This paper consists of an analysis of the concept of empowerment—which is often defined as a key issue in health care—at the macro, meso, and micro levels by focusing on health care reform in Belgium. Three research teams collected data and combined them in an inductive secondary analysis. Our preliminary results demonstrate that patient empowerment does not always encompass the same scientific reality. At the macro level, this concept is linked to the authorities’ wish to support at-home care for chronic patients. At the meso level, the role of caregivers in maintaining patients’ autonomy, but also the social conditions of their lives, is a salient component of empowerment. At the micro level, individual and personal features such as identity can influence patient empowerment and behavior in the health care system. This cross-level research suggests that patient empowerment is not sufficiently clearly defined at each level of the care production chain, which could impede the reform of health care. This paper underlines the polysemy of a concept viewed as a milestone in European health care policy and the necessity of a clear, collective definition to operationalize and implement it.

While IQ tests are the most common and largely accepted measurement of how "smart" a person is, whether they are the best measure of this construct is up for debate. This paper will discuss the relationship between IQ tests and their corresponding order of hierarchical complexity developmental stage scores based on the model of hierarchical complexity (MHC). The Verbal Comprehension Index (VCI) scales of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) were used for scoring. The study shows that, according to the Hierarchical Complexity Scoring System (HCSS), the WAIS-IV fails to test verbal intelligence beyond the formal stage. This study used Rasch analysis to demonstrate that scoring the VCI of the WAIS-IV from a developmental sequence using the HCSS was successful in explaining the majority of the difficulty in VCI items. Much of the additional difficulty of tasks came from the knowledge of rare items and noise. This demonstrates the ceiling effect of the VCI of the WAIS-IV. Difficulties with scoring items, additional limitations with the IQ test, and their implications are discussed.

Considering patients' empowerment in chronic care management: a multidisciplinary approach

L'expérience de la maladie cancéreuse demeure une épreuve bouleversante tant pour le patient que pour ses proches affectant diverses sphères (psychologique, sociale, affective) et plusieurs aspects de leur vie. La psycho-oncologie constitue aujourd'hui un corpus significatif de connaissances empiriques et cliniques permettant de s'intéresser aux difficultés et problématiques liées à la maladie cancéreuse ainsi qu'aux différentes interventions influençant positivement l'ajustement psychologique du patient ou de ses proches. Les travaux en psycho-oncologie s'intéressent également à l'impact psychologique du cancer où l'on retrouve plusieurs angles cliniques de recherche telle que l'impact du cancer sur la qualité de vie du patient ou de ses proches ou encore l'impact physique, psychologique ou psychiatrique du cancer; ceux-ci pouvant se rencontrer tant dans la phase active des traitements que durant la phase de rémission et de l'après-traitement. Le cancer de l'adulte et de l'enfant se distingue d'un point de vue étiologique, médico-clinique et des protocoles de soins mis en place. Cependant, l'expérience du cancer exige tant chez le patient que chez ses proches un ajustement et un processus continu d'adaptation à la réalité du cancer et de l'après-cancer.