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Construire, transmettre et s’approprier des savoirs sur le cancer et la chimiothérapie orale : Une étude psychosociale située dans la perspective théorique des représentations sociales

Abstract : AbstractBased on a psychosocial approach, this thesis investigates the construction, the transmission, and the appropriation of health-related knowledge through the conceptual and the practical seizure of a complex object: Cancer treatment with oral chemotherapy. From a contextual perspective, the ambition of this thesis is anchored in the development of the ambulatory setting, the promotion of self-care in cancerology, and the growing number of patients treated with oral chemotherapy. The prescription of oral anticancer agents tends to be related to a call to set up self-care management programs to “secure” oral chemotherapy. Moreover, this context leads to a transformation of the patient’s experience of cancer: they are called to become responsible for their treatment (taking oral chemotherapy as it is prescribed, in a way that is consistent with medical advice) and they have to carry out different self-care tasks. From a theoretical perspective, this research is based on the social representations approach, which offers a conception of social thought that highlights the context in which it is anchored, shaped and embodied. This thesis aims at grasping the specificity, the heterogeneity and the dynamic of the knowledge related to cancer and oral chemotherapy – through a psychosocial view that brings to light communicational, interactional and sociosymbolic mechanisms. This scientific work also aspires to investigate how health related knowledge both influence sick people’s health practices and health care providers’ therapeutic and educational practices.This thesis is based on a collaboration with a medical team from the Rhone-Alpes area whose members have developed a self-care program for cancer patients treated with oral chemotherapy. Our work consisted in collecting and analyzing qualitative data (semi-structured interviews, observations) and quantitative ones (questionnaire). Three phenomena were investigated by these methods: i) the construction of sick people’s experience of cancer and oral chemotherapy – by emphasizing the social, the cognitive, the affective and the symbolic aspects of this process (semi-structured interviews and questionnaire), ii) the way health care providers come to terms with the patients’ therapeutic and education follow-up (ethnographic study), and iii) the circulation of health knowledge within the therapeutic situations regarding the information and the meanings that sick people and health care providers share and transmit to each other.Looking at the specificity of the results and their interrelations, this thesis highlights the dialogical aspects of knowledge related to health, illness, and the body. The way the social and the medical thought comes to terms with the treatment of cancer with oral chemotherapy is structured by different aspects of the social context. Moreover, this process involves different systems of thoughts, which are both plural and complex. The way the social and the medical thought come to terms with the cancer treatment with oral chemotherapy is rooted in therapeutic settings, social interactions, and both social and professional practices. This process refers to different ways of grasping the cancer treatment with oral chemotherapy: these ways are practical, cognitive, affective, and sociosymbolic. Furthermore, our results show that the cancer treatment with oral chemotherapy involves different kinds of grids between social and medical thoughts. These grids are not just involved in medical settings and they cannot be reduced to an objectivation of the prescribed work neither, nor a linear model of information by which knowledge would be defined as transmission from a point A to point B. These grids are determined by the dual nature of social thought: the dynamic relationship between the product and the process aspects of cognition.
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Submitted on : Monday, February 7, 2022 - 3:51:41 PM
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Thibaud Marmorat. Construire, transmettre et s’approprier des savoirs sur le cancer et la chimiothérapie orale : Une étude psychosociale située dans la perspective théorique des représentations sociales. Psychologie. Université de Lyon, 2021. Français. ⟨NNT : 2021LYSE2054⟩. ⟨tel-03560510⟩



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