BackgroundPatients 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.ObjectiveThis 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.MethodsThe 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.ResultsThe 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.ConclusionsThis 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.

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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 évaluéep ar la science, surveillée par les professionnels et expliquéea up atient. Pour ce faire, il est nécessaire de construire une modélisation de l'ensemble des connaissances scientifiques et d'usage sous la formed 'une ontologie informatique. Cette ontologie des INM faciliteral es recherchesb ibliographiques, les statistiques d'usage et l'amélioration des bonnes pratiques. Une première version de cette classification internationale évolutiveest disponible sur le site Internet de la Plateforme universitaire CEPS en accès libre.

Background: Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. Methods: Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. Results: Nurses recognize their role as being witnesses to the patient's experience through their constant presence. This is in line with their professional values and gives them an "alert role" that can anticipate a patient-centered palliative approach. The physician's positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, "rethinking care within a team environment" allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses "balance" while providing personal and professional support.