BACKGROUND:Screening for colorectal cancer reduces mortality by enabling early detection. In Quebec, follow-up within 60 days after an incomplete colonoscopy is recommended. In this study, we sought to assess the impact of delays in follow-up on patient outcomes. METHODS:In this retrospective study, we included adults who underwent a colonoscopy following a positive immunochemical fecal occult blood test at the Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier de l'université de Sherbrooke between Jan. 1, 2013, and Dec. 31, 2015. We verified colonoscopy adequacy and guideline adherence. We classified advanced polyps and colorectal cancer as clinically significant lesions (CSLs) to assess the clinical impact of incomplete or missing follow-up colonoscopies. RESULTS:In 89 cases of incomplete colonoscopies, inadequate bowel preparation was the leading cause of exam interruption (61.8%). A total of 57 patients had a subsequent follow-up, and 23 colonoscopies were completed within the 60-day time frame. Six CSLs, including advanced polyps and cancer, were detected within the recommended 60-day time frame, and 4 were identified after 60 days. We found a statistically significant difference in the rates of colorectal cancer diagnosis (p < 0.001), the need for surgery (p < 0.02), and death (p < 0.001) between patients who had a complete colonoscopy diagnostic process and those who did not. CONCLUSION:The poorer prognosis associated with patients who had a delayed or missing follow-up highlights the importance of respecting provincial guidelines concerning follow-up after incomplete colonoscopies.
Objectif Les sciences cognitives de l’apprentissage sont un vaste champ de recherche étudiant depuis plusieurs dizaines d’années les facteurs qui permettent d’optimiser l’apprentissage. Ces données de recherche peuvent être appliquées à l’éducation thérapeutique du patient (ETP). Très peu d’études investiguent le lien entre éducation thérapeutique et sciences cognitives, et aucune n’a été réalisée dans le contexte d’ETP formalisé tel qu’il est proposé en France. Nous avons donc souhaité proposer un programme d’éducation thérapeutique pour la narcolepsie et l’hypersomnie idiopathique, dont la pédagogie est basée sur la science, et adapté aux besoins des patients. Méthodes Nous avons épluché la littérature sur les sciences cognitives de l’apprentissage afin d’isoler les méthodes pédagogiques qui seraient les plus efficaces à adopter dans un contexte d’ETP, en fonction des informations à apporter. À partir de cela, nous avons élaboré un questionnaire d’attentes interrogeant les patients sur les notions qu’ils attendent et les méthodes pédagogiques dont ils souhaiteraient bénéficier durant les ateliers. Ce questionnaire a été envoyé aux patients narcoleptiques et hypersomniaques de la base de données du CRMR du service. Résultats Le questionnaire a été répondu par 779 patients, dont 425 narcoleptiques et 354 hypersomniaques. Ceux-ci attendent principalement des informations sur la recherche, sur la prise en charge non médicamenteuse, et des connaissances sur la maladie elle-même. En termes de méthodes pédagogiques, ils attendent surtout des témoignages avec patient-expert, des documents écrits (fiches, brochures…), et des diaporamas structurés adaptés. À partir de ces informations, nous avons pu élaborer un programme d’éducation thérapeutique qui a été mis en place dans le service, avec un premier cycle déjà effectué. Ce programme est découpé en 6 séances : généralités médicales, prise en charge non médicamenteuse, prise en charge médicamenteuse, hypersomnies/famille et société, réseau de soins et démarches administratives, vécu et ressenti de la maladie. Conclusion Les informations à apporter au patient et les méthodes pédagogiques à adopter ne sont pas forcément les mêmes que ce qui est habituellement considéré. Ces informations peuvent nous permettre d’adapter nos programmes d’ETP. Une future étude concernant l’évolution du niveau de connaissances des patients au décours de nos ateliers est prévue.
Background Multiple myeloma (MM) is a chronic hematologic malignancy characterized by complex therapeutic strategies, repeated relapses, and substantial information and psychosocial needs. Advances in oral therapies and outpatient management have shifted greater responsibility to patients and caregivers, emphasizing the need for accessible, high-quality educational resources. Therapeutic patient education (TPE) aims to empower patients to understand and manage their condition more effectively. Digital education tools such as massive open online courses (MOOCs) represent an innovative approach to deliver structured, interactive, and scalable learning experiences to large patient populations. However, few MOOCs have been specifically designed for patients with oncological or hematological disorders, and even fewer have been rigorously evaluated for their educational impact. Objective This study aimed to develop and evaluate a MOOC co-designed with patients, caregivers, and health care professionals to improve knowledge, skills, and empowerment among patients living with MM and their relatives. Secondary objectives included assessing participant satisfaction, engagement, and the feasibility of this digital education model at a national scale. Methods The MOOC “Understanding and Living with Myeloma” was jointly developed by the French Association of Patients with Multiple Myeloma (AF3M) and the French-Speaking Myeloma Intergroup (IFM). The program consisted of 5 thematic modules delivered over 8 weeks, covering disease mechanisms, diagnosis, treatment options, side-effect management, and daily-life adaptation. Content combined educational videos, self-assessment quizzes, peer-tutoring forums, and live web conferences with experts. Participants self-assessed their knowledge using a 52-item questionnaire rated from 1 (poor) to 5 (excellent) before and after completing the program. Descriptive and inferential analyses were performed using the Wilcoxon signed-rank test (2-sided α=.05). Results During the first session, 254 participants registered for the course. Among them, 76 (30%) completed all modules and both evaluations. The mean global knowledge score increased from 3.06/5 before to 4.21/5 after the MOOC (mean gain + 1.15, + 38%; P<.001). Improvements were consistent across all knowledge domains, including understanding of treatments (+40%), recognition of warning signs (+35%), and self-management skills (+39%). Overall, 98% (74/76) of respondents reported being satisfied or very satisfied with the course, and 99% (75/76) would recommend it to other patients. Since 2018, the MOOC has been conducted 6 times at different periods, enrolling a cumulative total of 2400 participants, confirming its sustainability and scalability. Conclusions Participation in this co-designed, patient-centered MOOC was associated with a statistically and educationally significant improvement in knowledge among patients with MM and their caregivers. The program was highly valued by users and demonstrates the feasibility of large-scale digital patient education in oncology. As a freely accessible, repeatable, and peer-supported resource, this MOOC complements medical consultations and traditional TPE programs. Its design and outcomes may serve as a model for future digital health education initiatives targeting other chronic diseases.
Le dismenorree sono un disturbo frequente delle donne che si rivolgono a ginecologi e a medici generici. Incidono sulla qualità di vita delle pazienti e sono spesso considerate inevitabili. Un interrogatorio dettagliato e un esame clinico quando le pazienti non sono vergini sono la base per la diagnosi di un'eventuale causa secondaria. Possono rivelarsi necessari altri esami, come un'ecografia pelvica. In particolare, l'endometriosi deve essere indagata in caso di segni associati come disuria, dischezia, dispareunia o infertilità senza che siano state individuate altre cause. A seconda del carattere primario o secondario delle dismenorree, il trattamento comprende farmaci antinfiammatori non steroidei, la prescrizione di una pillola contraccettiva in sequenza o in modo continuo, un supporto psicologico e il trattamento dell'eventuale patologia sottostante.
