Qualitative Phenomenological Study on Videoconferencing Therapeutic Education

Therapeutic patient education (TPE) is one of the mechanisms that make patients with chronic disease as competent as possible to manage illness and treatment by helping them to be autonomous and responsible for their decision-making.

The COVID-19 pandemic has changed the organization of care, prioritizing the emergency fight against the epidemic.

The French High Authority of Health (HAS) has recommended maintaining individual TPE sessions by videoconference or telephone, based on the usual stages of the educational process. Several working groups have looked into remote TPE and recommendations have been issued in the form of practical advice but without questioning the participants, who did not participate in the reflection. No consensus, including health authorities, has been reached on this subject.

At Necker Hospital, ETPs were carried out remotely, by videoconference. Understanding remote therapeutic education by videoconference through lived experience, by means of a one-hour interview, of the caregivers who deliver it and the parents of patients or the patients who receive it, will make it possible to better understand the effects of remote mode on therapeutic education sessions but also on professional practices and on participants.

The benefit will be twofold: for caregivers: to facilitate the deployment of this new educational offer. For patients and their carers: give priority access to TPE to families who are far from the healthcare system or to patients who are too fragile to travel and thus reduce inequalities and geographical barriers.

Chronic disease onset, due to its lasting and progressive nature, generates significant personal, family and socio-professional disabilities and difficulties. This situation requires active participation on the part of the patient, who must adopt protective behaviors in order to live better as much as possible.

Therapeutic patient education (TPE) is one of the mechanisms that will make patients as competent as possible to manage illness and treatment by helping them to be autonomous and responsible for their decision-making.

The COVID-19 pandemic has changed the organization of care, prioritizing the emergency fight against the epidemic. The TPE programs were also impacted by the pandemic.The French High Authority of Health (HAS) has recommended maintaining individual TPE sessions by videoconference or telephone, based on the usual stages of the educational process, without however defining clear recommendations for remote TPE. Several working groups have looked into remote TPE and recommendations have been issued in the form of practical advice without questioning the participants, who did not participate in the reflection. No consensus, including health authorities, has been reached on this subject.

At Necker Hospital, ETPs were carried out remotely, by videoconference. This new way of providing training required upstream preparation, reflection on the content, the use of digital tools and their mastery on the part of participants and speakers. The purpose of this qualitative study is to understand remote therapeutic education by videoconference through lived experience, by means of a one-hour interview, of the caregivers who deliver it and the parents of patients or the patients who receive it. The interviews will make it possible to better understand the effects of distant mode on therapeutic education sessions on participants but also on professional's practices. The benefit will be twofold: for caregivers: to facilitate the deployment of this new educational offer. For patients and their carers: give priority access to TPE to families who are far from the healthcare system or to patients who are too fragile to travel and thus reduce inequalities and geographical barriers.

Eligibility Criteria:
Inclusion Criteria:

* Understanding of the French language (oral and written) for all participants.
* Information and non-opposition of the subjects and of holders of parental authority of minor subjects.
* Caregivers: any health professional practicing videoconferencing therapeutic education can be included without age limit, regardless of gender, profession exercised (medical or paramedical) or the program concerned as long as the program is authorized (or declared) to authorized by the Ile-de-France Regional Health Agency (ARS).
* Participants: depending on the age of the patients, parents can be the exclusive target of therapeutic education (especially for young patients) or be present with their child during the sessions. The participants are the beneficiaries of therapeutic education either:

  * Parents/caregivers who have taken part in a videoconferencing TPE session (individual or collective) as part of a program authorized by the Ile-de-France ARS, regardless of their age, sex or the pathology concerned in the education program.
  * Patients: from 10 years old and only if the videoconferencing therapeutic education session was intended for them, regardless of gender or pathology.

Exclusion Criteria:

* Lack of training (40 hours) in TPE for caregivers.
* ETP program not authorized or not declared to the Ile-de-France ARS.