Sante Publique最新文献

{"title":"La décolonisation de la santé publique en Bolivie ou la fragmentation de tout un secteur.","authors":"Amélie Aubert Plard","doi":"10.3917/spub.251.0043","DOIUrl":"https://doi.org/10.3917/spub.251.0043","url":null,"abstract":"<p><strong>Introduction: </strong>During its first ten years (2006-2016), the government of Evo Morales led Bolivia through a wave of reforms aimed at establishing a popular nationalism, free from what it calls \"Western imperialism.\"</p><p><strong>Purpose of the study: </strong>This article analyzes the implementation of the decolonization process, particularly in the reproductive health sector. It highlights the effects generated on those involved and the mechanisms of appropriation and/or rejection. To do this, it focuses on three measures: the My Health program, the professionalization of traditional midwives, and the cultural adaptation of delivery rooms.</p><p><strong>Results: </strong>While the deployment of the My Health program is developing community medicine that is appreciated by users, it is also giving rise to deep rivalries among healthcare professionals and decision-makers alike. Furthermore, when it comes to intercultural childbirth, the study reveals a lack of both supply and demand.</p><p><strong>Conclusion: </strong>Far from reforming it structurally, the decolonization process seems to have caused a deep ideological and organizational split within the health sector. The new measures have been implemented in the form of additional, competing programs, which has caused difficulties regarding their acceptance and integration within the established healthcare system. What's more, while in its discourse the government rejects Western colonization, in practice it remains heavily dependent on international aid.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"43-51"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact d’un stage en unité spécialisée en soins palliatifs sur les représentations des étudiants en soins infirmiers. Étude qualitative au sein d’une équipe mobile de soins palliatifs.","authors":"Marc Degois, Michaël Chenevez, Géraldine Blanchot-Gruet, Frédéric Ferreres, Angelina Morra, Marie-Jeanne Zanatta, Florence Mathieu-Nicot, Aline Chassagne, Jean Maillet-Contoz","doi":"10.3917/spub.252.0115","DOIUrl":"https://doi.org/10.3917/spub.252.0115","url":null,"abstract":"<p><strong>Context: </strong>Among student nurses (SNs), who are key future actors in determining access to palliative care (PC), 30% have avoidant attitudes toward end-of-life (EOL) patients. In 2017, in response to this issue, the French Ministries of Health and Higher Education introduced a mandatory PC placement for health care students as part of a national plan to develop PC. It was in this context that all third-year SNs in our town (population of 20,000) did a 5-day placement in a mobile PC team.</p><p><strong>Objective: </strong>To identify whether this placement changed representations of PC among the SNs we hosted, and if so, how.</p><p><strong>Method: </strong>This was a two-stage qualitative study. It used the method of thematic analysis of verbatim comments made by SNs during the 2021-2022 academic year, on the first day (D1) and last day (D5) of their placement.</p><p><strong>Results: </strong>The sample consisted of 31 SNs. On D1, PC and EOL were regarded in spiritual terms, and could provoke negative feelings. By D5, the SNs were using professional PC vocabulary, highlighting new perceptions of inter-professional relations, and had a better understanding of which patients needed PC and of the ethical challenges relating to EOL.</p><p><strong>Conclusions: </strong>Our study showed an immediate benefit of this placement on professional representations among SNs. While further research is needed to clarify its long-term effects, it supports a proactive policy of including PC training in nurse education.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"115-126"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fièvre Hémorragique Crimée Congo au Sénégal en 2023 : situation épidémiologique et riposte.","authors":"Youssou Bamar Gueye, Papa Samba Dieye, Boly Diop, Ibra Diagne, Diambogne Ndour, Yoro Sall, Mariei Ndiaye","doi":"10.3917/spub.252.0239","DOIUrl":"https://doi.org/10.3917/spub.252.0239","url":null,"abstract":"<p><strong>Introduction: </strong>Crimean-Congo hemorrhagic fever (CCHF) is a serious viral disease caused by a virus of the genus Nairovirus. It is transmitted mainly by ticks and, in some cases, by contact with infected blood or body fluids. CCHF is endemic in several parts of Africa. This study focuses on cases of CCHF in Senegal in 2023, and on the actions implemented to manage the epidemic.