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Étude de l’équilibre de vie des personnes présentant des troubles obsessionnels compulsifs : Utilisation de stratégies d’adaptation pour faire face aux situations de déséquilibre occupationnel.

Abstract : Because of compulsive rituals and haunting thoughts, people with OCD are concerned about their level of functioning in all spheres of life. A sense of occupational imbalance and impaired quality of life may appear in these people when their routine is perceived as unsatisfactory. This thesis has three main objectives: (1) to determine the situations of occupational imbalance in people with OCD, (2) to identify the coping strategies used at home, and (3) to develop and document the use of technical/technological devices to maintain a balanced life through the promotion of occupations. A scoping review was first conducted to determine existing data in the international scientific literature related to quality of life indicators for people with OCD (Chapter 1). The objectives were to (1) to explore the components of the quality of life of people with Obsessive Compulsive Disorders (OCD); (2) to identify the variables that modify their quality of life; (3) to analyze the impact of OCD on activities of daily living. Among 1458 articles identified, the literature review selected 22 relevant publications on the quality of life of adults with OCD. This scoping study made it possible to raise additional questions, as yet little explored by clinical research, such as the impact of OCD on time management, occupation of home space, maintenance of meaningful activities, or increased financial expenditures.1 The second chapter presents an innovative approach and was the subject of an article published in a collective work. The second chapter presents an innovative approach and was the subject of an article published in a collective work that describes the research specifications of the project Analyse du Handicap Associé aux Troubles Obsessionnels Compulsifs [AHATOC] (Morgiève and Briffault, 2015). This project is a participatory clinical research project which aims to identify environmental factors related to OCD and to design technical and technological devices to compensate for handicap situations (e.g. home automation environment, mindfulness relaxation apps, personalised technical aids). The article also proposes two environmental assessment tools: (1) a chrono-ergometer is a circadian disc that can map daily routines over time, which can be disrupted by the manifestation of OCD; (2) a methodology has been developed to map compulsive rituals and haunting thoughts in the home environment in 2D and 3D. The third chapter concerns a study that identifies the coping strategies used by people with OCD (chapter 3) and documents the altered dimensions of life balance (chapter 4). To this end, semi-structured interviews were conducted in the homes of eight participants with OCD to explore the impact of obsessions and compulsions in activities of daily living. In addition, a questionnaire entitled Life Balance Inventory [LBI] (Larivière and Levasseur, 2016, Matuska, 2012) was used to document the impairment or disruption of daily activities. This information was collected in the participants' homes on two occasions (24 months apart). The interviews revealed a degree of dissatisfaction among respondents with respect to the time they spent carrying out their occupations (equivalence). The results also indicate that the implementation of strategies to deal with the difficulties of daily life is an important part of the process of compensating for mental health problems and the recovery process for the people concerned. The data from the LBI showed a favourable evolution of life balance, although the level of imbalance is still significant for all participants' activities of daily living. Chapter 5 discusses a case study of two participants with OCD who experienced technical/technological devices proposed by the AHATOC project. The case study analysed the occupations disrupted by the manifestations of OCD and their evolution over a period of 30 months. Three tools were used to document these two situations : (1) semi-structured interviews using the SWOT matrix (Strengths Weaknesses Opportunities and Threats) ; (2) the Life Balance Inventory; (3) mapping of OCD over time. According to the observations made, the occupations of the two participants evolved favourably thanks to the use of technical and technological compensatory devices. In short, the design of technical and technological devices associated with adaptation strategies seems to promote the maintenance of life balance. It is important to conduct participatory research to involve individuals, clinicians and researchers. This makes it possible to formalize the work of community mental health teams and to develop a rehabilitation program specific to people with OCD.
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Yannick Ung. Étude de l’équilibre de vie des personnes présentant des troubles obsessionnels compulsifs : Utilisation de stratégies d’adaptation pour faire face aux situations de déséquilibre occupationnel.. Sciences de l'Homme et Société. Université Sorbonne Paris Cité / Université Paris Descartes, 2018. Français. ⟨tel-02520967⟩

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