Background & Aims

The Haute Autorité de Santé (HAS) – or French National Authority for Health – defines “bientraitance” as a collective approach aimed at identifying the best possible support for patients, while respecting their choices and adapting to their needs. In recent years, and even more so since the outbreak of the COVID-19 pandemic, the shortage of caregivers, the technical nature of care and the need to evaluate it have all undermined the caregiver-patient relationship. Non-recognition and disillusionment with the altruistic and ethical values of care that go hand in hand with the vocation of the carer have led to suffering and even pathologies at work (burn out). The professional nursing commission (CPI) of the Société Française d’Etudes et de Traitement de la douleur (SFETD) has launched a clinical reflection on the care of patients in pain, from mistreatment (SFETD 2022 congress) to “bien-traitance” (SFETD 2023 congress).

Methods

An open group of 10 inter-regional nurses working in pain centers came together to engage in a collective clinical reflection on well-treatment. A qualitative focus group methodology was chosen to encourage storytelling, collective dynamics and experimentation. Two two-hour videoconference meetings took place between February and April 2022. The meetings were filmed, their content transcribed, and then analyzed thematically using a content analysis method.

Results

The results show a consensus among the peer group on the definition of well-treatment. They underline the concern of caregivers to take care of themselves by developing behaviors that are kind to themselves and to their colleagues, such as listening to oneself and respecting one’s own limits. This kind of self-care appears to be necessary to fulfil the role of caregiver for patients in distress. In addition, the results show that good treatment is an ethic of the care relationship, opening the way to compassion and kindness towards others. Finally, good treatment is part of a continuum opposing it to mistreatment, whether institutional, as a defensive position in response to unbearable patient distress, or psychopathological, when impulsive aggression is turned against oneself.

Conclusions

These elements of analysis open the way to a reflection on clinical practices and the difficult work of care for caregivers confronted with the physical and psychic suffering of their painful patients. They also offer recommendations on how to prevent suffering at work for nurses, by suggesting a posture of openness, stress management strategies and emotional sharing, and by reminding us of the benefits of person-oriented approaches (e.g. mindfulness) or analysis of the practice of medical teams.

References

(1) Evans, C. (2011). Focus groups. In Mener l’enquête. Guide des études de publics en bibliothèque. Presses de l’enssib.
(2) Bardin, L. (2013). L’analyse de contenu. Presses Universitaires de France.
(3) Masselin-Dubois, A. (2021). Interventions la 3ème vague des TCC en douleur chronique. In Laroche F. & Roussell. P. Douleur chronique et thérapies comportementales et cognitives (TCC). Editions In Press.

Presenting Author

Anne Masselin-Dubois

Poster Authors

Anne Masselin-Dubois

PhD

Université de Bourgogne Franche-Comté / Laboratoire, Psy-DREPI EA-7458

Lead Author

Sylvie Rostaing

Algologist

Pain Consultation, Avignon-Provence – Sainte Catherine Cancer Institute, Avignon, France

Lead Author

Karine Constans

Nurse

Multidisciplinary Pain Assessment and Treatment Unit, Beauvais Hospital Centre

Lead Author

Florence Vinit

Professor

Department of Psychology, Université du Québec à Montréal (UQAM), Canada

Lead Author

Topics

  • Access to Care