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SETE 2019 : Efficacité et acceptabilité de l'Atelier d'Education Thérapeutique (AET), étude pilote. Zahya GHADDAR KHALIFE

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Congrès 2019 de la SETE à Toulouse

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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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SETE 2019 : Efficacité et acceptabilité de l'Atelier d'Education Thérapeutique (AET), étude pilote. Zahya GHADDAR KHALIFE

  1. 1. Efficacité et acceptabilité de l’Atelier d’Education Thérapeutique (AET) : Etude pilote 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 1/10 Zahya GHADDAR KHALIFE, MSc Orthophoniste, Institut Superieur d’Orthophonie, Université Saint Joseph – Beyrouth, zahyag@gmail.com, zahya.ghaddar@usj.net.lb Dr Nayla MATAR ZEIN, PhD ORL, Département d’Otorhinolaryngologie - Université Saint-Joseph Faculté de Médecine – Hopital Hôtel-Dieu de France – Beyrouth - Liban: Nayla.matar@hdf.usj.edu.lb Michèle PUECH Orthophoniste, CHU de Toulouse - France: puech.m@chu-toulouse.fr
  2. 2. Contexte et But de l'étude 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 2/10 Dysphagie • Ce n’est pas une maladie • Symptomatologie d’une ou plusieurs conditions médicales. • Difficulté à avaler • Difficulté du transport des aliments de la bouche à l’oesophage en protégeant les voies respiratoires. Prise en charge de la dysphagie oropharyngée • Prise en charge pluridisciplinaire • Implication du patient et son aidant familial • Optimisation de son évolution et de sa QDV Manque d’adhésion à la Prise en charge orthophonique (PECO) • Atelier d’éducation thérapeutique (AET) du patient et de l’aidant familial Impact d’un AET dont le but d’acquérir une compétence spécifique • Adhésion du binôme(Patient dysphagique et aidant familial) à la PECO • QDV du binôme Speyer, R. (2013). Oropharyngeal Dysphagia. Otolaryngologic Clinics of North America, 46(6), 989–1008. Cot, F. (1996). La dysphagie oropharyngée chez l'adulte. France: edisem. Logemann, Jeri A. (1998). Evaluation and treatment of swallowing disorders. Texas: Proed.
  3. 3. Population 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 3/10 Choix par randomisation: 16 binômes (patients dysphagiques et leurs aidants familiaux) Groupe Contrôle (GC) • 8 binômes • - Rééducation orthophonique conventionnelle Groupe Expérimental (GE) • 8 binômes • - Rééducation orthophonique conventionnelle - AET lié aux fausses routes (FR)
  4. 4. Intervention 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 4/10 Recueil des données Axe 1: Comprendre et expliquer une fausse route Axe 2: Repérer, analyser et mesurer les différents signes cliniques d’une FR Axe 3: Faire face et décider des aliments à risque causant les fausses routes Inspiré du diagnostic éducatif de l’ETP (Education thérapeutique du patient) Support vidéo de « Aspiration Disorders- Blue Tree Publishing, Inc. » D’Ivernois, J.-F., & Gagnayre, R. (2011). Apprendre à éduquer le patient. Approche pédagogique. (4eme édition). Paris, France : Maloine. - Plateau alimentaire - Aliments liquides et solides - Différentes textures
  5. 5.  Questionnaire évaluant les connaissances liées aux FR du binôme utilisant des réponses à type Vrai ou (outil en ad-hoc)  5 items du Questionnaire « Caregiver Mealtime and Dysphagia* » (CMDQ) de type Likert évaluant l’adhésion du binôme à la PECO  Echelle de QDV en utilisant une échelle de différenciation sémantique d’Osgood* composee de 6 degrés allant de 1 à 6 Outcomes 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 5/10 GE: avant l’atelier éducatif GE: après l’atelier éducatif Colodny, N. (2008). Validation of the Caregiver Mealtime and Dysphagia Questionnaire (CMDQ). Dysphagia, 23(1), 47–58. http://doi.org/10.1007/s00455- 007-9094-3 D’Ivernois, J.-F., & Gagnayre, R. (2011). Apprendre à éduquer le patient. Approche pédagogique. (4eme édition). Paris, France : Maloine. Pré-test GC: après la signature du consentement Post-test GC: après une semaine
