No abstract

No abstract

Objective: We assessed whether breast cancer survivors' (BCSs) supportive care needs, posttraumatic growth (positive psychological changes) and satisfaction with doctors' interpersonal skills could be related to physical activity (PA). Methods: A total of 426 BCSs were approached during the last week of treatment. Eight months later, 278 (65%) provided information on their PA levels. Ordinal logistic multiple regressions were performed. Results: PA levels included no PA (n = 68), some PA (n = 83), high PA levels more than twice or more than 2 h per week (n = 127). The multivariate model significantly explained 13% of PA variance (p = 0.001). An increase in posttraumatic growth total scores (proportional OR = 1.310; p < 0.05) and a decrease in physical and daily living supportive care needs subscale scores (proportional OR = 0.980; p < 0.001) and in satisfaction with doctors' interpersonal skill scores (proportional OR = 0.898; p < 0.05) were significantly associated with an increase in the likelihood of performing higher levels of PA. A lower educational level was associated with a decrease in the likelihood of performing PA. Conclusion: The prevalence of PA in BCSs should be improved. Positive psychological changes after a breast cancer experience might contribute to performing PA. Encouraging PA needs to be accompanied by the alleviation of physical symptoms.

Ce texte retrace le vécu d'une jeune femme, oncologue médical, traitée pour un cancer du sein à l'âge de 32 ans. Le diagnostic, la chirurgie mutilante, la chimiothérapie lourde sont racontés par la patiente, mais analysés au regard de son expérience professionnelle. Le vécu de « gros bras » est aussi abordé dans ce récit, séquelle physique majeure et source de souffrance psychique. En 2003, la rechute ébranlera, une fois de plus, le fragile équilibre retrouvé. Quand on est métastatique, quelles décisions prendre, jusqu'où est-on prêt à se battre, et surtout qui décide et avec quelles informations ? À côté de ces différentes questions posées pour elle-même et les patients se dévoilent, au fur et à mesure, d'autres difficultés : comment réinvestir sa propre spécialité, comment rester crédible devant les autres collègues, comment retrouver une place au sein de la communauté médicale, lorsque la maladie et certains autres médecins vous renvoient à votre propre finitude ? Au-delà de ce témoignage, c'est une réflexion qui est proposée pour chacun des acteurs de santé sur sa propre pratique professionnelle.Mots clés Témoignage médecin patient · Représentations des cancérologues · Cancer du sein · Lymphoedème du membre supérieur · Évolution métastatique · Soins de support Abstract This document traces the experiences of a young woman, an oncologist, who was herself treated for breast cancer at the age of 32. The diagnosis, the mutilating surgery and the severe chemotherapy are told by the patient, but analysed in the light of her professional experience. The report also deals with her experiences of "swollen arm", a major physical side effect and a cause of mental suffering.In 2003, a relapse would once again upset her life, a fragile balance only having just been found. When a patient is metastatic, what decisions need to be taken? How long are they prepared to fight? And above all, who makes the decisions and with what information? In addition to these various questions that she asked for herself and for other patients, further difficulties appear along the way: how can she reinvest her own specialist knowledge? How can she remain credible in the eyes of her colleagues? And how can she refind a place within the medical community when the disease and certain other doctors have already written her off? Beyond a simple testimonial, this work offers every healthcare practitioner a point of reflection on his own professional practice.