</p><p><strong>Methodology: </strong>A retrospective study was conducted to analyze the 2023 CCHF epidemic in Senegal. The Syndrome Sentinel Surveillance Network (4S Network) was used to detect cases. The reference laboratory used ELISA and PCR tests to confirm diagnoses, while the health emergency operations center coordinated the response using an incident management system (IMS) implemented at the national and regional level.</p><p><strong>Results: </strong>In 2023, Senegal reported 11 confirmed cases of CCHF in 7 regions, with a case fatality rate of 36.6%. The average time from symptom onset to laboratory diagnosis was 10 days, which sometimes led to delays in case management. Follow-up of 413 contacts was carried out, with no secondary cases identified. Preventive measures, including awareness-raising campaigns in high-risk areas, were also taken.</p><p><strong>Conclusion: </strong>CCHF represents a persistent threat to public health in Senegal. Surveillance efforts, rapid detection, and the control measures put in place have proved essential in limiting transmission. The observed delays in diagnosis highlight the need to strengthen diagnostic capabilities and improve the responsiveness of the health care system, in particular via implementation of the 7-1-7 framework. Increased intersectoral collaboration is essential to improving containment of this emerging zoonosis.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"239-244"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aborder les disparités de genre en France pour promouvoir l’équité en matière de santé des femmes.","authors":"Alexandre Vallée, Jean-Marc Ayoubi","doi":"10.3917/spub.251.0081","DOIUrl":"https://doi.org/10.3917/spub.251.0081","url":null,"abstract":"<p><p>Despite the firm entrenchment of gender equality in the laws and values of our modern societies, undeniable disparities between genders continue to exist. It's important to note that health disparities between genders are not solely a result of biological differences but are also due to sociological dynamics and the French healthcare system. The leading cause of death among women is not cancer but cardiovascular disease. Cancer occupies the second position, with breast cancer being the primary cause of mortality. Despite a very large number of cases, too little is still known about endometriosis and it is diagnosed late, with an average delay of seven years in France. Menopause is a physiological state in women, but various health problems can gradually develop as a result, like the climacteric syndrome. By placing women's health at the heart of concerns, we can transform this unacceptable situation into a victory for gender equality and justice in health.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"81-87"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lorsque les vécus d’oppression se propagent des patient.es aux chercheur.es : comment intégrer les données expérientielles à la recherche en santé mondiale ?","authors":"Émilie Pigeon-Gagné, Élise Bourgeois-Guérin, Sophie Gilbert","doi":"10.3917/spub.251.0067","DOIUrl":"https://doi.org/10.3917/spub.251.0067","url":null,"abstract":"<p><strong>Introduction: </strong>Global health researchers tend to focus on the social and structural determinants of health and offer solutions for the \"decolonization of public health\" by addressing these determinants. These solutions address the root causes of social inequalities in health, but too often ignore the affective and intersubjective dimensions that underlie the complex human relationships in global health.</p><p><strong>Methods: </strong>In this article, we focus on experiential data through the concept of geo-corpo-political knowledge (Tlostanova &amp; Mignolo, 2009). We explore the emotional experiences we can have as researchers engaging in authentic dialogue in research sites. We draw on collaborative research with Doctors of the World in Montreal, Quebec, focusing on barriers to health care for undocumented migrants to inform our analysis.</p><p><strong>Results: </strong>In qualitative interviews with caregivers working with this population, we identified paradoxes, areas of silence, and difficulties in verbalizing their lived and emotional experiences.</p><p><strong>Discussion: </strong>In this paper we go beyond what can be put into words. We aim to explore our feelings as researchers to offer a systemic understanding of the oppression experienced by patients in their interactions with healthcare institutions. We argue that to reach the most marginalized populations and better understand their experiences, it is important to develop research methods that integrate the emotional world of researchers.