Phénoménologie de la non-observance dans les maladies chroniques

Abstract

On admet qu'un patient sur deux ne suit pas les recommandations médicales qui lui sont données. Cette non-observance concerne tous les aspects du soin, et ils sont souvent liés. Le but de cet article est de présenter une analyse phénoménologique de la non-observance dans les maladies chroniques, d'une part, en s'appuyant sur les données empiriques de la littérature et, d'autre part, en se réfé-rant à deux champs disciplinaires : la philosophie de l'esprit et la neuroéconomie. Nous proposons que la non-observance soit associée à deux traits de caractère : d'une part, l'impatience qui fait que certains individus donnent la priorité au présent ; d'autre part, la faiblesse de la volonté qui les empê-che de décider sans réserve de donner la priorité au futur. Nous suggérons que ces deux traits de caractère sont psychologiquement liés.Mots clés Observance · Impatience · Faiblesse de la volonté · Philosophie de l'esprit · Neuroéconomie Abstract One patient out of two does not follow medical recommendations. This non-adherence concerns all the aspects of the care, and they are often bunched. The purpose of this article is to present a phenomenological analysis of non-adherence to long-term therapies, on one hand by relying on empirical data found in the literature, on the other hand by referring to concepts developed by two disciplinary fields: the philosophy of mind and neuroeconomics. We propose that non-adherence is associated with two characteristics: on one hand impatience, which makes that certain individuals give the priority to the present. On the other hand, weakness of will, which prevents them from deciding wholeheartedly to give the priority in the future. We suggest that these two characteristics are psychologically linked.

Development of a marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer and undergoing chemotherapy: a modified Delphi method

“…The sessions allowed couples to discuss health-related issues, psychological/behavioural and social/interpersonal processes, their relationship as a couple, plans, and the affection they have for each other. Imagery and future-oriented exercises may also help remind couples of their coping ability and available resources, as well as facilitate discussions around difficult or sensitive topics ( Gremore et al, 2021 ; Robieux and Bridou, 2022 ). Studies also indicated that since verbally disclosing certain matters to a partner may be challenging or problematic, a written disclosure would be more beneficial ( Zhang et al, 2019 ; Yucel et al, 2021 ; Boyd et al, 2022 ).…”