Дисертації з теми "Maladies rares – Aspect psychologique"
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Burgevin, Melissa. "Évaluation neuropsychologique et médico-sociale des adolescents et adultes porteurs d’un syndrome de Silver-Russell." Thesis, Rennes 2, 2021. http://www.theses.fr/2021REN20049.
In France, rare diseases are a major public health issue with more than 3 million people affected by a rare disease. Because of their rare nature, these diseases generally suffer from limited knowledge. Silver-Russell syndrome (SRS), a rare (epi)genetic disease characterized by pre- and post-natal growth retardation, is no exception to this observation. Indeed, although many advances have been made in recent years concerning medical knowledge of SRS, there are still gaps in the cognitive and psychosocial phenotype of individuals with this syndrome. This thesis, which is at the crossroads of medicine and psychology, has a double objective: on the one hand, to study the cognitive, psychological and behavioral characteristics of adolescents and adults with SRS (e.g., intellectual efficiency, executive functions, self-esteem) and, on the other hand, to identify the factors associated with these different characteristics (e.g., age, molecular anomaly). A total of 19 participants with SRS (8 adolescents and 11 adults), and 19 control participants took part in this research. The results of our studies show that participants with SRS have intellectual abilities similar to those of the general population. Cognitive and psychological difficulties were observed in our participants with SRS. However, these difficulties were not expressed in the same way in adolescents and adults with SRS. Links between the phenotype and genotype of the participants were also observed. These results offer a better understanding of SRS and open perspectives on SRS management
Del, Volgo Marie-José. "L'instant de dire : historisation et roman de la maladie en milieu médical." Aix-Marseille 1, 1994. http://www.theses.fr/1996AIX10052.
Sounga, Dufeil Leyb Rodneil. "Stress et AVC : approche psychologique des patients en milieu hospitalier." Amiens, 2009. http://www.theses.fr/2009AMIE0021.
Lemoine, Pascal. "Le lien familial à l'épreuve du cancer : à propos du suivi de patients et de leurs familles en service d'onco-hématologie." Grenoble 2, 2000. http://www.theses.fr/2000GRE2A014.
Humphreys, Manterola Derek Andrew Robert. "Constitution d'un rapport de l'immunologie à la psychanalyse : l'approche du somatique." Paris 7, 2004. http://www.theses.fr/2004PA070037.
Our interest is on the first place the determination of the status of auto-immune diseases. This opens the question of the relationships between the biological individuality and the subjectivity. Are auto-immune diseases the manifestation of an unrecognizing-destructive SELF? Or are they just the result of a genetically determined dysfunction of integrative and communicational organic systems? The Self metaphor shows a certain historical utility, an epistemological tool. There is still a third possible reasoning: disease is always, in part, subjective; human nature is cultural. But the modern medicine's scientific quest of a diagnostic and therapeutic purity denies the subjective component of disease. Though an historical and epistemological approach, we established a splitting of individual aspects during the 2nd half of 19th century, moment of separation between "substantial" aspects that will become immunology, and "subjective" aspects, i. E. Psychoanalysis. The end of the 20th century will see a shift in the immunological speech. It will no longer be a matter of self organisation, protection against foreign, but a communication system within an integrated organism. However, this view won't be an answer to the auto-immune disease paradigm. Based on a clinical experience, we argue that a technological approach of modern medicine underestimates the disease concept. More than a psychosomatic clinic, we plea for a body in its whole, organic and subjective
Valas, Vincent. "De la maladie mortelle comme expérience ontologique." Paris 1, 1995. http://www.theses.fr/1995PA010573.
Renson, Jacques. "Odontostomatologie et psychiatrie." Bordeaux 2, 1992. http://www.theses.fr/1992BOR2OE01.
Argentin, Vicogne Sabine. "Maladie génétique chez l'enfant : fonctionnement psychique et relations familiales. Enfants et adolescents atteints de mucoviscidose : approche clinique et prévention psychopathologique." Rouen, 2000. http://www.theses.fr/2000ROUEL378.
Rolhion, Sophie. "Psoriasis et alexithymie : de l'atteinte chronique du cutané à la vulnérabilité émotionnelle." Bordeaux 2, 2004. http://www.theses.fr/2004BOR21117.
Psoriasis is a chronic skin disease which affects about 2% of the French population. Numerous parameters (genetics, climatic, infectious) may be involved in its onset. Many patients with psoriasis are resistant to most treatments. We know that complete remission is often not achieved and patients are left to deal with chronic, relapsing, visible lifelong disorder. Psoriasis still represents a therapeutic challenge. We wonder if there was a possible psychological explanation for the absence of effects of treatement in many patients. Psychological factors are involved in the beginning of the onset and relapse of psoriasis. Some studies suggest that alexithymia is very frequent in psoriatic patients. Alexithymia may influence illness behavior rather than leading to chronic organic diseases, such as psoriasis. We tried to explore if alexithymia was linked with psoriasis and was stable in the face of clinical improvement or aggravation. The a priori hypothesis was that psychological variables, mainly alexithymia, could be involved in insufficient healing of psoriatic lesions. Alexithymia could be associated with psychiatric disorders in many patients. These psychiatric disorders could be also involved in a bad response to treatment. Thus, we have undertaken this study (about 93 patients) to explore the importance of links between skin, emotions and schemes of therapeutic observance. It provides a better understanding of relationships between body, temporality and care. Finally, we allow to propose an original therapeutic project for psoriatic patients care
Beaumont-Gaudet, Sarah. "Le vécu de l'arthrite chez les femmes québécoises : une approche phénoménologique." Master's thesis, Université Laval, 2015. http://hdl.handle.net/20.500.11794/26241.
