BACKGROUND: Working with women to best meet their needs has always been central to midwifery in Quebec, Canada. The creation of birthing centres at the end of the 1990s consolidated this desire to prioritize women\'s involvement in perinatal care and was intended to encourage the establishment of a care and services partnership between care providers and users. The aim of this pilot study is to evaluate the perceptions of clients, midwives and birth assistants of the way in which women are involved in partnership working in Quebec birthing centres.
METHODS: A single qualitative case and pilot study was conducted with midwives (n = 5), birth assistants (n = 4), a manager (n = 1), clients (n = 5) and members of the users\' committee (n = 2) at a birthing centre in Quebec, Canada in July and August 2023. The partnership was evaluated using the dimensions of a validated CADICEE questionnaire.
RESULTS: The women and professionals stressed that the relationship was established in a climate of trust. The caregivers also attached importance to autonomy, information sharing and decision-making, adaptation to context, empathy and recognition of the couple\'s expertise. The women confirmed that they establish a relationship of trust with the professionals when the latter show empathy and that they adapt the follow-up to their knowledge and life context. Key factors in establishing this kind of care relationship are the time given, a de-medicalized environment, the comprehensive care received, and professionals who are well-informed about the partnership. In addition, the birthing centre has a users\' committee that can put forward ideas but has no decision-making powers.
CONCLUSIONS: Both the women and the professionals at the birthing centre appear to be working in partnership. However, at the organizational level, the women are not involved in decision-making. A study of all birthing centres in Quebec would provide a more comprehensive picture of the situation.

Restraint during care in pediatrics is a professional practice that is beginning to be studied. However, few studies explore this phenomenon from the point of view of the parents of children who are firmly restrained during care. Guided by the caregiver\'s perspective, care remains a priority for them. Some perceive the violence of the situation, while others focus on the benevolence of the professionals. In all cases, this practice implies the need for professionals to support the parents and children concerned, in order to safeguard the best interests of the young patient.

Joy, fear, disgust, anger, sadness, surprise, emotions are fleeting and natural affects that catch us off guard. Care, as a face-to-face encounter with others, in a sometimes difficult context of serious or chronic pathologies, can become a place of affectivity, all the more so as care crosses the barriers of bodily intimacy. What to do with one\'s emotions in care?

As part of the MAEVAS day, organized by the Paris Psychiatry & Neurosciences University Hospital Group, three nursing students from the Théodore-Simon inter-hospital training institute in Neuilly-sur-Marne (93) presented a conference entitled \"Humanism & Cure at the Heart of the Care Relationship: Dare to Think!\" to an audience of caregivers on May 23, 2022. They report on the essence of the reflections shared.

Touching someone is a multisensory encounter with the other, it is listening, hearing, seeing, smelling, feeling, perceiving, etc. This contact allows for the interpersonal circulation of a host of information in a close relationship. The caregiver touches the patient\'s body with his or her eyes before beginning to grasp it with his or her hands. In order to adjust his or her approach to care, he or she must be attentive to the messages that the patient sends. But touching a patient\'s body also means that the caregiver is touched by the emotions produced by the confrontation of the person\'s body with his or her own body.