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"67-80"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La sécurisation culturelle est-elle suffisante pour prévenir le racisme systémique et réduire les iniquités en santé ? Regard critique sur le projet de loi 32.","authors":"Loubna Belaid, Tatiana Garakani, Lara Maillet","doi":"10.3917/spub.251.0053","DOIUrl":"https://doi.org/10.3917/spub.251.0053","url":null,"abstract":"<p><strong>Introduction: </strong>Faced with the glaring inequities between Indigenous and non-Indigenous populations, the Quebec government has proposed a bill to increase cultural safety in its health and social services for Indigenous populations.</p><p><strong>Objective: </strong>This article aims to critically examine this bill.</p><p><strong>Results: </strong>We show that it is marked by a colonial rationale. This rationale is as evident in the content of the bill as it is in its form. Regarding the content, Indigenous stakeholders were not consulted to jointly develop the bill, which fails to include any Indigenous demands. It denies the existence of systemic racism within healthcare institutions and neglects the inherent power dynamics integral to the concept of cultural safety. Regarding its form, the drafting of the bill is marked by paternalism, and the use of the \"us/them\" dichotomy reinforces a racialized and binary discourse between the dominant culture and Indigenous cultures. This dichotomy perpetuates ideologies of superiority and inferiority among population groups.</p><p><strong>Conclusion: </strong>By focusing on Indigenous cultural realities, the government sidesteps addressing the root causes of health inequities. Instead, the government should collaborate closely with Indigenous stakeholders and support policies addressing the structural determinants of health. It must also support the self-determination of Indigenous peoples.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"53-58"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact des violences subies sur la santé de femmes migrantes consultant dans deux policliniques parisiennes.","authors":"Bacha Kaoutar, Sigolène Roumieu, Laeticia Audiffred, Olivier Cha","doi":"10.3917/spub.252.0073","DOIUrl":"https://doi.org/10.3917/spub.252.0073","url":null,"abstract":"<p><strong>Introduction: </strong>Migrants are people who settle in a foreign country. In 2020, the global migrant population was estimated at about 281 million. Of the patients seen by the Comité pour la santé des exilés (a French non-profit that works to improve the health of refugees), 62% report having experienced violence. Migrant women are particularly exposed to gender-based violence. Among women who have migrated from the Democratic Republic of the Congo to Cameroon, 39% report having experienced sexual violence, significantly more than the rate among the host population (3.9%).</p><p><strong>Purpose of the study: </strong>To analyze the impact of violence on the physical and mental health of migrant women consulting primary health care centers in Paris.</p><p><strong>Methods: </strong>This was a cross-sectional analytical study carried out in two Parisian outpatient clinics. Migrant women were interviewed about whether they had experienced violence prior to their arrival in France. Their medical history and current state of health were also analyzed in light of the violence experienced.</p><p><strong>Results: </strong>131 migrant female patients were included over a period of three weeks. They were mainly from sub-Saharan Africa (75%), with an average age of 43 years, and 59% of them had experienced violence. Post-traumatic stress disorder (PTSD) was found in 66% of patients who had experienced violence, and half had symptoms of depression or anxiety, while these symptoms were only present in 22% and 20% respectively of migrant women in the group that had not experienced violence. Furthermore, among the patients who had experienced violence, 48% had cardiac symptoms versus 26%, 53% had respiratory symptoms versus 20%, and 58% had gastrointestinal symptoms versus 23% (p&amp;lt;0.05).</p><p><strong>Conclusions: </strong>These results indicate the need for particular vigilance regarding the history of violence in the migrant population, due to an increased risk of post-traumatic stress disorder frequently associated with physical symptoms.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"73-88"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évolution des troubles mentaux liés au travail au Québec entre 2012 et 2021.","authors":"Jaunathan Bilodeau, Martin Lebeau, Marc-Antoine Busque, Alain Marchand","doi":"10.3917/spub.252.0229","DOIUrl":"https://doi.org/10.3917/spub.252.0229","url":null,"abstract":"<p><strong>Introduction: </strong>Several countries have seen an increase in the number of accepted mental disorders in recent years, but the possible variations of this change in the workforce are yet to be explored.