Résumé
Un programme d’éducation thérapeutique pour les patients (ETP) atteints de fibromyalgie a été mis en place au CETD de l’Hôtel-Dieu à Paris, afin d’induire un changement dans la gestion de leur maladie, d’accroître leur autonomie et de renforcer leur motivation. Une fois le diagnostic éducatif établi et après une évaluation initiale, l’équipe pédagogique multidisciplinaire réunit six à huit patients pendant cinq séances hebdomadaires de trois heures. Le déroulement du programme permet de développer des capacités d’autosoins (gestion des traitements médicamenteux, planification et fractionnement des activités quotidiennes, résolution de problèmes, implication de l’entourage, pratique régulière d’activité physique) et d’autoadaptation (gestion des émotions et du stress, développement d’une réflexion critique, prise de décision, auto-observation et autoévaluation). Une évaluation à moyen et long termes est mise en place. Une revue de la littérature montre que l’évaluation de l’efficacité des programmes d’ETP se heurte à plusieurs écueils: la disparité de la formation des équipes pédagogiques et des techniques utilisées, la diversité des critères de jugement, l’absence fréquente de groupe témoin, l’association aux techniques de rééducation, et la durée variable de la période d’évaluation.
Abstract
A therapeutic education programme (TEP) for patients with fibromyalgia has been established at the CETD at the Hôtel-Dieu in Paris, to introduce changes in the management of their disease, increase their independence and heighten their motivation. Once the educational diagnosis has been made, and after an initial assessment, the multidisciplinary educational team brings together six to eight patients for five weekly three-hour sessions. The programme allows self-care skills to be developed (medication management, planning and dividing up of daily tasks, problem solving, implications for family members and taking part in regular physical exercise) as well as those of self-adjustment (emotion and stress management, development of critical thinking, decision making, self-awareness and self-assessment). A medium and long-term assessment is made. A review of the literature shows there are a number of problems when assessing the effectiveness of these TEP programmes: disparity in the training of the educational teams and the techniques used, diversity in the judgment criteria, a frequent lack of a control group, the association with physiotherapy techniques and the variable duration of the assessment period.
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Perocheau, D., Perrot, S. Éducation thérapeutique et fibromyalgie. Douleur analg 24, 189–196 (2011). https://doi.org/10.1007/s11724-011-0270-8
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DOI: https://doi.org/10.1007/s11724-011-0270-8