In this third expanded edition of his “Therapeutic patient education manual” (Dunod), Jean-Marie Revillot, researcher, health executive, lecturer in educational sciences, unfolds his concept of “ care ».
You are publishing the third edition of your work on therapeutic patient education. Why a new edition?
This new edition has become a necessity in response to the demand from healthcare professionals. In addition, practices are evolving, healthcare organizations are transforming in response to the expectations of patients and professionals. Therapeutic patient education (TPE) is not only a regulatory system, it is a transversal skill essential to all health professionals, in the city as well as in hospitals. It was therefore important to update the conceptual foundations and adapt tools to current realities on the ground.
You return in your work to the conceptual foundations. Why is this so important for professionals?
Clinical practice without a solid conceptual foundation becomes exhausted. Rethinking chronic illness, health, education and the care relationship makes it possible to restore meaning to educational action. Chronic illness transforms the patient’s life in the long term and involves permanent adjustments. Therapeutic education is therefore not a simple transmission of information, an acquisition of skills or a search for patient autonomy; it is a process of support and development over time. Clarifying these notions allows professionals to act with consistency and reflexivity.
The great innovation of this edition is the introduction of the concept of “ care “. Can you explain it to us?
I designate by care a development space shared between the caregiver and the patient. From this perspective, care is not a unidirectional act. The caregiver does not just teach or support; he too is transformed in the relationship. An authentic and involved relationship allows the co-construction of knowledge and the recognition of each person’s abilities. The patient develops his self-management and psychosocial skills, his power to act to project himself towards life. The caregiver, for his part, develops his relational, educational and reflective skills. The relationship becomes a place of mutual learning.
We can say that the care is perceptible in 3 registers: existentialthat is to say the élan vital, the ability to project oneself despite illness; cognitivethe co-construction of knowledge between patient and caregiver and emotionalthe reciprocal recognition of capacities, vulnerabilities and resources. Thus, the care is a relational dynamic that transforms both the patient and the caregiver. The ETP then becomes a place of mutual recognition, a lever of development for both the patient and the caregiver, another way of caring, and another way of being a caregiver.
How does this concept change the professional posture?
It invites us to leave a posture of exclusive control to enter into a posture of partnership. This does not mean renouncing clinical expertise, but accepting that the patient has indispensable experiential expertise. This recognition transforms the dynamic of care: it promotes patient commitment and gives meaning to the caregiver’s work. There care also helps prevent professional wear and tear, because it enhances the evolving and enriching dimension of the relationship.
Your book also offers many practical tools. Who are they aimed at?
To all health professionals: doctors, nurses, pharmacists, physiotherapists, psychologists, educators, health executives, but also students and patient partners, health mediator. The tools offered can be used in hospitalization as well as outpatient settings. I wanted this edition to remain operational, with supports, diagrams and summaries facilitating rapid appropriation of concepts.
You have long defended the patient’s place as a partner in their care. Where are we today?
Significant progress has been made, but the partnership culture remains unevenly integrated. Recognizing the patient as a partner requires a real paradigm shift: sharing information, negotiating decisions, recognizing lived experience as a legitimate source of knowledge. Therapeutic education constitutes a major lever to realize this ambition.
What message do you want to send to healthcare professionals?
Therapeutic education is not an additional burden: it is a different way of practicing your profession. It gives meaning to care, enhances the relationship and allows mutual development. There care reminds us that we also grow in the encounter with the patient. It is an invitation to consider care as a space of co-construction and shared growth.