When pain imbeds itself in the body, when it takes over the daily life of the individual, it overwhelms “normalcy” and familiarity. The day-to-day standard experience of individuals stricken by arthritis is of a painful body that incapacitates and restricts. In the context where this chronic illness transforms the individual, perturbs the embodied and psychologi-cal experience of life, what are the aspects of daily life affected by the condition and the pain it entails? How do individuals manage this pain? What are the strategies and behav-iours adopted to live a fulfilling life despite the affliction? The objective of this project has been to identify the daily hurdles and issues with which individuals afflicted by arthritis are confronted, as well as seek to understand the process by which the illness is strategically managed by the adoption of appropriate behaviour. This project has allowed, by interview with individuals on their experience of the illness, to demonstrate that the repercussions of the illness and of pain are not limited to the body, but radiate to all spheres of the individu-al’s life.
Mormède, Cécile. "Etude de l'influence de stimuli psychiques sur le fonctionnement du système de l'immunité innée." Bordeaux 2, 2003. http://www.theses.fr/2003BOR21034.
Proinflammatory cytokines produced by innate immune cells trigger a set of centrally mediated physiological and behavioural alterations. Conversely, the innate immune system can be influenced by brain functions. The present research aimed at studying the influence of the central nervous system on the cytokine network. We showed that pharmacological treatment by an atypical antidepressant attenuated proinflammatory cytokine induction by lipopolysaccharide (LPS). Chronic mild stress also led to alterations of the cytokine network, including increase of hypothalamic interleukin-6. However, the presentation of a conditioned stimulus paired with interleukin-1β or LPS in a procedure of conditioned place or taste aversion did not affect the cytokine network, but impacted on their intracellular signalling pathways. In conclusion these findings show that the cytokine network can be activated non specifically by non immune psychological factors but that it cannot be classically conditioned
Guedj, Myriam. "L'acceptabilité de la rupture du secret médical dans le cas d'un patient atteint de maladie sexuellement transmissible ou potentiellement violent envers sa partenaire chez le grand public." Toulouse 2, 2004. http://www.theses.fr/2004TOU20063.
Objectives : The study measured the conditions of acceptability of breaching confidentiality. Three hundred and thirty-nine participants judged acceptability of each of the 48 scenarios. Those describe fictitious situations where a patient - either reached of a sexually transmitted disease or dangerous for its partner - is consulting a general practitioner. The general practitioner decides to break confidentiality by alerting the patient's wife of the danger represented by her husband. Results:the five factors handled in each of the two studies have variable weights in the acceptability of breaching confidentiality. The cognitive rules used in the judgement differ according to the factors and from the studied situations. Some individual variables influence the judgement of the participants. Conclusion: it appears that the acceptability of the breaching confidentiality depends largely on the factors reaching in the scenarios
Bénony, Hervé. "Les aspects psychopathologiques dans la myopathie de Duchenne de Boulogne." Paris 5, 1989. http://www.theses.fr/1989PA05H057.
Petit, François Mickael. "Aspects moléculaires des maladies rares du métabolisme hépatique : à propos de la maladie de Crigler-Najjar." Nantes, 2008. http://archive.bu.univ-nantes.fr/pollux/show.action?id=5dcfa87e-f2cb-468d-8a87-767381d67fe9.
Crigler-Najjar syndrome is a rare hepatic disorder due to partial or total deficiency of enzymatic activity of UGT1A1 involved in bilirubin conjugation. The disease manifests itself during the first hours of life by intense and persistent unconjugated hyperbilirubinaemia. Affected children are at high risk to develop brain non-reversible damages (kernicterus) due to bilirubin encephalopathy. Since 1952 and the description of this syndrome by Crigler and Najjar, molecular studies allowed to identify the gene. UGT1A1 gene is located on the terminal part of the chromosome 2 and is composed of 5 exons. Crigler-Najjar syndrome can take two forms: type I with complete and non-inducible enzymatic deficiency and type II with non-complete and inducible enzymatic deficiency. In this work, we have described new mutations responsible for Crigler-Najjar syndrome type I or II and we have analysed them in terms of phenotype-genotype correlations. Secondly we have studied two families with non-canonical presentation (first description of paternal isodisomy for chromosome 2, molecular characterisation of a large deletion in UGT1A1 gene), highlighting the importance of familial investigations in this syndrome. In the last part, we have molecularly characterised a founder effect for the mutation c. 1070A>G in the Tunisian population, in whom Crigler-Najjar syndrome is particularly frequent
Thériault, Linda. "Impact d'un programme d'entraînement périodisé sur la santé physique et psychologique des personnes atteintes de maladies mentales." Thesis, Université Laval, 2014. http://www.theses.ulaval.ca/2014/30869/30869.pdf.
Rouvière, Huguette. "L'estime de soi, l'image de soi, les strategies de coping aux risques de la maladie, du cancer, du s. I. D. A." Toulouse 2, 1994. http://www.theses.fr/1994TOU20041.
On the one hand, the thesis aims at analysing the effects of two diseases, cancer (hemopathy) and aids, on sel-esteem and self-image. On the other hand, we will see what are the coping strategies adopted by the patients to deal with the disease and adapt to it. In chapter one, we will develop different representations of the disease li ke myth, as well as the consequences of the representations of cancer and aids on personal and social identity, on body scheme and image, on self-representation. However the patient reacts opposing defence mecanisms or "reactional" behaviours. Coping processes, which are cognitivo behavioural strategies of stress management, enable the patien to adapt himself to his disease either by focusing on one problem, direct action, or by regulating his emotion, indirect action. Statistical analyses of self esteem, self-image and coping strategies are based on various parameters such as health (hemopathics witnesses), sex and age. The disease by means of over-adjustment process, has positive consequence on self-esteem, self image and coping strategies. Expansive, open-minded women evaluate themselves positively; they have less control on their feelings than steady introverted men who are more able to deal with situa tions. Impulsive and combative teenagers overcome threath. Young steady adults ratio nalize and control difficulties. The disease overwhelms introverted adults, even steady; they are more often reluctant to try to overcome it
Chekour-Bengéloune, Ahlam. "Représentations de la maladie et de la guérison chez les saisonniers agricoles marocains du pays d'Arles." Aix-Marseille 2, 2003. http://www.theses.fr/2003AIX20677.
