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Que peuvent apporter l’anthropologie et la sociologie à la pratique en cancérologie ? Apport des sciences humaines à la cancérologie
Abstract
Depuis les débuts des sciences humaines en cancérologie, la recherche sociologique et anthropologique, dans les établissements
de soins, s’est largement développée sans toujours convaincre de son intérêt. Cet article vise à aborder les freins qui entravent
la rencontre et la compréhension mutuelles entre soignants et chercheurs en sciences humaines, les problématiques qu’engendre
l’introduction des sciences humaines en cancérologie, ainsi que les intérêts et les apports pratiques que peut apporter un
véritable partenariat soignant-chercheur.
From now on, the introduction of human sciences studies in the field of oncology has not always been conclusive. This article
aims to analyze the bounds that border the meeting and the understanding between physicians and human sciences researchers.
It also treats the problems due to the introduction of human sciences in the field of oncology and points up the interests
and practical contributions that a partnership between physicians and researchers could bring.
Cet article pose la question de la diffusion des résultats scientifiques pour et vers les acteurs sociaux. La réflexion se fonde sur une recherche financée de trois années (2015-2018) consacrée à la « diversité » de l’information sportive télévisée. L’analyse s’organise en deux temps. Elle montre d’abord comment les résultats envisagés, qui sont au cœur des stratégies de demandes de financement, pèsent sur le déroulement du programme de recherche. Elle expose ensuite comment ces mêmes résultats anticipés servent à négocier l’accès au terrain et, sur place, à structurer en partie la conduite de l’analyse.
The policy of fieldwork. On the production of data in anthropology. The specific method of production of facts which a field inquiry is, in anthropology (or again in sociology, sometimes called “qualitative”), works essentially through prolonged interactions between the researcher in person and the “environment” which he studies. Above all it is a question of know-how, learnt by practice and not formalized. However, this specific methodological configuration is not without principles, nor entirely submitted to the risks of subjectivity. A “policy of field-work” anxious to answer the demands of plausibility and validity, must give itself certain frames of reference. A description is attempted here across four large types of data : (a) participant observation (observations and interactions giving rise to data of corpus and data of impregnation) ; (b) interviews (consultations and narratives on a conversational tone, of a recurrent nature dependant on “invisible negociations”) ; (c) the devices of census (systematic and intense process of observation and measure) ; (d) written sources. Through these four kinds of data, a field researcher attempts somehow or other to construct a “qualitative exactness” which rests on some simple principles : the triangulation and empirical research of strategic groups, reiteration, interpretative explicitation, the construction of describers, the saturation of information, the witness social group and last but not least, the management of suggestive evasive answers.
This paper reports the patient care experience during the trajectory of the radiotherapy. Plights are multiple. Patients are confronted with a complex and unknown distressing space, an irrelevant information, a banalisation of side effects, an isolation with a frequent inadequate support of their family or the caregivers team, with the fear of a definitive abandonment at the end of the treatment without conforting follow-up. It is imperative to state a real policy in order to improve the patient support. Sensibilisation and training of the caregivers, in spite of a frequent overbooking technical work, is required in a pluridisciplinary approach to provide a relevant reception with the collaboration of psychologists, social workers and self care groups and associations. The personal implication of the physicians and technologists is also essential. The simple smile is the intangible proof of the reliable emotional support.
Nasopharyngeal carcinoma is prevalent in Southeast Asia, Maghreb countries and Greenland/Alaska. This cancer, wherever prevalent, is closely associated to the Epstein-Barr virus (EBV), but its geographical repartition also suggests the possibility of a cultural factor. A comparison of food habits and way of life of Cantonese, Maghreb populations and Eskimos shows certain common points: dried fish or meat, fermented and sometimes rotten, as well as salt preserved vegetables. Certain berries of Euphorbiaceae are eaten by children and the plant itself is used in traditional medicine. These Euphorbiacea contain cancer promoting agents, able to reactivate the EBV latency. The hypothesis proposed here is that cancerous effects common to the different regions at high risk for nasopharyngeal carcinoma exists and that they either act separately or reactivate the EBV latency.
This paper reports the patient care experience during the course of the radiotherapy. Plights are multiple. Patients are confronted with a complex and unknown distressing space, an irrelavant information, a banalization of side effects, an isolation with a frequent inadequate support of their family or the caregivers team, with the fear of a definitive abandonment at the end of the treatment without comforting follow-up. It is imperative to state a real policy in order to improve the patient support. Sensibilization and training of the caregivers, in spite of a frequent overbooking technical work, is required in a pluridisciplinary approach to provide a relevant reception with the collaboration of psychologists, social workers and self care groups and associations. The personal implication of the physicians and technologists is also essential. The simple smile is the intangible proof of the reliable emotional support.
The development of good-quality patient information is a major challenge to improve quality of cancer care. The SOR SAVOIR PATIENT program aims to improve patients' understanding of cancer treatment and to facilitate their participation in clinical decisions. This programme develops evidence-based information for cancer patients based on clinical practice guidelines in oncology, the "Standards, Options and Recommendations" (SOR) which are used as primary information sources. "Translation" of SOR guidelines to laymen uses a multidisciplinary approach involving specialists in cancer care, psychologists, linguists and anthropologists. The development actively involves cancer patients using focus group methods, individual interviews and postal surveys. The SOR SAVOIR PATIENT program is conducted by the FNCLCC and the 20 French regional cancer centres, with active participation of specialists (public and private), learned societies and institutions, collaborating in multidisciplinary working groups. The leaflets Understanding scanner and Understanding Magnetic Resonance Imaging available in this edition of Bulletin du Cancer have been developed by a multidisciplinary group (radiologist, oncologist, methodologist, health care practioners, psychologist, linguist) and 30 patients, experienced patients and caregivers. These leaflets stem from a collection of patients documents on radiological examinations (Understanding mammography, Ultrasound, etc.) which have been developed to help patients and caregivers to better understand these examinations.
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