ObjectiveBreast cancer screening decision aids (DAs) are designed to help women decide whether or not to participate in mammography-based programmes. We aimed to explore women’s and healthcare professionals’ expectations of a breast cancer screening DA, as part of the French DEDICACES study.MethodsThis French qualitative study was based on semistructured, individual interviews with women from the general population, general practitioners (GPs), midwives, gynaecologists, radiologists and screening centre managers. Sampling was purposive and used diversification criteria. The inductive analysis was based on grounded theory.ResultsBetween April 2018 and May 2019, we interviewed 40 people: 13 women, 14 GPs, 4 gynaecologists, 3 midwives, 3 radiologists and 3 screening centre managers. The women and the healthcare professionals considered that a DA could help to improve levels of knowledge, harmonise medical practice and provide reliable, comprehensive information. Overall, the interviewees wanted an easy-to-use, intuitive, graphic-rich, interactive, computer-based, patient-centred DA. Use of the DA might be limited by a lack of familiarity with shared decision-making (SDM), the risk of misuse and a preference for asymmetric positive information.ConclusionThe present results are likely to facilitate the development of the first validated tool for SDM support in French breast cancer screening programmes.
Helicobacter pylori (Hp) infects half of the world population and is responsible for gastric, duodenal ulcers and gastric cancer. The eradication of Hp cures ulcers and prevents ulcer recurrences and gastric cancer. Antibiotic resistance of Hp, and particularly clarithromycin resistance, is the primary cause of treatment failure and is a major concern identified by the WHO as a high priority requiring research into new strategies. Treatments guided by the detection of antibiotic resistance have proven their medical and economical superiority. However, this strategy is severely hampered by the invasive nature of the fibroscopy, since antibiotic resistance detection requires gastric biopsies. The eradication of Hp involves primary care physicians. The objective of this study will be to evaluate the feasibility of a strategy for the management of Hp infection in primary care by a recently developed non-invasive procedure and its non-inferiority in eradication rates compared with the strategy recommended by the French National Authority of Health. The non-invasive procedure is a PCR on stool to detect Hp infection and mutations conferring resistance to clarithromycin allowing a treatment guided by the results of the PCR. We present the protocol of a prospective, multicenter, randomized, controlled interventional study in two arms.
Helicobacter pylori, a gram-negative bacterium that specifically colonizes gastric mucosa, is one of the most widespread infectious diseases in the world [...]
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in men and the second in women worldwide. During the period 2017-2018, in France, 32.1% of the eligible population completed screening, which is under the acceptable uptake rate. The FORCEPS study aimed to test whether a training program focused on improving general practitioners’ (GPs’) communication skills could increase their patients’ CRC screening rate. Our study reports on the construction of, participation in and evaluation of the e-learning training program tested in the FORCEPS study.METHODS: An interdisciplinary team designed an e-learning program for French GPs on the Moodle® platform. Learning activities related to the stated learning objectives and interactive approaches were specified. Two sessions took place, in May and November 2018. The training lasted 6 weeks. RESULTS: In all, 116 GPs registered for the training program. Seventy per cent of the GPs who registered for the first session opted to follow the training via e-learning rather than in person. Among the participants, 36.0% followed the training in its entirety during session 1, as did 24.0% during session 2. At the end of the training, none of the participating GPs self-assessed themselves as a “novice”, and the number of GPs self-assessing as “intermediate” or “experienced” increased. Overall, 62.9% of the participants were generally satisfied with the e-learning course.CONCLUSIONS: The web-based program focused on improving GPs’ communication skills to encourage CRC screening was chosen by a large majority of the participating GPs and received positive reviews. While GPs’ theoretical knowledge can be improved through our training program, it remains to be seen whether or not this will be reflected in their everyday practice, thus resulting in an increased CRC screening participation rate among patients.
Introduction:
Breast cancer, the most common cancer in women, affects young women. Advance directives allow the expression of one's wishes concerning end of life wishes but they are poorly drafted. General practitioners report, in fact, real difficulties in talking about the end of life.
Purpose
This study aims to propose a model of advance directives that facilitates the exchange between the doctor and a breast cancer patient.
Methods
It is the result of a consensus of experts, obtained by the Delphi method. Twenty-one experts were included. A Delphi survey consisting of three rounds. The panel of experts were caregivers in contact with breast cancer patients, a Doctor of Sociology, deputy director of the National Center for Palliative Care and End of Life, as well as a former patient in remission from cancer. breast, association president. This new innovative model obtained takes into account in a more intimate way the moral values, the wishes of care and their environment.
Results
The first round lasted three weeks. Of the 29 questions posed to the experts, 20 were deemed relevant by over 70% of the experts. The second round lasted four weeks. Nine reworded questions were addressed to the experts. Eight of them were validated. The last question was validated in the third round. All experts responded to all three rounds.
Conclusion
The model created is a tool to create a more efficient dialogue between the physician and the patient. It is intended to be a faithful testimony of the patients’ wishes.
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