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Avec l’augmentation des accidents vasculaires cérébraux (AVC), améliorer le bien-être des aidants naturels (AN) est devenu une priorité. Quels sont les déterminants psychosociaux de l’estime ressentie par les AN en accomplissant ce rôle ? Méthodologie. Sur une période de 12 mois, les personnes victimes d’un AVC deux ans auparavant, dont le diagnostic a été confirmé, vivant au Luxembourg et ayant donné leur consentement, ont désigné leur AN principal. Etude nationale transversale menée au domicile. Instruments : - Caregiver Reaction Assessment : estime de l’aide, manque de soutien familial, impacts financier, sur l’emploi du temps, sur la santé générale. - Carer Satisfaction of Community Services : services socio-sanitaires et éducatifs - Aides à domicile utilisées : soins corporels, repas, ménage, sorties, courses Résultats. Taux participation 26,5 % ; 48 AN (59,5 ±12,3 ans). Régression multiple (R²ajusté=.230) : une estime élevée est associée à un faible impact de l’aide sur la santé (β=.479***) et un recours important aux aides à domicile (β=.351**). Discussion. Il est possible de valoriser le rôle d’AN en motivant les aidants à utiliser les services disponibles pour les soulager dans leurs tâches quotidiennes. Les soutiens psychologiques peuvent également intégrer le concept de « health capability » pour renforcer l’acquisition de cette estime.

To assess the association between social support and subsequent premature mortality (PM) (15 years, randomly selected in north-eastern France, completed in 1996 a postal questionnaire gathering characteristics, smoking, alcohol abuse, obesity, social support from colleagues/family/friends, and physician-diagnosed diseases. The cohort was followed-up until 2008 (12.5 years). Data were analyzed using Poisson models. Results: There were 165 PM (115 men, 50 women) during the follow-up. For all the cohort, social support was strongly associated with PM: crude relative risk (RR) 2.09 (95%CI 1.53-2.85). It decreased to 1.52 (1.11-2.09) when adjusted for age, 1.46 (1.06-2.00) with further adjustment for occupation, 1.44 (1.04-1.98) with further adjustment for smoking, alcohol abuse and obesity, and 1.28 (0.92-1.78) when diseases (cancer, diabetes, mental, nervous-system, cardiovascular, respiratory, genitourinary and musculoskeletal diseases) were taken into account. Similar results were found for men: crude RR 2.46 decreasing to 1.81, 1.70, 1.60, 1.45 respectively. But not for women: close-to-significant crude RR 1.57 (small number of PM). Conclusions: Social support influenced PM in men but not in women. Occupation, health behaviours, and diseases play a role.

Domestic accidents are a public health problem. This study assessed the disparities between socioeconomic positions and the confounding role of gender, age, education, living alone, income, poor health, obesity, current tobacco use, alcohol abuse, fatigue/sleep disorders, and physical, sensorial and cognitive disabilities. Methods: 6,198 people aged ≥15, randomly selected in north-eastern France completed a post-mailed questionnaire including domestic accident(s) during the last two years. The data were analyzed via logistic models. Findings: Domestic accidents affected 3.1% of subjects. Manual workers and clerks had higher risks (age-gender adjusted OR 1.6, 95%CI 1.1-2.6 and 1.5, 1.0-2.4) compared with the other socioeconomic groups. These differences became non significant when controlling for all covariates of which those significant were: sex, current tobacco use, alcohol abuse, and fatigue/sleep disorders (adjusted odds ratios 1.48-1.88). Discussion: There are social disparities in domestic accidents, and they are confounded by sex, substance use, and fatigue/sleep disorders.

Objectives. To assess the relationships of multiple deprivation and gender differences towards tobacco, alcohol and psychotropic drug use. Design and methods. The sample included 6,216 subjects, aged 15 years, randomly selected in north-eastern France who completed a mailed questionnaire. Data were analyzed with the logistic model. Results. Multiple deprivation (noted MD, defined by the cumulative number of: low educational level, manual worker, unemployment, living alone, nationality (other than Western Europe), low income, and non-home-ownership) concerned many people: 37.4% for MD1, 21.2% for MD2, 10.0% for MD≥3. Tobacco and excess alcohol use was more frequent in men than in women (30.2% vs. 21.9%, 12.5% vs. 3.3%, p

Objectives. To assess the effects of individual and family characteristics on psychotropic drug use among male and female adolescents. Design and methods. The sample included 2,396 subjects attending two middle schools and two high schools. Respondents completed self-administered questionnaires covering gender, age, body mass index, smoking, alcohol use, illicit drug use, tiredness during the daytime, self-reported personality traits, family conditions, and psychotropic drug use. The data were analyzed using logistic models. Results. The prevalence of frequent psychotropic drug use (for headache, tiredness, nervousness/anxiety, insomnia) was 43.0% overall; twice as high among girls than boys. In girls, frequent psychotropic drug use was associated with frequent tiredness during the daytime (adjusted odds ratio OR 2.03, 95%CI 1.61-2.57), smoking (2.02, 1.50-2.71), alcohol use (1.34, 1.04-1.74), higher body mass index (18 kg/m2, 1.54, 1.16-2.04), poor family atmosphere (1.33, 1.03-1.72), and being worried (1.93, 1.53-2.43) or easily becoming irritable (1.28, 1.01-1.62). In boys the factors with significant ORs were frequent tiredness during the daytime (2.21, 1.67-2.93), alcohol use (1.52, 1.15-2.01), and being worried (1.70, 1.28-2.26) or easily becoming irritable (1.42, 1.06-1.89); univariate analysis revealed a significant relationship with smoking and family atmosphere. An association was also observed for illicit drug in both sexes and for age17 years in girls. Conclusions. Individual and family characteristics have marked influences on psychotropic drug use among both male and female adolescents. This finding may be useful for the psychologists, the physicians, the parents and the school staff to be more aware of the risks and to find remedial measures.

Développer un instrument de qualité de vie (QV) spécifique de l’arthrose du genou et de la hanche (AMIQUAL) et étudier sa validité et sa reproductibilité. Méthodes. – Soixante-dix-neuf patients et 28 professionnels de la santé ont participé à des entretiens individuels ou de groupe. L’analyse de contenu des entretiens a permis d’extraire une liste de 80 items potentiels. Quarante-six de ces 80 items ont été sélectionnés sur leur contenu pour former la version 1.0 de l’AMIQUAL. Les propriétés psychométriques de l’instrument ont été étudiées chez des patients suivis pour coxarthrose ou gonarthrose définies selon les critères d’Altman. Résultats. – L’analyse psychométrique de l’AMIQUAL (1.0) complété par 263 patients a permis d’exclure trois items supplémentaires pour aboutir à une version 2.3 du questionnaire. L’analyse en composantes principales a identifié quatre facteurs : « Activités Physiques », « Santé Mentale », « Activités Sociales » et « Soutien Social ». Une dimension « Douleur » a secondairement été individualisée. L’analyse des dimensions a montré que la reproductibilité, la validité de construction et les capacités discriminantes de l’instrument étaient satisfaisantes. Les réponses moyennes standardisées étaient proches de 1 pour les dimensions « Douleur » et « Activités Physiques » et de 0,7 pour la dimension « Santé Mentale » témoignant d’une bonne validité longitudinale après mise en place d’une prothèse. Conclusions. – L’AMIQUAL est le premier instrument de QV spécifique de l’arthrose des membres inférieurs. Il est capable de capturer les aspects spécifiques de la QV des patients et possède les propriétés psychométriques requises pour être utilisé dans des études longitudinales.