Morkmued, Supawich. "Approches cliniques, précliniques et translationnelles des anomalies bucco-dentaires associées aux maladies rares." Thesis, Strasbourg, 2017. http://www.theses.fr/2017STRAJ040.
The goal of this thesis is to investigate genetic and environmental factors, both initiating and influencing signaling centers that regulate tooth development and thus producing associated defects. Essentially, my research program utilizes patient-based rare disease phenotypes to create novel mouse models. This study also involved investigating the developmental effects of excess retinoic acid on enamel formation to gain understanding of the mechanisms by which environmental factors can alter enamel development. Other studies investigated enamel and dental anomalies in Ltbp3 and Smoc2 mutant mice. These results advance our understanding of tooth development, and may translate towards optimizing clinical diagnosis, and improving treatment strategies for several human rare diseases. An improved understanding of rare disease models and our testing of clinically relevant approaches using rodent models is a feasible approach to address bone degeneration problems
Bousquet-Jacq, Nathalie. "Le développement des enfants traités pour hypothyroi͏̈die congénitale : l'annonce de la maladie, le vécu des parents." Montpellier 1, 1992. http://www.theses.fr/1992MON11098.
Nicolas, Elsa. "Identification du gène responsable du syndrome CAMOS, une forme autosomique récessive d'ataxie cérébelleuse congénitale non progressive." Aix-Marseille 2, 2007. http://www.theses.fr/2007AIX20707.
Piquard, Ambre. "Attention préparatoire et attention sélective : étude et relations avec la planification et les activités de la vie quotidienne chez des patients présentant une maladie neurodégénérative responsable d'un dysfonctionnement frontal." Paris 5, 2003. http://www.theses.fr/2003PA05H018.
Attention is essential for mental functioning (in individuals) because of its implication in behavioural regulation and adaptation. LaBerge (1995) proposed a model of attention including the notion of preparatory attention, in which the frontal lobes seem to play a crucial role. Preparatory attention contributes to goal achievement and, more generally, to adaptative behavior. We studied preparatory attention, using an experimental test developed by LaBerge (LaBerge et al. , 2000) in patients suffering from a neurodegenerative disease involving frontal lobe dysfunction (frontotemporal dementia associated or not with amyotrophic lateral sclerosis, Alzheimer's disease, Parkinson's disease) in which attentional defecits are frequently described. The results are in contradiction to precedent studies. The slope of response times, measure of preparatory attention proposed by LaBerge, could reflect different processes depending on whether this slope is high or low. The study of the orientation of selective attention using the spatial cueing task (Posner, 1980) demonstrates an engagement and/or disengagement deficit associated with an inhibition of return deficit in patients with FTD and AD. We also studied the implication of preparatory attention in planning and activities of daily living. The relationship with planning and activities of daily living confirms the necessity to dissociate both types of slope in so far as only low slopes are correlated with these activities. The low slopes may potentially be the reflection of a deficit in working memory, global attention or divided attention. Our results confirm the implication of an attentional component in planning and activities. However, preparatory attention does not seem to be linked specifically to these activities
Guimier, Anne. "Identification des bases moléculaires et étude physiopathologique de maladies cardiaques rares en pédiatrie." Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCB241.
Rare diseases are defined in Europe by a prevalence of less than 1/2,000 individuals and represent more than 7,000 different diseases of which 80% are genetic. Most have a paediatric onset. My project involved the study of rare cardiac disorders in familial cases with recurrence in siblings, focusing on congenital heart disease in the context of heterotaxia (laterality defects) and sudden unexpected death due to cardiac arrest in infancy and the neonatal period. Whole exome sequencing was used as a tool for disease gene discovery in these families with the hypothesis of autosomal recessive inheritance. This strategy led to the identification of 3 novel disease genes. I performed functional validation for two of these genes in different models, confirming their involvement in each disease. 1) Loss of function of MMP21 and cardiac malformations due to left-right patterning defects during embryonic development. MMP21 encodes a metallopeptidase for which I demonstrated a highly specialized role in the generation of left-right asymmetry at the node using zebrafish. This gives new insight into the molecular mechanisms at the origin of left-right asymmetry in vertebrates. Interestingly, all mammals have a left-sided heart, but some species have lost the Mmp21 gene, indicating that there are different pathways leading to left-right determination in vertebrates. 2) Hypomorphic mutations in PPA2 cause sudden cardiac arrest in infants. PPA2 is a nuclear gene encoding the mitochondrial pyrophosphatase and using a yeast model we showed that this enzyme is essential for the mitochondrial energy transducing system and biogenesis. I described a novel clinical spectrum for a mitochondrial disease responsible for unexpected cardiac arrest in infancy. 3) PLCD3 loss of function and fatal cardiomyopathy by cardiomyocyte apoptosis and necrosis in neonates. Exome sequencing in one familial case with 2 siblings presenting fatal cardiomyopathy led to the identification of compound heterozygous mutations in PLCD3, a gene previously implicated in a similar pathology in a mouse model. Identification of further cases with mutations in this gene will be needed in order to confirm the role of PLCD3 in the disease. In total, these studies are crucial from a clinical point of view for the genetic counseling of the affected families and they contribute to the elucidation of biological mechanisms of embryonic development and left-right determination (MMP21), mitochondrial function (PPA2) and post-natal cardiomyocyte survival (PLCD3)
Paterniti, Sabrina. "Anxiété et risque vasculaire : l'étude EVA, enquête de cohorte d'une population de 1389 sujets de la ville de Nantes âgés de 59-71 ans et suivis pendant 7 ans." Paris 11, 2002. http://www.theses.fr/2002PA11T018.
