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Introduction: Professional activity represents an injunction to participate in the collective and sustains our identity. Being deprived of it can lead to social exclusion. At the same time, the injunction to autonomy is prevalent in our society. The disabled person can suffer from social stigmatization and find himself in tension between disability/autonomy/work. Work is then essential to identify oneself as a worker and not as a dependent person.

Purpose of research: The participatory research presented has a dual objective: to give a voice to a stigmatized population - disabled workers - and their families; to understand and analyze with them the strategies used to work or remain in employment and the impact of these strategies on health at work and the relationship to risks.

Results: Exchanges between the peer Group and the scientific team enabled us to refine the initial questions, to reformulate analyses, to modify communication supports, to make them more acceptable and accessible. This participatory approach has modified our research practices by guaranteeing that the people concerned by the research become actors in it.

Conclusions: For populations suffering from symbolic domination, participatory research makes it possible to restore the confidence of individuals and the legitimacy of experiential knowledge.

Introduction: In France, 122 women were killed by their partner or ex-partner in 2021.

Purpose of the research: The principal objective of the AVIC-MG study, on women victims of domestic violence and their expectations of their general practitioner, was to observe whether the women in question, who visit specialist facilities for victims of domestic violence, would like to be questioned about domestic violence by their general practitioner (GP). The secondary objective was to describe this population of women and the characteristics of their GP visits during the last twelve months.

Results: The study showed that more than 90 percent of these women had consulted a GP in the last twelve months and 65 percent of the mothers in the group had consulted a GP for their child(ren). The majority of these women (82 percent) wanted the GP to ask them about domestic violence. They had gone to the GP for specific reasons: fatigue, pain, psychological suffering (anxiety, sadness, difficulty sleeping).

Conclusion: The majority of women victims of domestic violence would like primary care practitioners to identify the abuse. Tools are available to help GPs with this complex identification, in particular the DECLICVIOLENCE.FR website.

Introduction: Assessing patient turnaround times is essential for improving the quality of care in emergency service departments.

Purpose of the research: This study looked at waiting and treatment times, and their associated factors, in the surgical emergency service department at the Souro Sanou National Teaching Hospital (SSNTH) in Bobo-Dioulasso, Burkina Faso.

Results: This study was carried out on 380 patients with a median age of thirty-eight. The sex ratio was 0.54. In 63.7 percent of cases, the participants lived in urban areas. Most of the patients surveyed were farmers (34.7 percent). The median waiting time for patients was eleven minutes. The nature of the trauma sustained was associated with the waiting time. The median time taken to administer first aid was sixty-three minutes, with the unavailability of medication at the hospital pharmacy cited as a factor contributing to this delay. The median time taken to obtain paraclinical results was 134 minutes and 102 minutes for laboratory tests and scans, respectively. The factor associated with delays in obtaining scan results was the need for surgical intervention. The median waiting time for surgery was 24.3 hours.

Conclusions: The turnaround times in the SSNTH surgical emergency department are long. For the improvement of patient turnaround times to be possible, an overhaul of the department is in order. In particular, a rapid consultation team needs to be established, and essential drugs for emergency care need to be made readily available.

Introduction: Demand for dental care in Basse-Normandie has been severely affected by the reduced availability of local services. One of the missions of hospital dental services is to respond to these difficulties in accessing care.

Purpose of the research: The objective of this study is to determine how hospital activity fits into the local dental care offer. To do this, we compared the activity of the dental service of the Caen hospital with that of private practices.

Results: The proportion of young patients, particularly those under fifteen, was greater at the university hospital than in private practice (20.9 percent vs 12.9 percent, p < 1.10 -5). The activity of private practices included a higher proportion of fixed prosthetic care and oral prophylaxis procedures, in contrast to surgical procedures, direct restorative care, and consultations, which account for a higher proportion of hospital activity (10 percent vs 22.5 percent, p < 1.10-5).

Conclusions: The dental service at Caen hospital differs from private practices in Basse-Normandie in that its activity is oriented toward primary care or emergency care. This activity seems to reflect a high individual caries risk, probably associated with social vulnerability. The unit therefore seems to respond to a need for primary care.

Introduction: The caregiver-patient relationship has been the subject of numerous studies in the field of medicine, but has received little attention in the context of chiropractic care, particularly in France.

Purpose of the research: This ethnographic and sociological study aims to gain a better understanding of the characteristics of the chiropractic relationship in chiropractic care through the observation of consultations followed by interviews with both patients and caregivers. These observations were carried out in the Franco-European Chiropractic Institute’s two outpatient clinics and in three private practices.

Results: The data were collected between October 2022 and March 2023. Most of the patients treated their health as an asset to be preserved or even improved, and had a good knowledge of their body as a tool for work and/or sports performance. They turned to chiropractic care to find relief from their pain and a form of care combining technical and interpersonal skills. Chiropractic care is based on manual therapy, combined with a dimension of self-management by the patient. Follow-up of the exercises and advice given by chiropractors varies greatly from patient to patient, from diligent application to non-application, and with everything in between.

