La Garde

This research focuses on elderly patients hospitalized in Continuing and Rehabilitation Care Units CRCU who often suffer from neurodegenerative diseases and require personalized rehabilitation care. Many of these patients struggle with eating independently due to difficulty gripping standard cutlery, which may contribute to malnutrition. The study aims to evaluate the use of customized ergonomic cutlery handles designed with 3D printing technology to improve patients autonomy during meals. Participants will receive cutlery handles with diameters tailored to their hand grip capacity, determined by a functional and joint assessment conducted by an occupational therapist. The handles come in sizes of 25, 30, 35, or 40 mm and are made from lightweight, thermoformable materials using 3D printing and computer-aided design. The study includes assessments at three lunch times before using the adapted cutlery Day 0, the first use of the adapted handles Day 1, and after three days of use Day 3 to observe learning and adaptation. During the study, the occupational therapist will assess the patients autonomy in eating using the Katz scale and perform ecological assessments of meal interactions on Day 0 and Day 3 to observe compensatory movements. A dietician will measure the amount of food ingested at each lunch. The patients participation concludes after the Day 3 assessments, with outcomes focused on changes in food autonomy and upper limb compensation during eating.

Obesity is a chronic and progressive disease characterized by an increase in body fat, affecting physical, psychological, and social well-being. In France, about 17 of the population is affected, and projections suggest obesity rates will rise across Europe by 2030. The French National Authority for Health supports changes in care practices, emphasizing patient education and long-term management to help patients become active participants in their treatment and health decisions. The Var region has developed the Chronic Disease Unit to provide coordinated, individualized care pathways focusing on therapeutic education and psychosocial support for chronic conditions like obesity. This study aims to evaluate if this care pathway improves the self-efficacy and meets the expectations of obese patients. Patients will be identified during an initial consultation with a dietician and selected by the study investigator if they meet inclusion criteria. The research involves three main visits at the start M0, three months M3, and six months M6. At M0, patients give oral consent and complete several questionnaires on quality of life, self-efficacy, self-esteem, body image, anxiety, and depression. Follow-up visits at M3 and M6 include repeating these questionnaires and assessing satisfaction with the care pathway. Some patients will also participate in focus groups during M0 and M6, with audio recordings made after consent. Participants will complete questionnaires with the presence of a Chronic Disease Unit psychologist to provide support if needed. Researchers will evaluate changes in self-efficacy, quality of life, body measurements, self-esteem, anxiety, depression, and satisfaction with care over the six months. The study will also assess patient adherence and disruptions in care. The total involvement duration is six months, with assessments designed to capture both clinical and psychosocial outcomes of the care pathway.