BACKGROUND: Experience-based codesign (EBCD) is a valuable tool for participatory quality improvement. However, the EBCD process needs to be adjusted to make it suitable for long-term care. The focus of the improvement process needs to shift to the care relationship, as this is an important part of the quality of care in these settings. Furthermore, the EBCD process needs to be made more accessible to vulnerable populations.
METHODS: Through a participatory research approach, EBCD was adjusted to long-term care. The research was conducted in two care organisations: one supporting people with serious mental illness and intellectual disabilities in independent living and one providing homecare services for older persons.
RESULTS: The participatory research resulted in the development of \'Ask us!\'-a method for critical reflective codesign. The research furthermore provided valuable lessons for participatory projects with vulnerable clients. A common problem with participatory research in long-term care is ensuring the involvement of clients and informal carers. We report on various strategies developed to include experiences of a diverse set of services users, such as combining interviews with participant observation, photo-voice and involving experts-by-experiences as co-ethnographers. In close collaboration with an inclusive theatre company, these experiences were translated into 42 short videos on complex situations in the care relationship from the perspective of clients, professionals or informal carers. These videos instigate critical reflection and accelerate the participatory quality improvement process. Moreover, practical tools were developed to overcome barriers regarding the involvement of people with disabilities. These include the use of photo-elicitation to enable participation of clients with disabilities in heterogeneous group discussions and involving experts-by-experience as proxies to share experiences of clients for whom participation in the \'Ask us\' method remains inaccessible.
CONCLUSIONS: The result of a robust participatory process, \'Ask us!\' is a promising method for participatory quality improvement in long-term care. The research furthermore generated lessons for involving vulnerable populations in participatory research and codesign.
UNASSIGNED: Clients were involved as informants, sharing their experiences with the care relationship in interviews, photovoice and observations. They were also involved as consultants, helping to analyse input for the film scripts during data validation sessions.

The sense of smell presents itself to us as a means of forging an opinion of a situation, sending us back to our memories and giving us a form of knowledge of the patient. In addition, besides the obvious repulsion that certain wounds can engender, the sense of smell can also, conversely, lead us into an eroticization of care.

The new paradigm of precision medicine in oncology questions today the respective place of evidence-based medicine and doctor-patient relationship. Based on the results of a randomized study comparing the efficacy of a homeopathic molecule in the prevention of nausea and vomiting induced by chemotherapy in non-metastatic breast cancer, this article extends and develops the discussion of maintaining an unresolved tension between medical art and medical science, between care and cure. This tension sets a base for the authors of the therapeutic alliance in medicine, defined as a dialectic constantly adjourned between the alliance of the doctor with the patient and his therapy, and the therapeutic effect of this alliance. Because if a policy or a public opinion were to promote an exclusively rational medicine deprived of the field of relation to care, or on the contrary a medicine based only on clinical sense and intuition, then respectively the ethics of care and the progress of therapy would be threatened. It is advisable to be aware of erring from the truth, amplified today by social networks, as much due to a tide of scientific positivism, as an excess of the \"good caring soul\". Taking into account the therapeutic alliance makes it possible to no longer oppose scientific medicine and care relationship.

The reform of health studies and the inclusion in the Bachelor-Master-Doctorate curriculum implies a new way of teaching, with an inverted pedagogical relationship between student and teacher. The competency-based approach contributes to the development of the student\'s professional and interpersonal skills, in the same way as the support provided by the nurse in the care relationship, particularly in therapeutic education, in order to promote patient autonomy.

OBJECTIVE: This research was focused on expert professionals in epilepsy care to understand their points of view on the care pathway and their living relationships with patients.
METHODS: Researchers prepared a semi-structured parallel chart and distributed it online among 21 Italian centres of care. Each health professional was prompted to write five narratives on cases of patients with epilepsy, subsequently analysed through narrative medicine methods. Next, a consensus meeting was held, to individualise an action plan based on the narratives.
RESULTS: Ninety-one parallel charts were collected from 25 epileptologists, who had a mean age of 50 years; their narratives concerned patients with a mean age of 37 years, with different types of epilepsy (53 % drug-resistant; 31 % unemployed). The limitations in the daily life of people with epilepsy (57 %), employment (42 %), caregiver burden (51 %), and the universal prevalence of fear were the primary topics that emerged. Attentive and reassuring care relationships were found to be the main element of coping (21 %). A new multi-factorial classification of epilepsies, integrating clinical with social and legal risk factors, was the main agreed action to face the issues identified.
CONCLUSIONS: The narrative medicine approach supplied a broader scenario of living with epilepsy, including the family and social impact and possible effects on the choices for care pathways. The epileptologists showed a strong motivation to care for patients with epilepsy and deep involvement in the care relationships; the use of parallel chart demonstrated to be an effective tool to preserve their wellbeing.