L’Éducation Thérapeutique du Patient (ETP) constitue un outil précieux au CHS. Ce dernier a souhaité « identifier les maladies ou situations nécessitant l’élaboration d’une démarche structurée d’ETP intégrée à la prise en charge du patient ». Un appel à candidature a permis de constituer un groupe de travail ETP. Ce dernier a monté une enquête permettant d’interroger un échantillon de soignants, de patients et d’accueillants familiaux. Les résultats de l’enquête ont permis de mettre en lumière les difficultés et les besoins des patients. Ces dernières concernent les thèmes suivants : poids et alimentation, informations sur les médicaments et les pathologies, développement d’activités, aide au sevrage du tabac… L’analyse des résultats montre que concernant les difficultés des patients, il existe un différentiel de point de vue entre soignants, accueillants et patients. Des sous-groupes ont travaillé en binôme sur les thèmes validés : Médicaments et pathologies psychiatriques, Tabac et sevrage, Équilibre alimentaire et prise de poids. Afin de poursuivre la réflexion, le groupe a intégré les psychologues et le psychiatre. Les membres ont décidé de poursuivre l’évaluation avec la grille ELADEB de Lausanne.

Therapeutic education aims at helping patients acquire of maintain competencies they need to cope with chronic illness. It goes further than simple information because its objective is to improve autonomy and quality of life, not just treatment observance. Therapeutic education is an important instrument for psychiatric rehabilitation, notably in foster home care. Because of the various possible themes of therapeutic education, our institution worked toward the identification of situation needing a structured program of therapeutic education. A pluridisciplinary group was set up, aiming at building structured therapeutic education programs and following their implementation. This group built a questionnaire for mental health team members, care givers and patients. Mental health team members expressed their views during a focus group. They identified several issues such as: food and overweight, digestive problems, medication side effects, smoking, diabetes. The questionnaire was sent by post to foster caregivers: 63% of them answered. Sixty-four percent of the answers identify one or several problems encountered by patients: lack of information concerning treatment (27%), stress due to vexation (26%), medication side effects (18%), lack of information concerning mental illness (9%). Twenty-four patients were interviewed, expressing their difficulties: over sedation, loneliness and boredom, anxiety, food, information concerning medication and mental illness. Patients expressed specific needs: Food and overweight, information on medication and illness, activities, smoking cessation. This questionnaire, requiring approximately 45minutes interview, was living positively by patients. This preliminary inquiry led to identification of difficult themes for therapeutic education: medication and illness, smoking, nutritional balance. In order to both identify unmet needs, we decided to use an instrument developed in Lausanne, called ELADEB (Lausanne instrument to evaluate patients’ needs and difficulties)