Baudin, Marianne. "Approche métapsychologique d'une pathologie auto-immune féminine : le syndrome sec." Paris 5, 1998. http://www.theses.fr/1998PA05H002.
Sicca syndrome - or Gougerot Sjogren's syndrome - is an auto-immune disease whose main effects consist in salivary, lachrymal and vaginal secretions drying. Mainly a feminine one, this syndrome presents two forms : primary or secondary and then, it's associated to sclerodermia or lupus or other systemic diseases. . . In the part "theory", scientific and psychoanalytical points of view are studied and discussed as organizing actual debates in the new field of psycho-immunology. Freud's conceptualization of psychic system and psychosomatic theories give some markers to psychological functionning of such patients. Drying up and feminine characteristics of this pathology give rise to a reflexion about feminity in regard to its links with liquid element and also about ageing and menopause as natural drying up stage in the psychosexual life of women. Methodology is based on interview and projective methods, Rorschach and T. A. T. . It allowed a qualitative and a quantitative study of 36 cases of sicca syndrom (22 primary and 14 secondary) compared to 20 women controls. Hypothetis follow three axes : psychosomatic, feminity, ageing, added to a fourth axe about cerebral hypoperfusions shown by medical scanning. Results are presented and discussed in regard to new research perspectives : ageing, generally speaking, and changes send in psychic functionning by illness or by natural events, such as menopause. They offer some propositions about the care-giver relationship specially adressed to medical teams and psychotherapists who follow these patients hiding their failures behind a proud and stoic mask as price for their psychic survival
Boily, Marc. "L'exercice du rôle parental chez des personnes aux prises avec des troubles mentaux." Thesis, Université Laval, 2009. http://www.theses.ulaval.ca/2009/26705/26705.pdf.
Piperini, Marie-Christine. "Le travail psychique créateur : deux études sur l'écriture littéraire comme enveloppe narcissique." Bordeaux 2, 1997. http://www.theses.fr/1997BOR21018.
Using the concepts of "container" (w. R. Bion) and of "psychological shroud" (d. Anzieu), and from the research about creation introduced by S. Freud, D. W. Winnicott, M. De M'Uzan and D. Anzieu, we have explored the dynamic of the articulation : narcissism - writing - thought. This thesis questions the possibility for the writer to transform sensory images into parts of a representation of himself, and to accede like this to the conception of a protective unity. We have applied these theoretic means in analysing some representations explained by some writers who try to understand the literary creation process. Then we have observed the phenomenon which are mobilized during a writing session inside a psychiatric hospital. The results of our researches highlight that the creative thought stays on the inmost bodily experience. They set the place of the other's desire for engaging this process. We can see how the style's work and the research of a manner of writing like no one else constitute a paradoxal defence. It reveals the writer's identity (by what insists and shows) and it wears the mask of technicity at the same time. We note how the self-flawes and abilities appear into a text which are writer by psychiatric hospital's patient as well as in a famous writer. So, we grasp the potential supply of writing for going to get a new conscience of himself
Le, borgne Margaux. "Clinique de la douleur chronique au travail : approche cognito-émotionnelle des facteurs de risque et de vulnérabilité à la lombalgie chronique et prise en charge TCC de groupe." Thesis, Nantes, 2016. http://www.theses.fr/2016NANT2013.
Chronic exposure to stressful situations, notably atwork, atlers the health of workers and can lead to thedevelopment of low-back pain. A large body of researchhas sought to identify modifiable psychological riskfactors to form the basis of interventions aimed atpreventing the development of prolonged incapacity.However, despite the recommendations of the HauteAutorité de Santé, there is little research intopsychotherapy combined with CBT in France.Numerous international studies on the efficiency of CBTshow modest and irregular effects due to amisunderstanding of psychological factors or imprecisetheoretical foundations.The objective of this doctoral research is two-fold :- Study 1 : This quantitative study was performed with256 patients suffering from work-related chronic lowbackpain. Our results show that psychological riskfactors, particularly cogitive factors (beliefs) aresignificant predictive factors of pain and disability. Also,our results highlighted the role of cognitive andemotional dysregulations in links between risk factors,pain and disability.- Study 2 : Through evaluations of the level of risk andvulnerability factors, this study aims to analyse theefficiency of group CBT treatment for patients sufferingfrom chronic work-related low-back pain (N = 15). Theirresults have compared to those of control group (N =16). Results indicate a significant decrease in levels ofdisability, psychological risk factors and vulnerabilityfactors (rumination, difficulties in emotional regulation,somatosensory amplification), which is specific to CBTgroup.These observed clinical benefits should be extended toa larger number of groups. It would seem to be pertinentto work on a transdiagnostic and processual approachin order to identify underlying psychological factors inthe link between pain and risk factors / emotionalproblems in order to improve treatment efficiency
Aubourg, Pauline. "Etude par clonage positionnel de deux maladies neuromusculaires rares : la myopathie liée à l'X avec excès d'autophagie (XMEA) et une fibrose congénitale des muscles extra-oculaires (CFEOM)." Aix-Marseille 2, 2004. http://www.theses.fr/2004AIX20667.
