Centre Hospitalier Universitaire de Liege

A large number of patients at the Neurological and Functional Rehabilitation Centre of the University Hospital of Liège have associated pathologies, including diabetes. These patients may have diabetes-related complications that require recurrent hospitalizations in an acute structure or in rehabilitation. One of the ways to limit complications is to set up patient education.
1. Objectives
* To compare the impact of management through formal education with that of awareness.
* To evaluate the impact on knowledge of structured education.
* To evaluate the impact of structured education on the quality of life experienced by diabetic patients.
* Identify the patient's level of satisfaction with the education sessions.
* To evaluate the impact of structured education on the biological improvement of glycated hemoglobin.
* To evaluate the impact of structured education on diabetes-related complications.
2. Working Hypothesis The implementation of structured diabetes education allows "patients to acquire, or maintain, the skills they need to manage their lives as well as possible despite the constraints of chronic disease... ".
3. Study population All diabetic patients hospitalized in all care units.
4. Collection tools and techniques Collection tools
1. "Diabetes Knowledge Questionnaire". 2. SF-36 Health Questionnaire. 3. Satisfaction questionnaire for structured sessions on diabetes. 4. Questionnaire to identify complications and/or re-hospitalizations after your stay in rehabilitation.
Collection technology At admission (D+1)
* Validation of inclusion and exclusion criteria.
* Submission and distribution of the information and consent form.
* Obtaining informed consent from the patient.
* Distribution of collection tools 1 and 2 (collection on D+2).
* Control of glycated hemoglobin. At the end of hospitalization (D-2)
* Distribution of collection tools 1, 2 and 3 on D-2 before the release (collection on D-1).
* Control of glycated hemoglobin. 3 months after the end of hospitalization
* Sending collection tools 1, 2 and 4 by post. The patient will be invited to complete them and return them by post.
* The patient will be invited to take a blood test for glycated hemoglobin.

This controlled and randomized study aims to explore the feasibility and benefits of hypnosis in the management of patients who have suffered a traumatic brain injury or a stroke, by assessing its impact on behavioral disorders related to the dysexecutive syndrome, as well as associated symptoms (anxiety, sleep disorders, and pain).
For this study, a convenience sample of 40 adult patients with acquired brain injuries will be recruited and randomly assigned to two groups: one group will receive hypnosis sessions integrated into their usual care, and the control group will receive only conventional treatment. These patients are currently being followed in neurological rehabilitation with complaints (anxiety, sleep, pain, and/or behavioral disorders). These complaints will be initially assessed using visual analog scales (VAS) for these four points. Patients with scores higher than 4 on at least two of the scales will be admitted to the study. They will be randomly assigned to either the control or experimental group.
Sociodemographic data (age, sex, education) and certain medical data related to the brain injury will be collected, such as: the initial Glasgow Coma Scale score, medication treatment, lesion type, and the timing of the injury.
Several questionnaires and scales will be completed at patient inclusion and at the end of the protocol. The severity of behavioral disorders will be assessed using the DysEXecutive (DEX) questionnaire from the Behavioral Assessment of the Dysexecutive Syndrome (BADS). For anxiety, pain, and/or sleep disorders, the following questionnaires will be used: the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory, the Pittsburgh Sleep Quality Index (PSQI), and the Medical Outcome Study Short Form (SF-36) for quality of life.
For the hypnosis protocol (experimental group), 8 individual sessions will be offered to the patient, each lasting about one hour and spread over a period of 4 months (one hypnosis session every two weeks). The sessions will proceed as follows:
* In the first session, a history will be taken to gather the patient's request or issue for which they were referred for hypnosis, and specific goals will be established. An explanation of hypnosis will also be provided.
* The second session will offer a "safe haven" hypnosis, where the patient revisits a happy moment to find calm and a secure place.
* In the third session, a "red balloon" hypnosis will be offered, using a metaphor where the patient releases bothersome emotions.
* The fourth session will focus on sleep (hypnotic metaphor for sleep induction).
* The fifth session will use "object-tool" hypnosis, where the patient works on a specific issue represented metaphorically by an object and enhances it with tools that can modify it.
* The sixth session will introduce self-hypnosis training for the patient.
* The final two sessions will be personalized and address the patient's current needs.
At the end of each session, patients will be asked to complete a visual analog scale (VAS) to measure their level of absorption in the hypnosis.
Note that, except for the first two sessions, the order of the sessions may be slightly adjusted based on the patient's needs or requests. Patients in the control group will also complete the same questionnaires at inclusion and after 4 months.
During the 4-month period, all patients, from both the hypnosis and control groups, will continue to receive multidisciplinary rehabilitation care. Furthermore, the hypnosis sessions will replace one neuropsychology session each time so that both groups (control vs. hypnosis) receive the same number of sessions over the period. Finally, data will be analyzed for patients who have completed at least 80% of the prescribed hypnosis sessions.