  6. 6. Résultats 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 6/10 6.25 11.38 3.63 6.5 9.75 2.88 -1 4 9 14 Quest. Connaissance CMDQ QDV Pré-test GC v/s GE GC GE 6.38 11 4 7.88 9.5 3.5 -1 4 9 14 Quest. Connaissance CMDQ QDV Post-test GC v/s GE GC GE *
  7. 7. Résultats 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 7/10 6.25 11.38 3.63 6.5 9.75 2.88 6.38 11 4 7.88 9.5 3.5 0 2 4 6 8 10 12 Quest. Connaissance CMDQ QDV Quest. Connaissance CMDQ QDV GC GE Pré-Post (Connaissance/CMDQ/QDV) Pre Post ** *
  8. 8. Limites et Perspectives 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 8/10 - Taille restreinte de l’échantillon - PECO par différents orthophonistes et différents lieux de PEC - Durée de la PECO entre les deux groupes - Fatigabilité des patients - Plus large échantillon - PECO standardisée - Préciser la durée de la PECO - Simplification du questionnaire évaluant l’adhésion (en cours) - Répétition de l’AET lié aux FR - Couplage à un atelier éducatif complémentaire en Limites Perspectives
  9. 9. Résultats significatifs de la connaissance liée aux fausses routes et la QDV du GE Poursuite de cette étude avec une fréquence d’AET et un nombre de patients plus élevé Standardisation du programme de l’AET Implication du programme dans la prise en charge orthophonique Conclusion 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 9/10
  10. 10. Merci de votre attention 10 Contact: Zahya Ghaddar zahya.ghaddar@usj.edu.lb
  11. 11. Back-up 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 11/10 Axe 1: Comprendre et expliquer une fausse route Support vidéo de « Aspiration Disorders- Blue Tree Publishing, Inc. »
  12. 12. Back-up 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 12/10 1. M. Walid manifeste un raclage de gorge à plusieurs reprises après avoir avalé une bouchée de falafel… Axe 2: Repérer, analyser et mesurer les différents signes cliniques d’une fausse route Actions Conséquences Mécanismes physiopathologiques Il faut que je demande à M. Walid d’avaler une deuxième fois… Oui, pour permettre à M. Walid d’éliminer les résidus qui sont dans son larynx et qui lui font racler la gorge. Trouble de contrôle et de propulsion pharyngée Il faut que je donne directement une deuxième bouchée à M. Walid… Non, il faut laisser le temps à M. Walid d’éliminer les résidus sur les cordes vocales en avalant une deuxième fois, car si je lui donne directement une deuxième bouchée il va tousser et il y aura un risque d’étouffement. Il faut que j’attende un laps de temps avant de donner une deuxième bouchée à M. Walid… Ça peut l’aider à avaler une autre fois avant de prendre une deuxième bouchée.
  13. 13. 2 ‫ي‬‫السيد‬ ‫م‬ّ‫ل‬‫تك‬‫م‬.‫ف‬.‫مهر‬ ‫بطاطا‬ ‫لقمة‬ ‫ابتلع‬ ‫أن‬ ‫بعد‬‫وسة‬. ‫ل‬َّ‫ل‬‫ب‬ُ‫م‬ ‫صوته‬ ّ‫أن‬ ‫الحظ‬ُ‫ن‬. •‫ماء‬ ‫كوب‬ ‫إعطاؤه‬ ‫يجب‬. •‫م‬ ‫السيد‬ ‫من‬ ‫أطلب‬ ‫أن‬ ‫يجب‬.‫ف‬.‫ريقه‬ ‫ويبلع‬ ‫ة‬ ّ‫بقو‬ ‫يسعل‬ ‫أن‬... •‫الوجبات‬ ‫خالل‬ ‫مهروسة‬ ‫بطاطا‬ ‫إعطائه‬ ‫عن‬ ‫ف‬ّ‫ق‬‫أتو‬ ‫أن‬ ‫يجب‬ ‫المختلفة‬...
  14. 14. ،‫ال‬‫يجب‬‫أال‬‫عطيه‬ُ‫أ‬‫ماء‬‫ليشرب‬‫ألن‬‫ذلك‬‫قد‬‫ي‬‫زيد‬ ‫من‬‫خطر‬‫المرور‬‫في‬‫القصبة‬،‫ة‬ّ‫ائي‬‫و‬‫اله‬‫وبا‬‫لتالي‬ ‫زيادة‬‫الوضع‬‫ا‬ً‫سوء‬. ‫بل‬‫يجب‬‫أن‬‫أطلب‬‫منه‬‫أن‬‫يسعل‬‫ة‬ّ‫بقو‬‫أن‬‫و‬‫ي‬‫بتلع‬ ‫ريقه‬‫أو‬‫أن‬‫ب‬َّ‫رط‬ُ‫ت‬‫البطاطا‬‫المهروسة‬‫لت‬‫سهيل‬ ،‫القها‬‫ز‬‫ان‬‫فال‬‫تبقى‬‫في‬‫ة‬‫الحنجر‬.
  15. 15. ،‫نعم‬‫ساعد‬ُ‫ي‬‫ه‬‫ذلك‬‫على‬‫اغ‬‫ر‬‫إف‬‫ى‬‫مجر‬‫اء‬‫و‬‫اله‬ ‫وبالتالي‬‫استعادة‬‫أنفاسه‬‫لمتابعة‬‫وجبة‬‫ط‬‫عامه‬. ،‫لكن‬‫يجب‬‫ترطيب‬‫البطاطا‬‫المهروسة‬‫ل‬‫ز‬‫لتن‬‫ق‬ ‫بشكل‬‫أفضل‬‫ال‬‫و‬‫تبقى‬‫في‬‫ة‬‫الحنجر‬.
  16. 16. ،‫ال‬ّ‫د‬‫سيح‬‫ذلك‬‫من‬‫المذقات‬. ‫بل‬‫يجب‬‫ترطيب‬‫البطاطا‬‫المهروسة‬‫لتسهيل‬ ،‫انزالقها‬‫فال‬‫تبقى‬‫في‬‫الحنجرة‬.
  17. 17. Back-up 11 mai, 2019 SETE 7ème congrès de la société D’éducation thérapeutique européenne| Toulouse 9-11 mai 2019 12/10 Axe 3: Faire face et décider des aliments à risque causant les fausses routes

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