Conclusion: Trust is the foundation of all care, and even more so in manual therapy, because of the way the hands act on the body. To establish a working alliance with the patient, the chiropractor has to adapt his or her professional ethos and accept compromises regarding the treatment plan envisaged. Cooperation between a patient and a chiropractor is based on trust, the negotiation of objectives, and the division of tasks between the two parties.

Based on a reflexive approach centered on the co-construction of the Makasi project, involving researchers and associations, this article aims to highlight certain conditions required for co-constructing intervention research. Makasi is a community-based intervention research project carried out with sub-Saharan immigrants in precarious situations to strengthen their sexual health empowerment. It involves three research teams and two associations. Involving the three stakeholders in the various stages of the project and taking into account the diversity of expertise were the guiding principles. Outlining the challenges at each stage of the project and the solutions provided highlights the need to link, throughout the project, mixed decision-making bodies, formalized exchanges, and the utilization of high-level expertise and interpersonal skills. The experience of Makasi highlights the need to collectively discuss the relationship between stakeholders and the subject of study ahead of projects and establish and moderate a participative space for the duration of every project. Finally, the co-construction in the Makasi project was an opportunity for researchers to strengthen their capacity to decentralize and to rely on experiential knowledge, and for association workers to train themselves in research and to share their experiences and knowledge of migration and health.

Introduction: Strokes are the main cause of aphasia, a language disorder that makes it difficult to communicate with others. In the acute phase, patients are cared for in neurovascular departments. In this acute care context, conducting research among caregivers to gather their experiences of caregiver-patient relationships with regard to aphasic patients can be complex.

Purpose of research: To propose a participatory research methodology utilizing knowledge arising from the lived experiences of nurses and care assistants in a neurovascular department.

Method: A qualitative study based on observation was carried out with a view to ensuring that all the stakeholders involved were fully integrated into the field research. The analysis was carried out in a participatory manner with a nurse and a care assistant, using the grounded theory approach.

Results: Twenty-one care situations were observed over a three-month period. Following an initial report, eight situations from this group were selected and analyzed following the six stages of grounded theory analysis, four of which were carried out in a participatory manner with a nurse and a care assistant.

Conclusions: Discussing caregivers’ involvement in the research with them beforehand, given their professional constraints, helped maximize their participation throughout the study. The dynamics of the reporting and analysis stages were conducive to utilizing the nurses’ and care assistants’ lived experiences.

Introduction: The aim of this study was to analyze the rate of enhanced recovery programs (ERP) implementation in a range of surgical specialties in both the public and private sectors.

Methods: This was a retrospective longitudinal study based on hospital stays between March to December 2019. We studied thirteen of the activity segments most frequently included in ERP protocol. The procedures selected included digestive, gynecological, orthopedic, thoracic, and urological procedures. The assessment criteria was the rate of ERP. The results were analyzed first overall and then matching ERP stays to non-ERP stays according to type of institution, patient age and sex, month of discharge, and Charlson comorbidity score.

Results: We took 420,031 stays into account, of which 78,119 were coded as ERP. There were 62,403 non-ERP stays. Depending on the type of surgery, the implementation rate ranged from 5 percent to 30 percent. The overall rate of ERP implementation was higher in the private sector (21.2 percent) than in the public sector (14.4 percent). The results are reversed for some surgeries, notably for some cancers. Patients had a higher Charlson score in the public sector.

Conclusions: This large-scale national study provides a picture of the degree of diffusion of ERPs in France. Although there are differences between sectors, this diffusion is still insufficient overall. Given the demonstrated benefits of ERPs, more educational efforts are needed to improve their implementation in France.

Introduction: Mobilizing different types of expertise helps to meet some of the challenges faced by health care systems. In French-speaking Switzerland, patient expertise has been mobilized in a new postgraduate curriculum, the Certificate of Advanced Studies (CAS) in Care Coordination and Networking, according to the different levels of engagement described in the Montreal Model.

Purpose of the research: The aim of our research was to explore a) the feasibility and acceptability of implementing different levels of patient involvement in this continuing education program, b) the factors that influence them, and c) the preliminary benefits of this implementation for students. Mixed methods were used for this exploratory study conducted between 2021 and 2022.

Results: All the levels of patient engagement in teaching proposed by the Montreal Model were implemented. Among the success factors, the involvement and reflective skills of the patient partners are essential. However, human, organizational, and financial resources need to be allocated to ensure the sustainability of this curriculum. Partnership seems to be a lever for organizational transformation, for the development of professional skills, and for practice improvement.

Conclusions: To our knowledge, this exploratory study reflects a pedagogical and organizational innovation in the context of continuing education in French-speaking Switzerland. The results will be used to adjust the curriculum in its next edition, to disseminate it in other training contexts, to improve systemic elements to support the patient partnership in education, and to develop research.