L’individualisation dans un programme collectif d’éducation thérapeutique du patient pour les troubles bipolaires

Abstract

Bipolar disorder is a common and extremely debilitating condition that generates important social, family, professional, financial and somatic consequences. It is therefore essential to improve and promote optimal patient management to improve the quality of life and reduce mortality, which is much more common than in the general population. This mortality is explained in these patients by a suicide rate 15 times higher than in the general population but also by a major risk in the manic phase, as well as by the somatic and psychiatric comorbidities associated Bipolar disorder. In order to limit the mortality and psychosocial consequences associated with bipolar disorder, the management of these patients must be comprehensive. The patient's therapeutic education must be an integral part of the care and should be offered to any patient suffering from a chronic illness. But it is not always easy to set up in particular because of the social, professional, family or medical constraints of patients. The main objective of our therapeutic education program is to limit this mortality in patients with bipolar disorders but also to improve their quality of life. To avoid choosing between a collective Psychoeducation program rich in exchange and sharing and an individual program more adaptable to the life of each patient, we have set up a collective therapeutic education program in which each Patient can freely personalize his program in terms of duration, number of sessions, order of sessions, location and time slot in which it will be given. Thus, among the 14 workshops proposed with different themes and objectives, each patient, guided by a professional in therapeutic education, can compose his program by choosing the workshops that interest him according to his needs and its availability. The second peculiarity of the program is to address patients as well as caregivers, who can be integrated with patients during workshops or participate in two sessions dedicated to them. Each one chooses the workshops that interests him, so the group is not made up of the same individuals from one workshop to another, however each workshop is organized in the same way, and important concepts accompanied by clear messages are repeated from a Workshop to another. In addition, summary sheets, summarizing the important concepts discussed during the workshop, are distributed at the end of the sessions to allow patients to get reminders from one session to another, even if they are spaced over time. The pedagogical content as well as the materials used are very different from one session to another to maintain the interest of patients in therapeutic education in order to encourage them to resume further sessions as they progress through the Program. Adaptability and flexibility are the keys to the acceptance of therapeutic education in our patients with mental disorders.