Etude pilote sur l'observance aux chimiothérapies orales : construction d'une échelle de mesure de l'observance et études de ses déterminants psychosociaux

Abstract : Oral chemotherapies are increasingly prescribed in oncology. Many changes in health care have occurred. The complexity of these treatments is moved from the doctor to the patient. To make an inventory of adherence to oral chemotherapy, and then describe its main determinants. Studying changes in the representations of cancer and treatment. 59 patients participated in this stud. For the quantitative methodology, we used the following tools: BMQ (representations of treatment), B-IPQ (perception of cancer), HAD (anxiety and depression). We built a generic scale to measure adherence. It was adapted to cancer. For qualitative methodology, we conducted semi-structured interviews. 90% of patients have a medication compliance of at least 85%. Compliance with the specific modalities of treatment is severely affected. Psychiatric history are the main variable affecting adherence. There is a negative correlation between current anxiety and depressive affect and compliance. The oral route is perceived as less impacting daily life compared to the IntraVeinous route. The oral route is associated with an increased sense of control over the disease. Oral chemotherapy is mainly addressed in terms of its toxicity. Changes in perception of the disease are infrequent (eg lower perceived severity).The relationship between history of depression, current depressive affects and compliance demonstrates the importance of their identification and their management. Failure to comply may be considered a symptom of depression in oncology. These data justify the role of the psychologist to support adherence and its possible links with an overall psychological distress.
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Frédéric Peter. Etude pilote sur l'observance aux chimiothérapies orales : construction d'une échelle de mesure de l'observance et études de ses déterminants psychosociaux. Psychologie. Université de Lorraine, 2013. Français. ⟨NNT : 2013LORR0326⟩. ⟨tel-01750891⟩

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