Intérêt de l'éducation thérapeutique collective dans la gestion de biothérapie par voie sous cutanée chez des patients atteints de rhumatisme inflammatoire chronique

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HAL Id: dumas-00745340

https://dumas.ccsd.cnrs.fr/dumas-00745340

Submitted on 25 Oct 2012

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Intérêt de l’éducation thérapeutique collective dans la

gestion de biothérapie par voie sous cutanée chez des

patients atteints de rhumatisme inflammatoire chronique

Laure Berard

To cite this version:

Laure Berard. Intérêt de l’éducation thérapeutique collective dans la gestion de biothérapie par voie sous cutanée chez des patients atteints de rhumatisme inflammatoire chronique. Médecine humaine et pathologie. 2012. �dumas-00745340�

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- 4 - %%!T!"/#$6#-%(! !! ! "$.7(22(,$2!! !! 6U!'M>?AAP!4(22.&! ! ! ! -M>K>?!'MIAJC?@H>O@?!! 6U!!8?J<T8JLO@?=!4.&&('! ! ! "MJAKJL;B;Y>?!! 6U!!$;BJ<G!-#"$.&![",T"/\! ! ! 4>;CMP=>O@?!! 6U!!8?J<!-.2'(&'%&![",T"/\! ! ! "MJAKJL;B;Y>?!! 6K?!%=JZ?BB?!),4,2! ! ! ! 4>;LM>K>?!! 6U!!*;bL!7#1(&&(-![",T"/\! ! ! "JAJ=>H;B;Y>?!! 6U!!6>LM?B!3,($4('! ! ! ! ';c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eJZ?HM!-/.22.&! ! ! 4;HJ<>O@?!! 6B?!-IL>B?!-.$4%($(! ! ! ! 4>;LM>K>?!! 6U!!(A>L!)%''6#$! ! ! ! 4>;CMP=>O@?!! 6K?!&JHMJB>?!).,$6#"! ! ! "MJAKJL;B;Y>?!! 6B?!%=JZ?BB?!),4,-! ! ! ! "MJAKJL;B;Y>?!!! 6K?!$;=?B><?!),-*.2! ! ! ! "MJAKJL>?!3JBI<>O@?!! 6U!!#ZG?BMJ`>K!(*.6$%! ! ! "MJAKJL;Y<;=>?!! 6U!7AJ<];>=!(2'.,$! ! ! ! -M>K>?!.AYJ<>O@?!!! 6U!3>BB?=!3#$3#*#![6-,T"/\! ! ! "JAJ=>H;B;Y>?!! 6K?!&JfBJ!3/#$4%! ! ! ! -M>K>?!J<JBPH>O@?!! 6B?!6JA>?T*J@A?!3$.,*'! ! ! 4;HJ<>O@?!! 6U!/?AEI!/,(! ! ! ! ! 4>;CMP=>O@?!?H!6JHMIKJH>O@?=!! 6K?!/;<Y!*,! ! ! ! ! 4>;B;Y>?!! 6K?!2JZ><?!6(&#3($! ! ! ! -M>K>?!;AYJ<>O@?!! 6K?!-MA>=H?BB?!6.&'(%*! ! ! ';c>L;B;Y>?!! 6U!!"J@B!6,*)($! ! ! ! 2L>?<L?=!G@!KIG>LJK?<H!!! 6U!6;MJK?G!2X%4#! ! ! ! "MJAKJL>?!3JBI<>O@?!!! 6K?!6JB>`J!2X%4#! ! ! ! "MJAKJL>?!3JBI<>O@?!! 6K?!-MA>=H><?!'/#$#22(! ! ! -M>K>?!HMIAJC?@H>O@?!! 6U!$IK>!1#$%&![6-,T"/\! ! ! "MJAKJL>?!/;=C>HJB>_A?!! 6U!7AIGIA>L!5%(3*($! ! ! ! 4>;LM>K>?!! !! "$.7(22(,$!#22.-%(!! !! 6U!8?J<T">?AA?!3.,**(! ! ! ! ';c>L;B;Y>?!!!! !! ! 6#%'$(!)(!-.&7($(&-(!#22.-%(!! !! 6K?!2J<GA><?!"#&-/.,! ! ! "MJAKJL>?!.DD>L><JB?!! !! !

(7)

- 5 - "$.7(22(,$!#3$(3(!.,!-($'%7%(!! !! 6K?!#<<?T6JA>?!#&5(**.''%! ! ! #<YBJ>=!! !! #''#-/(!'(6".$#%$(!)+(&2(%3&(6(&'!('!)(!$(-/($-/(!! !! 6U!4IAI<>L?!-.0,($(*!! ! ! -M>K>?!#<JBPH>O@?!! 6U!8;MJ<<!"(*'%($! ! ! ! 6>LA;Z>;B;Y>?!! !! !! !! -/(7!)(2!2($1%-(2!#)6%&%2'$#'%72!:!6K?!1IA;<>O@?!)(*#7.&'#%&(!! !! /-&!T!/gC>HJB!-MJAB?=!&>L;BB?! ! ! /4!T!/g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

(8)

- 6 - 6U!!8?J<!-.2'(&'%&!!!!! ! ! ! ! ! "MJAKJL;GP<JK>?!! !! 6K?!%=JZ?BB?!),4,2! ! ! ! ! ! 4>;LM>K>?!! !! 6U!*;bL!7#1(&&(-! ! ! ! ! ! "JAJ=>H;B;Y>?!! !! !6U!!6>LM?B!3,($4('! ! ! ! ! ! ';c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hRi\!!!!!!!!!!! !! 6K?!3JaBB?!4.,3(#$)T)(&.9(**(! ! ! 4>;LM>K>?!?H!Z>;B;Y>?!K;BIL@BJ>A?!!!!!!! !! ! ! ! ! ! ! [,<>HI!%<=?AK!jSk\!! !! 6U!#<H;><?!.,1$#$)T"#2-#,)! ! ! "MP=>;B;Y>?![,<>HI!%<=?AK!jkk\!!!!!!!!!!!!!!!!!!! !! !! "$.7(22(,$2!)(2!,&%1($2%'(2!! !! 6U!6JA>;!'.2%! ! ! ! ! ! 4>;LM>K>?!?H!Z>;B;Y>?!K;BIL@BJ>A?!! !! ! ! ! ! ! ! [,<>HI!%<=?AK!jSk\!! 6U!2?AY@?>!7('%22.1! ! ! ! ! "MP=>;B;Y>?![3A;@C?!#)(&\!! !! 6K?!2@!$,#&!! !! !

(9)

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(10)

- 8 - !

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(11)

- 9 -

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