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Background In 2020, the number of new cancer cases was estimated at 20 490 862 worldwide up from 18.1 million in 2018 and 14.1 million in 2012. Since the 2000s, cancer treatments have significantly improved, allowing either a cure or control of the disease. Patients share their experience of the disease and use supportive care solutions through involvement in patient associations and online forums. All the associations were built on the principle of “peer support,” which is based on mutual aid between people who suffer or have suffered from the same somatic or psychological illness or had the same life experience. This experiential knowledge can be explored to understand the role of peers and associations in the appropriation of their cancer. Methods A qualitative phenomenological study was undertaken through semi-structured interviews with 12 participants. Interviews were audio-recorded, transcribed verbatim, then analyzed by means of triangulation up to the point of theoretical saturation by a semio-pragmatic method. Results Four categories emerged: (1) “Transforms a painful experience into a positive one. It mobilizes the human values of sharing, love, and humility, which facilitates resilience”; (2) “The characteristics of the association, a non-medical place between people sharing a common destiny, resonates with patients’ needs and improves their well-being”; (3) “The association transforms the patients’ experiences by facilitating engagement that leads to a patient-expert (empowerment)”; and (4) “Understanding what is happening to them is soothing, reassuring, because patients’ concerns need to be heard and their care understood”. Conclusions This study highlights patient associations can serve as the mediator of NPI and facilate the empowerment of breast cancer patients. Practice implications Educating health professionals in initial and continuing education about non-pharmacological interventions will be a major issue. Teaching the patient-centred approach to health professionals is one of the priorities in initial and continuing medical education.

This article presents a clinical description of the solitary aspect of alcoholism and an original psychopathological theorization of alcoholic isolation. Our aim is to better understand this vulner...

Dans cet article les auteurs insisteront sur les modalites de la sortie de l’isolement des sujets alcooliques afin de les soutenir dans l’experience parlee du sentiment de solitude. L’isolement correspondrait au maintien d’une jouissance debridee inhibant la dynamique psychique et plus particulierement la capacite du sujet a enoncer une position subjective face a l’enigme anxiogene du desir de l’Autre. Nous decrirons alors les prevalences d’identifications pathogenes, de productions quasi-delirantes ou hallucinatoires (intrus dans le corps, omnipresence psychique d’un Autre…) qui isolent l’alcoolique et le coupent du monde. Une courte sequence clinique traitera du depassement possible de cet isolement a la condition que le sujet puisse grâce a son inscription dans le cadre therapeutique faire avec le manque grâce a la fonction tierce incarnee par le therapeute. Cette fonction tierce viendrait soutenir le sujet alcoolique dans une possible mise a distance de l’objet favorisant l’enonciation des experiences de solitude qui doivent accompagner l’elaboration mentale des differentes enigmes de son existence.

Nous traiterons du vecu corporel dans l’alcoolisme (corps sous tension, a l’abandon, sans vie...) comme la consequence d’un impossible jeu entre reve et realite, une articulation problematique entre schema corporel et image inconsciente du corps, et enfin une difficulte pour l’alcoolique a capter son image dans le regard de l’Autre. A partir d’un cas clinique, nous decrirons en quoi l’attention particuliere au corps par le therapeute peut etre un moyen d’inviter a un nouveau nouage entre le corps et la parole. Le therapeute en tant que garant du pacte de la parole et du langage serait alors mis en position de tenant lieu de l’Autre, proche d’une fonction paternelle symboligene.

BACKGROUND Patients and health care professionals are becoming increasingly preoccupied in complementary and alternative medicine (CAM) that can also be called nonpharmacological interventions (NPIs). In just a few years, this supportive care has gone from solutions aimed at improving the quality of life to solutions intended to reduce symptoms, supplement oncological treatments, and prevent recurrences. Digital social networks are a major vector for disseminating these practices that are not always disclosed to doctors by patients. An exploration of the content of exchanges on social networks by patients suffering from breast cancer can help to better identify the extent and diversity of these practices. OBJECTIVE This study aimed to explore the interest of patients with breast cancer in CAM from posts published in health forums and French-language social media groups. METHODS The retrospective study was based on a French database of 2 forums and 4 Facebook groups between June 3, 2006, and November 17, 2015. The extracted, anonymized, and compiled data (264,249 posts) were analyzed according to the occurrences associated with the NPI categories and NPI subcategories, their synonyms, and their related terms. RESULTS The results showed that patients with breast cancer use mainly physical (37.6%) and nutritional (31.3%) interventions. Herbal medicine is a subcategory that was cited frequently. However, the patients did not mention digital interventions. CONCLUSIONS This exploratory study of the main French forums and discussion groups indicates a significant interest in CAM during and after treatments for breast cancer, with primarily physical and nutritional interventions complementing approved treatments. This study highlights the importance of accurate information (vs fake medicine), prescription and monitoring of these interventions, and the mediating role that health professionals must play in this regard.

