Interviews - Danielle Marcoux


Canada

ABOUT YOUR OWN STRUCTURE :


  1. Puce First of all, do you have an individual and/or collective approach ?

Well we are in the process of setting up our program which will be for

individual needs. The aim is to validate a standard set of guidelines and tools for the various centres around Canada. This, of course, takes a lot of time and energy.


  1. Puce Who will conduct the interviews (doctors, nurses, psychologists..) ?

The teaching will be carried out by a doctor, but a nurse will carry out the individual consultations assisted by a dermatologist. The doctor will not necessarily be in the room but will be close by in case an expert’s point of view is needed.


  1. Puce How will the sessions be organised ?

There will be two age groups: 0-2 years or infants and 2-5 years or pre-school children. At the moment education courses are given on a spontaneous basis according to the perceived need.


  1. Puce What are the aims of the sessions ?

When we see that patients need teaching on particular points we concentrate on these. For example we may have socio-cultural obstacles to good disease management. I mean patients from different ethnic backgrounds may have cultural notions of personal hygiene that aggravate their eczema and we concentrate on educating them on these points.


  1. Puce How long will it last ?

The consultations will be organised in 3 sessions of 45 mins. each. There will then be a phone call to the patient to see how he is doing.


  1. Puce Do you use educational support tools and, if yes, what type of tools are used with the patient ?

The teacher’s guides are called: The Paediatric Teaching Program for Atopic Dermatitis, and Training for Therapeutic Educators. The teachers documents contain more detailed information about the disease like complications, risk factors etc. The documents used in class are called Understanding and Controlling Atopic Dermatitis and Atopic Dermatitis Program for Patients and Families. We have a publishing house called the Centre for Children’s Health Information (CISE) who publish documents which can be bought by patients. They will publish our education tools.

The trainer will present the information on a flip chart, which is quite a visual way to work. These documents are given to the patient in the form of a booklet.


  1. Puce How do you use these tools ?

The trainer will use the visuals to present the disease and the different factors involved in managing the disease. As I said the patient will leave with this information in booklet form.


  1. Puce Is there a follow-up? If so, how is the follow-up organised, and who conducts it ?

There will be a follow up after 1 month, and 6 months.


  1. Puce How is the patient’s progress evaluated ?

Evaluating the progression is important and we’ll use two main tools: SCORAD and also the Paediatric Quality of Life Index. As we’re in the pilot stage of the project we have to demonstrate the benefits of patient education for Atopic Dermatitis to the Health authorities. This means that we have to organise a comparative study between a group of patients who have followed the education course and a group who have had no education. The tools also need to be standardised in order to be able to compare results from one centre to another


  1. Puce How many members of staff participate in this programme and what training, if any do they receive ?

We need to have validated methods and standards also in order to have the funding to employ a nurse one half day per week which corresponds to roughly 6 sessions per week. The training will be carried out by the dermatologist of the hospital department. In Montreal we want to create a network with the other hospitals and have 4 or 5 nurses in the city area.


  1. Puce Do private dermatologists participate in the Atopic school ?

No they don’t. It is a hospital based initiative.


  1. Puce How is your Atopic school funded ?

Well as I said, we are working on creating standard methods and validated tools and when this is done the funding will come from the Health Authorities for the hiring of a nurse.


PATIENT EDUCATION IN YOUR COUNTRY :


  1. Puce Do you have official patient education recommendations/guidelines in your country ?

You know patient education is not very developed in Canada and we really have to prove the benefits of this programme to the Health Authorities. There are 3 or 4 centres in Canada participating in the elaboration of standard guidelines and tools for patient education in Atopic Dermatitis. These are Toronto, Montreal and Terre Neuve. Doctors from these centres form a multidisciplinary team, and participate in the editing committee, which write up the tools and guidelines. These documents are then presented to the Canadian Dermatological Society for validation. A committee of 5 experts revise and validate the documents given to the patients. This validation also means we can use the premises of the CDS for our training courses.


  1. Puce Are there particular organisations to train the staff in patient education? If not, where are the staff trained ?

The staff will be trained by the heads of department in the various hospital centres.


  1. Puce How much do you invoice the whole education course ?

When the course is validated the patients don’t pay anything for these courses. The cost is covered by the state who fund the hospital department in the form of a nurses position.


Thank you Danielle Marcoux.


Dr. Danielle Marcoux


Paediatric Dermatologist,

Hôpital St Justine,

3175 Côte St Catherine,

Montreal, PQH3T  1CS,

Canada.