Psychosocial Health

Abortion is a fundamental right for women in France, where the legal time limit was extended from 14 to 16 weeks' gestation. This extension allows women, whose psychosocial determinants are poorly known, and who face various obstacles (personal, administrative, medical, or other), to access abortion. However, it may also expose them to psychological troubles and difficulties in accessing healthcare. This study aims to identify the psychosocial determinants and disruptions in the primary care pathway associated with late abortions (≥14 weeks' gestation \[WG\]) in order to propose preventive actions, particularly regarding contraception, screening, and referral, directly applicable in general practice.

The proposed two-arm randomized waitlist-controlled trial will use a mixed-methods design to investigate the effects of dyadic mindfulness on physio-psycho-spiritual outcomes in people with Parkinson's Disease (PwPD) and their family caregivers. One hundred Chinese patient-caregiver dyads will be randomized to receive eight weekly 90-minute dyadic mindfulness sessions or usual care. Outcome measures include negative emotions (primary outcome), patient-caregiver relationship, mindfulness, HRQOL, gut microbiome, PD-related symptoms, and caregiving burden. An actor-partner interdependence model will be used to explore the interactions of treatment effects within the dyads. The dyads will be assessed at baseline(T0), post-intervention(T1), and 4-months post-intervention(T2). The investigators will also invite 25 dyads to attend in-depth interviews exploring their experiences, perceived changes, and factors attributable to the effectiveness/ineffectiveness of the intervention. Generalized linear mixed-effects (GLME) with intention-to-treat analysis will be used to compare the changes in outcomes over time within and between the two arms. The findings will be triangulated to provide a comprehensive evaluation of the intervention's effectiveness. This study will generate rigorous scientific evidence to inform the application of dyadic mindfulness as a public health practice preventing the progression of psychological distress in PwPD and caregivers to clinically severe levels. Its self-help nature also enriches the primary care for this clinical cohort.