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Résumé L’inobservance thérapeutique est un problème majeur dans la prise en charge des adolescents asthmatiques. But de l’étude Étudier le ressenti des adolescents asthmatiques vis-à-vis de la prise en charge de leur maladie afin d’identifier des raisons à cette inobservance thérapeutique. Patients et méthodes Recherche qualitative par entretiens semi-dirigés avec analyse thématique réalisée auprès de seize adolescents asthmatiques entre août 2013 et mars 2014 en région Midi-Pyrénées. Résultats Être ou ne pas être observant vis-à-vis de son traitement semble être un choix délibéré de l’adolescent. Ce choix est principalement influencé par le niveau de connaissances concernant la maladie et le rôle du traitement, et par la capacité d’acceptation de la maladie. L’observance thérapeutique entre en conflit avec les aspirations de l’adolescence. Les adolescents souhaitent avoir une part active dans l’élaboration du projet thérapeutique. Les parents ont une place importante et complexe dans la gestion de la maladie. Conclusion Afin d’appréhender les freins à l’observance thérapeutique, il semble intéressant de renouveler l’annonce de la maladie asthmatique à l’adolescence en prenant en compte leurs connaissances et représentation de cette maladie. Non-compliance is a problem in the treatment of adolescents with asthma. Objectives To study experience of healthcare management for adolescents with asthma and to explore reasons for non-compliance. Patients and methods Qualitative research using semi-structured interviews and thematic analysis involving 16 adolescents with asthma between August 2013 and March 2014 in the Midi-Pyrénées region of southern France. Results Four main themes emerged: Experience of medication, experience of healthcare, experience of and reflexion on educational methods, the role of parents. Treatment compliance runs counter to the will of adolescents, who wish to assume a more active role in the design of their therapeutic project. Parents have an important and complex part to play in their child's healthcare management. Conclusion To anticipate hurdles to therapeutic compliance, it appears to be of value to renew the announcement to adolescents of their asthmatic disease taking into account their improved knowledge and awareness of their disease. [ABSTRACT FROM AUTHOR]

Résumé Contexte Les patients âgés aimeraient que la sexualité soit abordée par leur médecin généraliste. Pourtant ce sujet se fait rare en consultation, alors que les médecins généralistes se disent à l’aise pour en discuter. Objectifs Identifier les émotions et le vécu des médecins afin de comprendre leurs représentations et leurs comportements face à ce sujet empreint de paradoxe. Méthode Une enquête qualitative a été menée par entretiens semi-directifs auprès de 12 médecins généralistes installés, de Midi-Pyrénées ; par analyse transversale thématique. Résultats Les résultats révélaient que la majorité des médecins généralistes étaient encore sous l’emprise de quelques représentations erronées concernant la sexualité des aînés. Outre le fait qu’ils la percevaient comme différente, l’activité sexuelle des aînés serait vouée à diminuer puis à disparaître. Cependant, ils s’accordaient tous pour dire que l’intérêt d’aborder ce sujet est incontestable et que leur rôle de médecin généraliste présentait les compétences pour s’y confronter. Ils avaient conscience de la place de la santé sexuelle dans le bien-vieillir. Conclusion Les représentations constituent le socle des résistances et renforcent le sentiment d’illégitimité que les médecins ont sur l’abord de la sexualité avec leurs patients âgés. Un enseignement dédié, réclamé par les médecins tant dans leur cursus universitaire initial que continu, ainsi qu’une meilleure coordination du réseau de correspondants permettrait d’améliorer l’abord de la sexualité avec les patients âgés en consultation. Summary Context Old patients would like sexuality to be approached by their family doctor. However this subject is seldom dealt with in consultation, though general doctors say they feel comfortable discussing it. Objectives To identify the emotions and personal experience of the doctors in order to understand their representations and their behaviors in front of this subject full of paradoxes. Method A qualitative survey has been done by semi-directed talks with 12 family doctors installed in Midi-Pyrenees, in France; by thematic transversal analysis. Results The results revealed that the majority of family doctors were still under the influence of some false representations concerning sexuality of the seniors. Besides the fact they perceived it as different, it would be doomed to decline and then disappear. However, they all agreed to say that the interest to tackle this subject was undeniable and that their role of family doctor gives them skills to confront it. They were aware of the place of sexual health in aging well. Conclusion The representations constitute the base of resistances and reinforce the feeling of illegitimacy that the doctors have on the approach of sexuality with their old patients. A dedicated teaching called for by doctors in their initial university course as well as in their continuous formation, and a better coordination of the network of correspondents would improve the approach. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea is associated with increased motor vehicle accident risk, and improved detection of patients at risk is of importance. The present study addresses potential risk factors in the European Sleep Apnea Database and includes patients with suspected obstructive sleep apnea [ n = 8476, age 51.5 (12.5) years, body mass index 31.0 (6.6) kg m−2, 82.4% driver's licence holders]. Driving distance (km year−1), driver's licence type, sleep apnea severity, sleepiness and comorbidities were assessed. Previously validated risk factors for accident history: Epworth Sleepiness Scale ≥16; habitual sleep time ≤5 h; use of hypnotics; and driving ≥15 000 km year−1 were analysed across European regions. At least one risk factor was identified in male and female drivers, 68.75 and 51.3%, respectively. The occurrence of the risk factors was similar across Europe, with only a lower rate in the eastern region ( P = 0.001). The mean number of risk factors increased across classes of sleep apnea severity. Frequent driving was prevalent [14.0 (interquartile range 8.0-20.0) × 103 km year−1] and 32.7% of drivers had severe obstructive sleep apnea [apnea-hypopnea index 50.3 (38.8-66.0) n h−1]. Obesity, shorter sleep time and younger age were associated with increased traffic exposure ( P ≤ 0.03). In conclusion, the risk factors associated with accident history were common among European patients with suspected obstructive sleep apnea, but varied between geographical regions. There was a weak covariation between occurrence of risk factors and clinically determined apnea severity but frequent driving, a strong risk factor for accidents, was over-represented. Systematic evaluation of accident-related risk factors is important to detect sleep apnea patients at risk for motor vehicle accidents. [ABSTRACT FROM AUTHOR]