Quelle formation des savoirs sur le cancer et la chimiothérapie orale en contexte d’ETP ? Apports d’une approche psychosociale articulée à un dispositif de triangulation méthodologique

Abstract

Introduction

This article aims to consider the experience of cancer treated by oral chemotherapy as a frame for investigating the construction and the transmission of knowledge related to illness and treatment in the context of therapeutic patient education. This work is based on a doctoral thesis carried out in Social and health Psychology in which we investigated, according to a socio-constructivist approach, the contexts and the circumstances in which patients’ knowledge are assimilated and mobilized.

Method

Based on field research conducted in a Rhone-Alpes university hospital center, we led two qualitative studies, which combined research interviews (n = 27) and ethnographic data of a therapeutic education program (including non-participant observation of 44 therapeutic education sessions). For analyzing these qualitative data, we relied on the principles of analysis using conceptualizing categories.

Results

Our results show that the relationship between sick people and cancer and treatment refers to the intertwining of medical knowledge and lay knowledge. These are constructed and actualized in therapeutic relationships and the social situations through which participants experience their illness. This polyphasic knowledge operates as an active process of decoding the perceptions of the body and of the disease, and guides health behaviors.

Conclusion

This article shows the contributions of a comprehensive and holistic approach as well as a multi-methodological design to investigate the complexity of the illness and treatment representational elaboration, by highlighting its cognitive, affective, social, and symbolic dimensions.