The aim of this work was to determine the gene involved in two rare neuromuscular diseases : the X-linked myopathy with excessive autophagy (XMEA) and the congenital fibrosis of extraocular muscles type 3 (CFEOM3). XMEA is transmitted as an X-linked recessive trait and is characterised by a slow progressive weakness of proximal muscles, affecting males. It is located on Xq28 chromosome. Towards identifie the gene, we used a candidate gene approach based on structural changes observed in myofibers. None of the 38 genes studied allowed to determine the critical gene. As well, no rearrangement in the MAGEA genes cluster could be identified. However, we have considerably reduced the number of candidate genes. Additionally, a skewed X-inactivation pattern was detected and suggested that the gene involved in this condition could be ubiquitously expressed rather than having a muscle specific expression. CFEOM3 is an autosomal dominant inherited disease, characterised by a limitation of vertically gaze and ptosis. This condition belongs to the recently designed group of congenital cranial dysinnervation disorders (CCDDs). Two loci of CFEOM3 were known, on chromosome 16 and 12 (with KIF21A mutations). Here, we cloned the breakpoints of a balanced reciprocal translocation t(2;13) in a three generations family, and defined a new CFEOM3 locus (FEOM4) on 13q12. 11. A transcript whose the intron contained several blocks of conserved non coding sequences was interrupted by this breakpoint. The functional importance of these sequences remains to be identified. Meanwhile, the characterisation of this novel CFEOM3 locus will allow to test the genetic segregation at this locus, in families previously shown to be unlinked to any of the known loci. Furthermore, the study of two chromosomal rearrangements, involved in two families of Moebius syndrome type 1 (MBS1) on 13q12 will define if MBS1 and CFEOM3 are allelic or not
Janotta, Patrick. "Aspects psychanalytiques, psychiatriques et psychologiques du jeu et du joueur d'échecs." Montpellier 1, 1995. http://www.theses.fr/1995MON11118.
Sordes-Ader, Florence. "Les conséquences psychologiques du cancer : anxiété, estime de soi, projets et stratégies de coping des adolescents." Toulouse 2, 1996. http://www.theses.fr/1996TOU20083.
At the beginning of the eighties, scarce were curable cancers. Tooday, the control of this disease has become possible in numerous cases. However that may be, this serious illness, accompanied by a strong negative representation, through the crisis it brings about, may cause great personal distress, which may lead to a breaking point. Our purpose in making this study is to analyse the psychological consequences of such an illness on the adolescent who has already been confronted with various changes : the bodyfigure, the feeling of his intellectual competences,. . . In our research, we will put the stress on the intensity of emotions faced with cancer, on self-image affected by treatments and by their effects, on the temporal aspect linked to the threat (of death ?), and also on the course of action to take to face the problem, which is of the utmost importance in the management of the stressfull situation. The population of this research is composed of 51 adolescents suffering from cancer, and of 51 adolescents so-called "tout venant", aged from 14 to 20. The impact of the disease is evaluated by means of questionnaires on anxiety, self-esteem, temporal horizon and plans, and finally, on coping strategies. We have brought to the fore, contrary to what we had expected, weaker anxiety and stronger sel-esteem with sick adolescents, especially with girls. This refers to denial, to over self-actualization, even, to the effect of social support. Plans for the future, and occupational
Ruhland, José. "Contribution à l'étude psychologique de la personnalité des enfants souffrant de mucoviscidose : approche comparée des remaniements psychiques et familiaux." Nancy 2, 2000. http://www.theses.fr/2000NAN21016.
The author studied the relations between heredity, social situation and personality development in children with cystic fibrosis through a comparison of psychological and familial reorganisation. The use of a precise methodology authorized the comparative analysis of three potentialy lethal pathologies : cystic fibrosis, muscle dystrophy and congenital heart disease. The aim of this study is to establish a new theoretical formalisation to explain the psychological mecanism by which the integration of the disease and paternal parental relation, are or not, filtered by regulation processes in mentalisation work leading or not to a psychological dysfunction. The statistical comparative analysis of results demonstrated that children with cystic fibrosis have a peevischness affect underlined by a narcissic depressive syndrom. They manage their hostile projections in an adaptative way. Their organisation is pregenital with elaboration of parental images of couple, but inversed in there sexual identity. This analysis related to Oedipe's complex will be further developped in a theoretical conceptualisation under the name "androgyne parental image". This specific approach has a fundamental interest for clinical research and in dealing with these children and their parents. According to the resluts a new approach of medico-socio-psychological protocoles now used in accompagning this patents and their family should be proposed
Hegg-Deloye, Sandrine. "Contraintes psychosociales au travail, risque d'obésité et risque cardiovasculaire chez les paramédics." Thesis, Université Laval, 2014. http://www.theses.ulaval.ca/2014/30248/30248.pdf.
International literature on paramedics reports a prevalence of obesity, cardiovascular diseases and post-traumatic stress disorder. Furthermore, in Quebec, paramedics have a high rate of debilitating work injuries as well as an important rate of early retirement for disability compared to the average of other emergency workers. The aim of this thesis was to explore the issue of occupational stress and theirs consequences among paramedics working in Quebec and using the activity model by Guerin et al. (1997). To achieve this, we conducted a questionnaire study, a laboratory study and a field study. The questionnaire was used to determine the presence or absence of psychosocial constraints and cardiovascular risk among 205 paramedics. The laboratory study allowed us to investigate the physical condition in 31 paramedics. As for the field study, it provided a better understanding of paramedics’ eating habits while at work in 40 paramedics. The main results from are: a lack of social support and an effort-reward imbalance, a prevalence of obesity that tends to increase over time, low cardiovascular condition which tends to decrease rapidly for night workers compared to day workers, good muscular strength, smoking. Also, we have demonstrated causal links between lack of support from hierarchy, a large consumption of tobacco, emotional eating desinhibition and increased body mass index during employment. The findings show that paramedics combine several risk factors for cardiovascular disease during their careers. In conclusion, it is important to emphasize the absolute need to develop primary interventions with both companies and paramedics.
Touvenot, Valérie. "Approche psychodynamique de la mort subite du nourrisson et des malaises inopinés : évaluation clinique comparative." Nancy 2, 2000. http://www.theses.fr/2000NAN21026.
