Many effective physical activity (PA) interventions have focused on individual factors or a single theoretical model, limiting our understanding of the determinants of PA practice and their interactions in the cancer trajectory. The present mixed-method study aims to capture social and psychological determinants of PA practice from diagnosis to remission among cancer patients, and to identify key levers for PA practice. A nested sequential mixed-method design QUAN (QUAL+QUAL) will be used, with qualitative studies embedded in the quantitative study to broaden our understanding of the determinants of PA practice. The design is sequential, since qualitative data on medical staff will be collected before patient inclusion (Phase 1), followed by quantitative patient data collection lasting one year (Phase 2) and a final qualitative data collection one year after inclusion (Phase 3). Phase 1 will be a case study in the two hospitals involved in the study, exploring knowledge of and support for PA practice among medical staff. Through interviews and documental analyses, the PA support dynamic will be evaluated with regard to PA prescription. Phase 2 will be a one-year observational study among 693 cancer patients. Quantitative medical, social, dispositional and psychological data, PA practices and preferences, will be collected at diagnosis, and six months and one year thereafter. Phase 3 will be a retrospective study, evaluating societal and policy factors, as well as unexpected factors playing a role in PA levels and preferences among cancer patients. For this phase thirty patients will be identified six months after inclusion on the basis of their PA profiles. Quantitative data will provide the main dataset, whilst qualitative data will complete the picture, enabling determinants of PA practice and their interactions to be captured throughout the cancer trajectory. The present study aims to identify key levers and typical trajectories for PA practice among cancer patients, adapted to different times in the course of cancer and taking into account “what works”, “for whom”, “where” and “how”. The challenge is the tailoring of PA interventions to patients at different times in their cancer trajectory, and the implication of medical staff support. Clinical Trial NCT03919149 , 18 April 2019. Prospectively registered.

De nombreux effets bénéfiques de l’activité physique (AP) sont identifiés pour les patients atteints de cancer. La prescription d’AP adaptée pour les patients atteints d’une affection de longue durée est inscrite dans la loi depuis 2016, et les premières études montrent qu’elle serait efficace pour augmenter le niveau d’AP dans d’autres pays. L’OMS caractérise la prescription de manière générale à travers six étapes. L’objectif de cette étude est d’observer et comparer à travers les critères définis par l’OMS comment, au sein du CHRU Nancy Brabois et l’Institut de Cancérologie de Lorraine (ICL), l’activité physique adaptée est prescrite aux patients atteints de cancer et quel est le parcours des patients suite à cette prescription. Huit professionnels de santé ont été interrogés. Une approche déductive a été mobilisée pour coder les unités de sens au sein des différentes étapes de la prescription. Les résultats montrent que les étapes 1, 2, 6 sont effectués lors des consultations par les professionnels. Néanmoins, le décret de loi n°2016-1990 n’a pas modifié les habitudes d’information et de prescription des professionnels de santé, et sans la légitimité de la prescription, l’AP reste un supplément au parcours de soins plutôt que l’une de ses composantes.

The Generic Adherence for Chronic Diseases Profile is a French generic scale (GACID-P) developed to measure adherence in several disease areas such as cardiology, rheumatology, diabetes, cancer and infectiology. We aimed to study the measurement invariance of the Generic Adherence for Chronic Diseases Profile by an item response model, optimize the new instrument version from item response model and qualitative content analyses results, and validate the instrument. The metric properties of the optimized version were studied according to classical test theory and item response model analysis. A sample of 397 patients consulting at two French hospitals (in diabetes, cardiology, rheumatology, cancerology and infectiology) and in four private practices was recruited; 314 (79%) patients also completed the questionnaire 15 days later. Factor analyses revealed four dimensions: “Forgetting to take medication”, “Intention to comply with treatment”, “Limitation of risk-related consumer habits” and “Healthy lifestyle”. The item response model and content analyses optimized these four dimensions, regrouping 32 items in four dimensions of 25 items, including one item conditioned on tobacco use. The psychometric properties and scale calibration were satisfactory. One score per dimension was calculated as the sum of the items for the dimensions “Forgetting to take medication” and “Intention to comply with treatment” and as a weighted score according to the item response model analysis for the two other dimensions because of differential item functioning found for two items. Four adherence profile scores were obtained. The instrument validity was documented by a theoretical approach and content analysis. The Generic Adherence for Chronic Diseases Profile is now available for research targeting adherence in a broad perspective.

This project aimed to explore the impact of psychological distress (anxiety, depression and post-traumatic stress) and resilience on quality of life and psychological health at work (well-being or distress at work) of nursing home and healthcare staff members in the Moselle department in Northeastern France. In the spring of 2021 230 professionals replied to an online questionnaire. The theoretical model was tested through path analyses. Results showed that higher resilience scores were associated with lower post-traumatic stress, anxiety, and depression scores. Anxiety and depression were negatively correlated with quality of life, while higher quality of life scores were linked to greater well-being at work. Resilience was found to have a significant impact on the psychological state of professionals, with differences observed between well-being and distress at work. In conclusion, our study revealed that resilience plays a significant role in influencing the psychological state of professionals, ultimately impacting their psychological health at work. Therefore, interventions aimed at addressing anxiety, depression, and traumatic symptoms could potentially enhance resilience and mitigate work-related psychological disorders among frontline healthcare professionals.