Article disponible en ligne à l'adresse : http://hdl.handle.net/2042/65114; International audience; La multiplication des interventions non médicamenteuses (INM) et des doutes résiduels de leur efficacité imposent aujourd’hui de ne plus se cantonner à leur appellation générale et disciplinaire (psychothérapie, thérapie manuelle, complément alimentaire, activité physique adaptée, solution e-santé…) mais d’accéder à leur véritable contenu. Décrite de manière précise, chaque INM pourra être mieux évaluée par la science, surveillée par les professionnels et expliquée au patient. Pour ce faire, il est nécessaire de construire une modélisation de l’ensemble des connaissances scientifiques et d’usage sous la forme d’une ontologie informatique. Cette ontologie des INM facilitera les recherches bibliographiques, les statistiques d’usage et l’amélioration des bonnes pratiques. Une première version de cette classification internationale évolutive est disponible sur le site Internet de la Plateforme universitaire CEPS en accès libre.

http://hdl.handle.net/2042/65112; International audience; Traiter de la question de la relation à l’autre dans les interventions non médicamenteuses (INM) oblige à mettre à jour la réalité psychique et subjective du praticien ou du chercheur, l’identification de ses cadres de pensée, son implication dans le recueil et le traitement de ces données. L’intérêt et le bénéfice d’une INM dépend beaucoup du praticien qui la propose ou du chercheur qui l’évalue. Les conditions favorables à l’utilisation des INM tiennent aussi au fait d’accepter l’incertitude de toute rencontre, en apprenant au fur et à mesure de la rencontre avec l’autre. Il s’agit d’une posture intellectuelle « compréhensive » guidée à travers une plongée dans ces mécanismes constitutifs. C’est une volonté de s’immerger dans le phénomène pour mieux comprendre l’autre, les différentes interventions étant plus des moyens qu’une finalité.

International audience; Nous décrirons les différences et les ressemblances du rapport aux addictions chez l’homme et chez la femme. À partir du réel du corps, nous poserons le constat d’une « injustice » somatique et physiologique des femmes, puis nous évoquerons les différences au niveau du genre (rôle des facteurs culturels et enjeux sociaux). En revanche, sur le plan psychique, le rapport au produit différerait peu. Les sujets disparaîtraient derrière des identifications sociales ou des identifications addictives inconscientes. Le travail thérapeutique consisterait même à sortir de ces identifications pour traiter du passage obligé du rapport de tout sujet au manque et à la différence anatomique des sexes.

Background Patients and health care professionals are becoming increasingly preoccupied in complementary and alternative medicine (CAM) that can also be called nonpharmacological interventions (NPIs). In just a few years, this supportive care has gone from solutions aimed at improving the quality of life to solutions intended to reduce symptoms, supplement oncological treatments, and prevent recurrences. Digital social networks are a major vector for disseminating these practices that are not always disclosed to doctors by patients. An exploration of the content of exchanges on social networks by patients suffering from breast cancer can help to better identify the extent and diversity of these practices. Objective This study aimed to explore the interest of patients with breast cancer in CAM from posts published in health forums and French-language social media groups. Methods The retrospective study was based on a French database of 2 forums and 4 Facebook groups between June 3, 2006, and November 17, 2015. The extracted, anonymized, and compiled data (264,249 posts) were analyzed according to the occurrences associated with the NPI categories and NPI subcategories, their synonyms, and their related terms. Results The results showed that patients with breast cancer use mainly physical (37.6%) and nutritional (31.3%) interventions. Herbal medicine is a subcategory that was cited frequently. However, the patients did not mention digital interventions. Conclusions This exploratory study of the main French forums and discussion groups indicates a significant interest in CAM during and after treatments for breast cancer, with primarily physical and nutritional interventions complementing approved treatments. This study highlights the importance of accurate information (vs fake medicine), prescription and monitoring of these interventions, and the mediating role that health professionals must play in this regard.