Sudden infant death syndrome (SIDS) is still one of the major causes of post-neonatal death in industrialised countries. Apparent life-threatening events (ALTE) also often occur during the post-neonatal period and we may establish a relation between these two disorders. Although there may be many hypotheses about causes of these tragedies, they often remain unexplained. These disorders have hitherto been the domain of organicist medicine and has been little explored from the viewpoint of the family psycho-affective environment. This thesis is based on this question. The theoritical framework of the thesis is psychoanalysis, the psychosomatic theory of the Paris School and haptonomy or the science of affectivity. We tested five ethiological hypotheses. They refer to the organicist medical approach, the "explosive cycle" concept, transgenerational transmissions, the lack of a basic state of security and the contingencies of motherhood, respectively, without a priori giving greater importance to any one of them. We met three groups of ten subjects (families that had lost a baby to SIDS, families with a child who have suffered from ALTE and control families). We took down their testimonies during clinical interviews, guided by specific indicators. Our analysis of the contents of these interviews clearly shows that the four hypothese concerning the psychoaffective dimension are confirmed. There are however hierarchical differences that explain the different causes of the pathologies observed. We were able to highlight some factors of risk and protection, showing certain distinctive features for each of the two pathological groups. However, the differences were more pronounced in the two cases with the control group. The preventive measures proposed at the end of this study are based on this observation
Havard, Liliane. "Création musicale et psychose chez Robert Schumann." Nantes, 2008. http://www.theses.fr/2008NANT3027.
Robert Schumann (1810-1856) was not born into a family of musicians. He did everything he could to become one and showed great determination to this end. His search for solitude, his relations to woman, his auditory hallucinations, the foundering of his relation to his masters and his appeal to the father brought us to infer a psychotic structure. The limits of jouissance no longer restricted him, so that he found himself yoked to the unlimited, enigmatic jouissance of the Other, which is not regulated by the phallic signifier. Musical language is another register bearing the signification of the bond that the artist maintained with the Other. He was confronted to a language that short-circuited articulated language. But at a given moment, creation no longer sufficed; things fell apart and he disconnected from the social bond. His oeuvre maintained the subject within creation and the social bond, up to a certain point. The music that had permitted him to hold together gave way; that which was serving as his sinthome no longer had effect. The last witnesses speak of the strange state of the musician before his internment (April 1854), a state of a sort of confusion with music
Thompson-Leduc, Philippe. "Prévalence et facteurs de risque associés au conflit décisionnel cliniquement significatif en soins primaires." Master's thesis, Université Laval, 2015. http://hdl.handle.net/20.500.11794/27540.
Clinically significant decisional conflict (CSDC) leads to poor patient outcomes. We sought to identify the prevalence of CSDC in primary care using the Decisional Conflict Scale (score ≥ 25/100) in five datasets of patients who consulted in primary care. We identified its risk factors using logistic regression analysis. Selection of variables was based on a review of the literature and on their availability in the datasets. The prevalence of CSDC in primary care varied between 10% and 31% depending on the dataset, a variation that could reflect the different types of decisions addressed. Overall, CSDC was more prevalent in males, people aged 45 and over and people living alone. Healthcare professionals should be trained in screening for CSDC in order to reduce poor patient outcomes.
Pereira, Do Lago Marilucia. "De l'avènement du sujet à l'arrivée du VIH/Sida : structures non névrotiques, non-sens et maladie." Nice, 2004. http://www.theses.fr/2004NICE2023.
Built into the psychoanalytic approach, this dissertation aims to contribute at the comprehension of HIV/AIDS since this one involves the universe of non-neurotic structures, like boderline cases, narcissiques structures, psychopathic personalities and the perverts. In order to reach this objective, the author structures a reflection in three parts. The first one includes a metapsychologic study of human psyche as well as the participating process in the subject construction. In the second part, the theoretical-clinics models support the author in order to identify the convergence lines of these different pathologies. The study is organized around the deficiencies in the sphere of mentalisation, representation and the fantasy and it concludes with a discussion of the issues (destiny) of the destructivity present in those structures. The third part is taken from the clinical experience with HIV/AIDS patients (non-neurotic structure) and it provides the results of “unconscious” intrapsychic processes, through the triptych Structure-History-HIV/AIDS
Dantzer, Cécile Elsa. "Anxiété, dépression et facteurs psychologiques chez les adolescents malades chroniques." Bordeaux 2, 2002. http://www.theses.fr/2002BOR20974.
Soucy, Isabelle. "Contribution des facteurs objectifs et psychosociaux occupationnels dans l'explication de l'incapacité chronique liée aux lombalgies." Master's thesis, Université Laval, 2004. http://hdl.handle.net/20.500.11794/44910.
Hebrard, Maxime. "Conception et développement d’un système d’aide au diagnostic clinique et génétique des rétinopathies pigmentaires." Thesis, Montpellier 1, 2012. http://www.theses.fr/2012MON13519/document.
Diagnosis of retinitis pigmentosa could be difficult regarding both to clinics or molecular issues. Firstly, there are rare diseases, so the prevalence of each pathology in the world population is very low. Secondly, the symptoms of diseases are very similar, so their phenotypic characterization is hard. Moreover, the eye and the visual process are complex and numerous genes' products are implicated. Although retinopathies are mainly monogenic and mendelian inherited diseases, the polymorphisms involved in these diseases are very diverse.These both observations lead us to develop two complementary methodological approaches in a view to better understand the retinopathies.The first approach aims to identify all the genes involved in the diseases using genotyping chips. For this purpose, we studied genetic linkage between single nucleotide variations and pathologies. The second approach leads to the representation of clinical knowledge. An ontological compound was built to make explicit the knowledge involved in the process of diagnosis. The data previously collected by experts were labeled by terms that were organized in a specific thesaurus. The clinic profiles of the patients and diseases were handled as features collections and were compared by similarity calculations. The goal of this work is to build a knowledge-based system for diagnosis
Duplan, Bernard. "La douleur, un affect du traumatique : étude des processus algiques, antalgiques et transférentiels dans la clinique des pathologies douloureuses de l'appareil locomoteur." Thesis, Lyon 2, 2015. http://www.theses.fr/2015LYO20062.
