Altering Frontiers. Группа авторов

Altering Frontiers - Группа авторов


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      Partnership differs from models of engagement in which leadership is provided exclusively by professionals: information to patients by professionals; consultation by survey, interview, focus group or advisory committee; and ad hoc participation of patients and members of the public in a working group, citizen panel or deliberative meeting in which leadership is provided by professionals.

      Far from being copied, it actually adapts to the context. In France, for example, a grafting of this model in the spirit of Nice gives rise to the emergence of a “UniverCité” of care (Ghadi et al. 2019). It is organized around different modalities of action, for example:

      1 – popular and citizen education system;

      2 – action-training seminars for learning and doing together;

      3 – actions carried out by the Centre d’innovation du partenariat avec les patients et le public (CI3P). The CI3P brings together patients and their families and integrates them into medical education, healthcare and research environments as part of co-design initiatives, including new technologies.

Schematic illustration of systemic transformation practice.

      This moving ensemble, originating from the city, demonstrates the complementarity of knowledge and is oriented in the care(s) according to a paradigm of reciprocity from which contributing research will allow a desired systemic mutation.

      However, if this “UniverCité” of care is the first organization in France with this type of partnership, it is not the only one. There is, for example, an initiative in

      However, these companies develop while maintaining their local specificities. For example, we can note the implementation of patient trainers in the teaching of general medicine at the Bobigny Faculty of Medicine in the Paris region; it has chosen to mobilize only patients representing users and has preserved the relational model of the patient-centered approach, unlike the approach implemented in Montreal – although methodologically largely inspired by it. It is this model which, for the time being, is being adopted by the BEPP of the AP-HP, which does not appear to be the choice of Rennes, which is starting from the existing situation to develop it locally. Other attempts to grasp this model are under way in various European countries, such as Italy: since 2013, training in the teaching of family medicine integrates this approach at the Faculty of Medicine and Surgery of Modena. In Belgium, it is at the Free University of Brussels, under the impetus of the Institute of Nursing Sciences and the Department of Public Health, that teaching and research are organized according to the patient partnership. In Liège, a team of researchers, under the impetus of Benoît Petre, is organizing a research partnership between Belgium, Luxembourg and the University of Nancy based on the Montreal model. Switzerland is not to be overlooked with companies initiated by the Geneva (GHUG) and Lausanne (CHUV) hospital centers, through the Hôpital ami des aînés (elderly friendly hospital) project, and by the Réseau santé région Lausanne (RSRL) through the Anticipated Care Project (Projet anticipé de soin, PAS), which aims to accompany patients toward self-determination in the canton of Vaud.

      If the Montreal model seems to be the most accomplished, it is therefore far from being the only one and it can be considered as a legacy of a fruitful entity. It encompasses the achievements of patient movements invested in the fight against AIDS, and also the socialization of knowledge of people living with mental disorders through the “Recovery” movement. Quebec has largely integrated it into its approach thanks to the Association québécoise pour la réadaptation psychosociale (AQRP). Since 2006, the AQRP has been training and accompanying peer helpers integrated into care teams under the leadership of the provincial Ministry of Health, as an extension of a trend born in the United States and much studied in Minnesota. In this state, a program (Minnesota Program 1950) in the field of addictions has already been designed, inspired by the Alcoholics Anonymous model, initiated in 1946 and implemented in the 21st century in some 40 countries, including France, through the APTE center opened in 1994 (Flora 2012, pp. 114–115).

      In both cases, the aim is to mobilize peers in multi-professional teams. In the field of addictions, the range of individuals or groups supported by this system has largely developed


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