</p><p><strong>Purpose of the study: </strong>This study examines the breakdown over time in accepted mental disorders by occupation, industrial sector, sex, and age in Quebec.</p><p><strong>Results: </strong>Incidence rates and trends in mental disorders vary by occupation and industrial sector. While the rate is generally higher in mixed occupations and the tertiary sector, the increase in these rates is more marked in non-manual occupations and the primary sector. Significant variations are also observed by sex and for certain age groups.</p><p><strong>Conclusions: </strong>The use of administrative data on accepted mental disorders complements survey data on mental health at work for different groups of workers. The growth in rates of accepted mental disorders points to the groups to be prioritized for prevention of this category of occupational injury..</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"229-238"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Former les professionnel.les de santé aux mutilations génitales féminines (MGF) : étude qualitative d’évaluation de l’impact social de la formation FAM.","authors":"Bahar Azadi, Marion Le Tyrant, Lucie Étienne, Rim Bellamine, Emmanuel Levard, Armelle Andro, Claire Tantet","doi":"10.3917/spub.251.0183","DOIUrl":"https://doi.org/10.3917/spub.251.0183","url":null,"abstract":"<p><strong>Introduction: </strong>Female genital mutilation (FGM) encompasses the total or partial removal of a woman's external genitalia, carried out for no medical reason. Mainly carried out in sub-Saharan Africa, FGM is also practiced in Europe as a result of migration. Although French healthcare professionals say they are concerned, they claim to have insufficient knowledge and practical tools to deal with the subject in their consultations.</p><p><strong>Purpose of the study: </strong>Faced with this situation, training was offered to healthcare professionals between 2019 and 2023. A total of 150 professionals were trained over this period. A qualitative method was used to evaluate the social impact of the training, with the aim of identifying the effects on and concrete changes to the practices of trained professionals, compared with those of untrained ones. The evaluation methodology was based on 4 periods of observation of training sessions, 15 qualitative semi-structured individual interviews (8 with trained professionals and 7 with untrained professionals), and 5 observation sessions of consultations between trained and untrained professionals and their patients.</p><p><strong>Results: </strong>The evaluation highlights four main sets of results: on the one hand, the training contributes to reinforcing professionals' theoretical and practical knowledge of FGM, and on the other, to changing the approach they adopt during consultations.</p><p><strong>Conclusion: </strong>Multidisciplinary support for women who have undergone mutilation is also facilitated. Nevertheless, certain prevention-related aspects of the training, such as learning how to report cases to the public prosecutor, do not seem to have been immediately integrated into their practices.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"183-196"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les représentations émotionnelles de patients atteints de cancer : l’influence de vêtements adaptés lors des soins de chimiothérapie.","authors":"Emmanuella Di Scala, François Gueyffier","doi":"10.3917/spub.251.0197","DOIUrl":"https://doi.org/10.3917/spub.251.0197","url":null,"abstract":"<p><strong>Introduction: </strong>This work examines the effect that clothing adapted to treatment can have during chemotherapy sessions on the emotional representation of the individual, on perceived well-being, and potentially on the evolution of symptoms.</p><p><strong>Methods: </strong>This case study was carried out on forty-two cancer patients. The questionnaire was administered retrospectively to patients who initially underwent chemotherapy sessions without wearing suitable clothing, then who wore suitable clothing during subsequent chemotherapy treatments.</p><p><strong>Results: </strong>Significantly, the data suggest that wearing appropriate clothing during chemotherapy leads patients to perceive a reduction in aggravation and the appearance of new symptoms. Greater well-being and positive self image, as well as a more positive image of the illness and treatment, are also significantly associated with the use of adapted clothing during chemotherapy.</p><p><strong>Discussion: </strong>These data lead us to propose that adapted clothing contributes to the improvement of the positive emotional representation observed. However, we cannot define the extent of their participation in this study.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"197-207"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}