The research to be read in this thesis, is refered to pain, especially chronical pain, as an affect. When patients concerned with backache or locomotor disorders express their pain, they always refer to parts of their social and inner life.After a large survey of the pain phenomenon in the light of anthropology and history which emphasizes a dependance to representations and creeds, and then with the results of biology, medecine and neurosciences, a particular attention is paid to the knowledge of the patient as a subject, enabbled by the practice of psychoanalysis.S. Freud, from his first discoveries about pain as a neurologist, until his last writings reflecting his own experience, is taken as a guide, then the disciples are studied, particularly « psychosomatic medecine » followers. Studying the cases of five patients consulting for the first time in a pain unit, and the cases of two persons with more than ten years follow up in the same hospital, leads to know the affect of their pain, after a genuine sharing of it. First recognized in posture, behaviours, ways of speaking, and indeed in the very words of the patients, the affect of pain is experienced as transference-countertransference. This, both in the consulting head to head and in long run hospitalization, when the patient connects himself with the care device, conceived as the whole institution and as the staff of persons competent for his treatment, according to his proper life rhythm. The nurses, physiotherapists, occupational therapists, thermal agents act this large cycle of communication that needs to be ruled carefully.This research leads to avoid considering pain exclusively as a deficital sign of. Pain appears mostly as protective sensoriality and appeal to relationship ; obviously a narcissistic problem would stress its weight ;The trauma, ordinarily considered as the initial point of pain, appears as a retort of previous facts, repressed or denied. Pain also appears as an attempt to symbolise a mainly somatic sensorial affect. The therapists’ challenge is to support the affect reconstruction with symbolizing cares
Raffy, Julie. "Représentations graphiques de la maladie et du médicament chez l'enfant de 8 à 12 ans : enquête dans une classe primaire." Bordeaux 2, 1999. http://www.theses.fr/1999BOR2P056.
Zounon, Ornheilia Faith. "Trois études de santé publique au Bénin : maladies génétiques et accidents corporels." Thesis, Toulouse 2, 2014. http://www.theses.fr/2014TOU20019.
This thesis focuses on two main themes. The first one is related to sickle cell disease and the second theme is related to limb amputations. For studying the first theme, this research proposes to examine the knowledge of 178 men and women living in Benin, on the disease, its causes, effects and care. They answered a questionnaire and their responses had been compared to those given by an expert group. It had been found that there was an overall lack of awareness on the disease, and especially its most severe symptoms and treatment. The results reveal that the higher level of education they have, the less misconceptions about the disease they have. In addition, this ignorance was increased by people declaring themselves carrying the genetic trait (4.83) or sickle cell (5.19) than those who reported not being carriers (3.72) or healthy (3.62). The second study about the first theme, investigated whether the 137 respondents living in Benin had integrated adequately the rules of inheritance of the disease, based on the functional theory of cognition. Three distinct clusters emerge with data analysis. In the first group (n=46), respondents considered a higher risk of transmission if the one or the other of two parents was/were affected by the disease. In the second group (n=51), the risk was considered even greater as both parents were seriously ill. In the third group (n=40), the risk was considered as high only if both parents were touched. The second theme, Accidents involving physical injury, has motivated a study which aim was to examine the reasons that may underlie a refusal of amputation for 224 people living in Benin, by the approach of the reversal theory. The results show that the fear of losing personal identity, the fear of hospitals and medical staff, the belief that the surgery was unnecessary, a lack of confidence in the competences and dedication of doctors, the fear of losing others esteem and the loss of spiritual strength, are among the main factors motivating a refusal of amputation
Douguet, Florence. "Les malades chroniques acteurs de la gestion de leur affection : le cas des insuffisants rénaux dialysés." Brest, 1998. http://www.theses.fr/1998BRES1007.
Freire, Fonseca da Luz Rita Alexandra. "Un début différent : étude de l’adaptation psychologique du couple à la parentalité et au diagnostic prénatal d’une pathologie fœtale, de la grossesse à la première année de vie de l’enfant." Thesis, Université de Lorraine, 2015. http://www.theses.fr/2015LORR0347/document.
Transition to parenthood is an important period for personal and familial development. To become a parent is a long term project that implies the reconstruction of psychological and social roles by both parents.Different elements may influence the way parents assimilate this reality and adjust to the psychosocial context of parenthood. Hence, it is important to understand the process by which individual and dyadic factors contribute to the couples’ psychological adjustment to transition to parenthood and to evaluate the conditions that may be risk factors altering this developmental transition.The antenatal diagnosis of a fetal anomaly is a very specific situation in the context of parenthood that received little attention. The stress associated to this demanding, even traumatic, situation increases the risk of emotional and relational problems and may jeopardise the development and functioning of the family system.In order to study the process of psychological adaptation of couples to parenthood, specifically after the antenatal diagnosis of a fetal anomaly, we first evaluated the “normal” psychological evolution during pregnancy and postnatal period. Afterwards, using the same research protocol, we studied the process of psychological adaptation of couples who received the diagnosis of a fetal anomaly from pregnancy to one year after childbirth.This work may allow better understanding of the risk and protection factors for the psychological adjustment of parents during the transition to parenthood and after the antenatal diagnosis of a fetal anomaly. From a clinical and preventive perspective, this study may allow to increase knowledge on the elements perinatal healthcare professionals must take into account during the transition to parenthood and after the antenatal diagnosis of a fetal anomaly in order to promote psychological adjustment of the couple system
Mainville, Geneviève. "L'influence de la détresse psychologique sur l'évolution vers l'incapacité chronique des travailleurs atteints de lombalgie en arrêt de travail." Master's thesis, Université Laval, 2004. http://hdl.handle.net/20.500.11794/44860.
Bouchard, Julie. "Les facteurs psychosociaux qui interviennent dans la survenue de passage à l'acte violent chez les personnes présentant des troubles concomitants de santé mentale grave de toxicomanie : point de vue des personnes présentant ces problématiques." Master's thesis, Université Laval, 2008. http://hdl.handle.net/20.500.11794/19798.
