d'ateliers. Lors de l'inscription, elles s'entretiennent avec l'éducateur pour compléter, de façon spécifique à chaque thème, un diagnostic éducatif qui permet de connaître les dimensions clinique, socioprofessionnelle, cognitive et psychoaffective. Une évaluation de chaque atelier est demandée aux participants, sous forme de questions ouvertes et fermées. Résultats Les 2225 participants sont essentiellement de sexe féminin (79 %), relativement âgés (63,9 ans pour les femmes et 66,3 ans pour les hommes) et le plus souvent retraités (65 %). L'analyse des diagnostics éducatifs note la grande fréquence des facteurs de risque classique ; la bonne connaissance des facteurs les favorisant contrastant avec les faibles moyens mis en œuvre dans la vie quotidienne pour en réduire l'impact ; la conviction de la grande majorité (68 %) d'avoir une alimentation équilibrée ; la très grande implication des patients dans la prise en charge de leur santé, avec un locus externe discret impliquant le médecin généraliste, l'entourage immédiat et la société. Les notes des évaluations sont le plus souvent maximales. Conclusion L'éducation thérapeutique des patients suscite un vif intérêt du public, permet une approche personnalisée qui optimise l'apprentissage, augmente les connaissances, facilite la mise en place de nouvelles pratiques protectrices. Abstract Background As primary prevention against cardiovascular diseases, Patient Therapeutic Education helps to develop a protective lifestyle within a socioeconomic context where risk factors abound. Patients and methods Patient Therapeutic Education offers those eager to protect their cardiovascular health a program of six workshops. Upon enrolment, a Program aide conducts an educational diagnosis with the patient, specific to each workshop theme, so that he might understand the clinical, socio-professional, cognitive and psycho-affective dimensions. An evaluation of each workshop is requested from participants in the form of open and closed questions. Results The study comprised 2225 people, majority women (79%), relatively old (age 63.9 for women, 66.3 for men), most often retired (65%). An analysis of the educational diagnosis notes a great frequency of classic risk factors; a good knowledge of the factors favoring them contrasting with the weak means implemented in everyday life to reduce their impact; the great majority of participants (68%) believe they have a well balanced diet; patients are greatly involved in their own health, with a slight external locus involving the general practitioner, the immediate entourage and society. The notes of the evaluation are usually maximum. Conclusion Patient Therapeutic Education arouses strong interest in the public, allows a personalized approach that optimizes learning, increases knowledge and facilitates the use of new protective practices. [ABSTRACT FROM AUTHOR]

Résumé But de l’étude L’amélioration de l’hygiène de vie est utile en prévention des maladies cardiovasculaires mais les limites de sa réalisation pratique dans la population générale ont vite été atteintes. L’éducation thérapeutique du patient peut aider à les dépasser. Patients et méthodes Nous proposons en prévention primaire un programme personnalisé comportant une ou plusieurs séances individuelles et collectives ayant pour objectifs d’aider les participants à cheminer vers une hygiène de vie plus protectrice. Cela inclut une meilleure éducation sur 6 facteurs de risque (tabac, sédentarité, surcharge pondérale, hypertension artérielle, hypercholestérolémie, diabète) et la recommandation de quelques habitudes alimentaires ; une est limitée : charcuterie ; d’autres sont privilégiées : consommations de poissons, légumes verts, céréales complètes et légumineuses, fruits. Des scores ont été attribués aux 6 paramètres de facteurs de risque et aux 5 items d’habitudes alimentaires. Ils sont recueillis au moment du recueil du diagnostic éducatif et un an plus tard, permettant ainsi des comparaisons temporelles. Résultats À propos des 291 premières personnes ayant suivi ce programme, nous observons à un an une amélioration significative de la pratique d’une activité physique d’endurance et de la consommation des poissons, des légumes verts, des fruits, des céréales complètes et légumineuses. Conclusion L’hygiène de vie est globalement améliorée, certains paramètres plus que d’autres. Faciliter l’accès de l’éducation thérapeutique du patient au plus grand nombre est une voie à développer et à évaluer. Goal of the study Lifestyle improvement is useful in the prevention of cardiovascular disease, but its practical implementation in the general population is limited. Patient therapeutic education can help go beyond these limits. Patients and methods In primary prevention, we propose a personalized program including one or several individual and collective sessions to help the participants towards a healthier lifestyle. This includes better education about six risk factors (tobacco, sedentary lifestyle, overweight, high blood pressure, high cholesterol, diabetes) as well as advice on better eating habits. The first recommendation is to limit processed meats, the other recommendations advise more fish, green vegetables, whole grains and beans, and fruits. Scores are attributed to six risk factors and five eating habits. These scores are given at the time of the first session and again a year later, thus permitting time comparisons. Results For the first 291 participants in the program, we observed at one year a significant improvement in physical activities of endurance and in the consumption of the recommended food groups (fish, green vegetables, fruits, whole grains and beans). Conclusion The patient's lifestyle has improved as a whole, certain parameters more than others. Assessed patient therapeutic education should be offered to a larger number of people. [ABSTRACT FROM AUTHOR]

Abstract: Cardiovascular diseases are mainly caused by atherosclerosis, the development of which is highly dependent on our Western lifestyle. Slowing this pathology depends on the reduction of risk factors such as hypercholesterolemia, high blood pressure, smoking, lack of physical activity, excess weight and diabetes. Drug treatment exists and is very effective, but too often they treat the immediate abnormality such as diabetes, high blood pressure and hypercholesterolemia and not the underlying causes: poor eating habits, lack of physical activity and excess weight. These have a negative impact on endothelial function, oxidative stress, and can trigger inflammation, arrythmias and thrombosis. Cardiovascular prevention must therefore target sedentary lifestyle, excess weight, and favor low-calorie, low-salt food and Mediterranean diet. The way this diet works begins to be understood and goes beyond simple cardiovascular prevention. Therapeutic education holds a growing and complementary role in the Public Health system which should call upon the strengths of all healthcare professionals. [Copyright &y& Elsevier]

Abstract: The global coverage of the patients having had an acute coronary syndrome requires the modification of their life hygiene. Six hundred and sixty-seven consecutive victims of this syndrome benefited from clinics by a nurse, aiming at decreasing their risk factors and to modify their food customs. The initial interrogation allows the collection of these items and every answer is transformed into a digital score. The patients being seen again every 6 months in consultation, progress was observed, not only for the control of the risk factors (the score passes from 6.4 to 5.1, P <0.001) but also for that of the food customs (the score passes from 1.5 to –6, P <0.001). The evolution of the patients was compared as they are (group 1, N =216) or not (group 2, N =448) followed regularly in consultation, on the basis of a voluntary service, with a follow-up of 20, 8 months. Three patients were lost sight. The patients of the group 1 have fewer cardiovascular events (17 patients with event vs 82, P <0.02), in particular a cardiac insufficiency (2 vs 28, P <0.01) or the other events bound to the atherosclerosis (13 vs 55, P <0.02), They are less often hospitalised (14 vs 70, P <0.001). The deaths are less frequent in group 1 (Curve of Kaplan-Meyer: P <0.01; RR=0.23; IC=0.09–0.58. The bad hygiene of life, which led to the arisen of an acute coronary syndrome, can be corrected and this is translated by an improved prognosis. [Copyright &y& Elsevier]