Maryvette Balcou-Debussche

Bio: Maryvette Balcou-Debussche is an academic researcher from University of La Réunion. The author has contributed to research in topics: Patient education & Health care. The author has an hindex of 11, co-authored 35 publications receiving 423 citations. Previous affiliations of Maryvette Balcou-Debussche include Blaise Pascal University & University of Picardie Jules Verne.

Characterisation of health literacy strengths and weaknesses among people at metabolic and cardiovascular risk: Validity testing of the Health Literacy Questionnaire.

Abstract: Objectives:Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. The assessment of health l...

Structured peer-led diabetes self-management and support in a low-income country: The ST2EP randomised controlled trial in Mali

Abstract: Objectives: Our objective was to evaluate the effectiveness of peer-led self-management education in improving glycaemic control in patients with type 2 diabetes in a low-income country (Mali). Methods: We conducted an open-label randomised controlled trial. A total of 151 adults (76% women, mean age 52.5) with type 2 diabetes (HbA1c!8%), treated in the diabetes consultation units of two secondary health centres in Bamako, were allocated to peer-led structured patient education (n = 76) or conventional care alone (n = 75). The intervention group received 1 year of culturally tailored structured patient education (3 courses of 4 sessions) delivered in the community by five trained peer educators. Both groups underwent conventional diabetes monitoring and follow-up. Primary outcome was the mean absolute change in HbA1c from baseline to 12 months. Results:177 education sessions were delivered to the intervention group. Patient attrition was 8%. From baseline to 12 months, the decrease in HbA1c levels was 1.05% (SD = 2.0; CI95%: 1.54;-0.56) in the intervention group compared with 0.15% (SD = 1.7; CI95%:-0.56; 0.26) in the control group, p = 0.006. Mean BMI change was-1.65 kg/m2 (SD = 2.5; CI95%:-2.25;-1.06) in the intervention group and +0.05 kg/m2 (SD = 3.2; CI95%:-0.71; 0.81) in the control group, p = 0.0005. Mean waist circumference decreased by 3.34 cm (SD = 9.3; CI95%:-5.56;-1.13) in the intervention group and increased by 2.65 cm (SD = 10.3; CI95%: 0.20; 5.09) in the control group, p = 0.0003. Conclusions: on delivered over 1 year to patients with poorly controlled type 2 diabetes in Mali yielded substantial improvements in glycaemic control and anthropometric parameters. This is of importance for the scaling up of efficient interventions in low-resource settings in the future.

Éducation thérapeutique du patient. Modèles, pratiques et évaluation

Abstract: Issu d’une collaboration entre l’Inpes et des acteurs de l’education therapeutique du patient, cet ouvrage rassemble des analyses d’interventions d’education therapeutique mises en place en France et au Quebec, dans le cadre de huit maladies chroniques : diabete, obesite, maladies cardio-vasculaires, VIH/sida, asthme, cancer, polyarthrite rhumatoide et lombalgie En rendant compte des modeles theoriques qui sous-tendent l’education therapeutique et des demarches mises en œuvre, les contributions mettent au jour une large diversite de pratiques Qu’il soit professionnel de sante, formateur ou chercheur, le lecteur trouvera ainsi des pistes pour demarrer, developper et evaluer ses actions educatives Il trouvera aussi matiere a eprouver ses conceptions de la sante et de l’education, notamment a travers la decouverte de pratiques qui produisent des resultats tres encourageants alors qu’elles se referent a des cadres theoriques diversifies et a des voies differenciees pour penser l’action educative Parce qu’elles ne montrent pas l’excellence d’une voie plutot qu’une autre, ces analyses invitent au developpement de nouvelles perspectives d’action et de recherche L’ouvrage offre ainsi une ouverture precieuse dans un contexte general ou l’education therapeutique s’inscrit dans le Code de sante publique, notamment a travers la loi Hopital, patients, sante et territoires du 21 juillet 2009, qui en reconnait l’importance pour l’amelioration de l’etat de sante des personnes, en particulier de celles atteintes d’une maladie chronique

Hospitalization for Type 2 Diabetes: The Effects of the Suspension of Reality on Patients' Subsequent Management of Their Condition

Abstract: Hospitalization still plays a major part in the management of uncontrolled type 2 diabetes and its complications. In this article, we assess the effects of self-management education on the individual practices of 42 patients after discharge from specialized diabetes units on the French island of Reunion. Hospitalization offers respite and temporarily suspends the realities of daily life. When patients leave the unit where they have acquired new knowledge and practices, the extent to which the latter can be maintained depends on the practice in question, the individual's circumstances, and his or her social relationships and support systems. In the longer term, therefore, the effects of self-management education interventions can be weak. The study findings reveal the complexities surrounding the acquisition of habits that maintain health and prevent illness. The article makes a significant contribution to the debate on patient support and the role of inpatient educational units.

Role of self-care in management of diabetes mellitus.

Abstract: Diabetes mellitus (DM) is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute (Type 1 DM) or relative (Type 2 DM) deficiency of insulin hormone. World Health Organization estimates that more than 346 million people worldwide have DM. This number is likely to more than double by 2030 without any intervention. The needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications; disability limitation and rehabilitation. There are seven essential self-care behaviors in people with diabetes which predict good outcomes namely healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care. Despite this fact, compliance or adherence to these activities has been found to be low, especially when looking at long-term changes. Though multiple demographic, socio-economic and social support factors can be considered as positive contributors in facilitating self-care activities in diabetic patients, role of clinicians in promoting self-care is vital and has to be emphasized. Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications.

A Metasynthesis of the Self-Management of Type 2 Diabetes

Abstract: Type 2 diabetes is a metabolic disorder characterized by chronically elevated blood glucose and high risk of comorbidities. In this article we report a metasynthesis of the 21st-Century qualitative research concerning the self-management of type 2 diabetes. We identified 38 relevant articles (sample size range 6 to 175), which were synthesized through a process of iterative reading and theory development. In this literature, authors argued and assumed that diabetes management is influenced by multiple, complex, competing factors, including interpersonal relations, gender, and sociocultural context. Conversely, self-management was sometimes construed as a facet of individual agency and was accepted uncritically, placing accountability for health with patients themselves. We conclude that a satisfactory account of diabetes care would pay attention to the “inner” world, while acknowledging the social and political conditions in which diabetes-related experiences unfold.

The role of patient education in the prevention and management of type 2 diabetes: an overview

Abstract: The management of type 2 diabetes mellitus includes ability and empowerment of the patient to change lifestyle, maintain an adequate diet and physical activity, manage the disease, and follow a specific program of periodic medical checks and education sessions. In addition, the patient should be able to correctly identify and adequately solve problems related to the disease and actively collaborate with the healthcare system. To obtain these goals, therapeutic patient education (TPE) is now considered a crucial element not only in the treatment but also in the prevention of type 2 diabetes. Several trials showed that TPE is able to improve clinical, lifestyle, and psycho-social outcomes. Nevertheless, studies have not clarified the ideal characteristics of a comprehensive patient education program in clinical practice. Other work is needed to answer open questions regarding the type of PTE (individual or group education), themes, frequency and number of education sessions, contact time between educator and patient, background of educators, use of new technologies, and barriers to self-management. The present review discusses these points on the basis of the most recent data of the literature.

Characterisation of health literacy strengths and weaknesses among people at metabolic and cardiovascular risk: Validity testing of the Health Literacy Questionnaire.

Abstract: Objectives:Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. The assessment of health l...