La Garde

This research focuses on elderly patients hospitalized in Continuing and Rehabilitation Care Units who suffer from neurodegenerative diseases and require personalized rehabilitation care. The study evaluates the use of ergonomic cutlery handles, designed with 3D printing technology, to help improve patients' autonomy during meals. These custom-sized handles aim to address difficulties patients face when gripping standard cutlery, which often does not improve their independence or nutritional status adequately. Participants will receive cutlery handles with diameters tailored to their hand flexion capacity, determined by a functional and joint assessment by an occupational therapist. The cutlery handles are lightweight, inexpensive, and designed using Computer-Aided Design and Manufacturing software in partnership with local fabrication labs. The study includes assessments before using the adapted cutlery, on the first day of use, and after a three-day learning period to evaluate their impact. During the study, patients' autonomy in eating will be measured using the Katz scale, and the amount of food consumed will be tracked by a dietician at three lunches. The occupational therapist will also perform ecological assessments of patients' upper limb movements during meals without and with the adapted cutlery. The study participation concludes after the Day 3 assessments, aiming to understand how these customized aids affect meal independence and upper limb compensation.

Obesity is a chronic and progressive disease characterized by an increase in body fat, affecting physical, psychological, and social well-being. With a prevalence of 17% in France, obesity remains a major public health concern. The World Health Organization projects an increase in non-communicable diseases like obesity by 2030 across Europe. To address this, the French National Authority for Health emphasizes patient education and long-term management, encouraging patients to actively participate in their treatment and care pathways. However, patients often struggle to navigate care options and identify supportive medical or paramedical resources. The Var region developed the Chronic Disease Unit to offer coordinated, personalized care pathways for chronic illnesses, including obesity. This approach centers on therapeutic education and psychosocial support, encouraging patients to build skills and autonomy at their own pace. The study evaluates if this care pathway improves obese patients' sense of self-efficacy, which is important for adopting health-promoting behaviors and managing weight effectively. Patients identified at the Chronic Disease Unit will attend three consultations over six months: at baseline, three months, and six months. During these visits, patients will complete questionnaires assessing quality of life, self-efficacy, self-esteem, body image satisfaction, anxiety, depression, and satisfaction with the care pathway. Some patients will also participate in focus groups. Questionnaires are completed with a psychologist present to provide support if needed. The main outcome is to assess changes in patients' self-efficacy at six months after starting the care pathway.