L’effet de Halo dans la mucoviscidose : quand les patients adultes et adolescents éduqués, éduquent à leur tour leurs aidants. [The Halo effect in cystic fibrosis: when educated adult and adolescent patients in turn educate their caregivers]

Introduction Caregivers are generally not very involved in the TPE programmes that their sick relative may follow. However, the transmission of knowledge and skills from educated patients with a chronic disease to their caregivergivers has already been demonstrated. This phenomenon is known as the ‘Halo effect’. In the context of cystic fibrosis, we hypothesise that the Halo effect also exists in adult and adolescent patients. Method This study was conducted at the Montpellier Cystic Fibrosis Center on 61 patients (31 adults, 30 minors) and their caregivers. Mirror questionnaires for patient and caregiver were used to measure the frequency and quality of transmission to the caregivers of the knowledge and skills acquired by the patients thanks to ETP, as well as the impact of this transmission on the daily management of cystic fibrosis. Results The study revealed that 83.6% of patients (P) passed on knowledge to their caregivers (C), although this perception was slightly lower on the caregivers’ side (67.8%). The Halo effect had a significant impact on the day-to-day management of the disease (P: 91.7%, C: 93.4%), thanks to the development by caregivers of emergency management skills (P: 85%, C: 90%) and of the ability to provide psychological support to patients (P: 80.4%, C: 80.3%). The help provided by caregivers to their relative was considered to be effective (P=80.3%, C=81.9%), helping to improve the relationship between them (P=61.7%, C=80.3%) as well as with healthcare professionals (P=64%, A=74.6%). Comparisons between adults and adolescents did not show any significant differences. The partial participation of the caregiver in the therapeutic education program appeared to significantly help the patient in the management of several aspects of the disease, such as eating and sleeping habits and relations with healthcare professionals. Discussion The results confirm the existence of the Halo effect, with a transmission of skills from the patient to the caregiver, which reinforces the support provided in managing the disease. The study highlights the importance of including caregivers more systematically in the TPE process, as their participation further improves certain aspects. The Halo effect appears to have a similar impact both on adult and minor patients. These data confirm the results already published for patients suffering from various other chronic diseases or in the context of perinatal care between educated women and their spouses. Conclusion This study demonstrates the existence and importance of the Halo effect in the therapeutic education program for patient living with cystic fibrosis, with positive repercussions on the management of the disease and the quality of life of these patients and their caregivers. Future prospective studies, including qualitative analyses, will provide a deeper understanding of this phenomenon.