Lanouzière, Jacqueline. "Le sein, approche psychanalytique, clinique et psychosomatique." Paris 7, 1988. http://www.theses.fr/1988PA070042.
The present work is based on a theoretico-historical, psychological, and psychosomatic study. The first theoretico-historical part which has 4 chapters (forming the first and second volumes) constitutes the basis of the whole study. Referring to Freud's (chap. 1), m. Klein's (chap. 2),H. Deutsch's (chap. 3) and m. Bonaparte (chap. 4) work, the study traces and reveals the place the breast is given in the psychoanalytic theory. In these 4 chapters we have particularly focused on two main issues, namely seduction, because the breast could be considered as the first agent of seduction, and precocious identifications, due to the presumed effects of the identification with breasts on girls' psychosexual development. The second part, consisting of 2 chapters collected in the third volume, presents a psychological study based on 39 interviews with women showing how girls wait for and react to the growth of their breasts (chap. 5) together with a study on graphic and verbal messages (chap. 6) enabling one to reveal the eternal character of the representations of the breast not only as a symbol of seduction but also as a symbol of protection, separation, and loss. The third part which constitutes the fourth volume (chap. 7) presents and discusses 10 clinical observations of women having major or minor mammary disorders. In both cases, the observation of a coincidence between a certain type of loss resulting in a narcissic injury and a somatic reaction suggests that the breast is sensitive to situations which elicit feelings of helplessness, loss of love and loss of self-esteem
Courty, Bénédicte. "L'épuisement professionnel des soignants en gériatrie." Bordeaux 2, 2003. http://www.theses.fr/2003BOR21030.
What about the suffering of geriatrics personnel ? It appears to be plural, frequently mentioned and denounced, however rarely examined in research. It is one thing to state it, to relay it, to talk about it. However, it is another to examine it closely, subdivide it into its principal components. We chose to study this topic based on a literature review of burn-out, and in a helplessness-hopelessness theory perspective. Trait anxiety was assessed using the STAI-Y (Spielberger, 1983), and depression was assessed using the CESD (Radloff, 1977). The 150 participants were recruited during a survey in geriatrics throughout the country. Our results demonstrate the existence of a continuum between anxiety-depression comorbodity and burn-out. This relationship is even stronger, and more significant when motivation is used as a mediator. The helplessness-hopelessness theory (Alloy et al. , 1989) offers directions for the understanding of burn-out in geriatrics personnel in that it brought us to consider resignation as a passive coping strategy when confronted to the threat of burn-out. Our findings allow us to understand the discrepancy between caregivers' expectations, and the everyday reality they are confronted to in their profession. We believe that this discrepancy becomes a vulnerability factor as it grows
Hérin, Fabrice. "Approche des facteurs psychosociaux et organisationnels dans les douleurs d'origine musculo-squelettique, en particulier les aspects longitudinaux (caractère prédictif)." Toulouse 3, 2014. http://thesesups.ups-tlse.fr/2526/.
Work-related musculoskeletal disorders (MSDs) have a multifactorial aetiology that includes not only physical stressors, but also psychosocial and organizational factors. But it is unclear whether these factors contribute to specific regional musculoskeletal pain or to multisite pain. Musculoskeletal pain is a leading cause of disability among people of working age and has a substantial social and economic impact. The objective of this thesis was to assess the impact of work-related psychosocial and organizational factors according to the musculoskeletal pain. The data for two prospective cohort studies (ORSOSA and ESTEV) on general population of workers) were analyzed. We identified and assessed specific healthcare organisational factors by the self-rated Nursing Work Index - Extended Organisation (NWI-EO) that have an impact on nurses' upper limb symptoms, sometimes independently of ERI perception (Herin et al. Pain 2011). Shoulder pain is the third most common type of musculoskeletal pain, and can have a major impact on health-related quality of life. This work emphasises the multifactorial nature of chronic shoulder pain during a prospective 5-year follow-up in a large representative sample of workers. Our results suggest that psychosocial work-related factors (job demand and decision control) are predictors of chronic shoulder pain at work. (Herin et al. Pain 2012). The role of psychosocial and physical factors in the development of musculoskeletal pain has now been clearly demonstrated, but it is unclear whether these factors contribute to specific regional musculoskeletal pain or to multisite pain. This work emphasises the multifactorial nature of regional body site pain and multisite pain in a large representative sample of female and male workers. Our results support the hypothesis that some psychological work-related factors are predictive of regional or multisite musculoskeletal pain but differ according to gender (Herin et al. Pain 2014). Finally, we have clarified the role of psychosocial and organizational work-related factors on musculoskeletal pain
Guilbaud, Auriane. "L'insertion progressive des entreprises dans la gouvernance mondiale de la santé : le cas de la lutte contre le Vih/Sida et les maladies négligées." Paris, Institut d'études politiques, 2012. http://www.theses.fr/2012IEPP0036.
Our doctoral research deals with the integration of business in global health governance in the case of the fight against HIV/AIDS and neglected diseases. We use an approach at the crossroad between a sociology of international relations and a sociology of global public policy. We argue that during the 20th century, business evolves from a position at the periphery of the global health governance system to a position at the center of the system, integrated through relationships with other actors. It is a gradual process, during which businesses play a diverse range of roles. This integration process is also characterized by an institutionalization of business participation, through the creation of new organizational forms and new market-based cooperation mechanisms. The dissertation is divided into six chapters. They follow a global historical development, which is not strictly linear but retraces the integration of business in the international health system and its governance structure. The first three chapters highlight the different roles played by corporations and the beginning of the dynamics of integration with the building of ad hoc collaborations. The last three chapters analyze the structural changes which allow a deepening of the integration of business and the creation of new forms and new mechanisms of cooperation