Résumé
Objectives: to describe the experiences, needs and expectations regarding their care of 20 subjects with chronic illnesses in a vulnerable situation, prior to their participation in the EFFICHRONIC project, which evaluates the effectiveness of the health education programme ‘Healthy Living with Chronic Illness’ (Chronic Disease Self-Management Programme). Describe how they feel about their participation and the impact on their daily lives at the end of the programme, after 6 months. Methodology: qualitative, prospective study conducted in the form of semi-directive interviews with a semiopragmatic analysis. Triangulation of verbatim. Results: these patients suffered from a transformation of their previous life (loss of identity, physical and financial dependence, changed relationships with others) with difficulties in rebuilding themselves and accessing appropriate care. The commitment of the programme participants (linked to learning, the peer group, the caregiver-patient facilitators, the location, etc.) can lead to a feeling of self-efficacy or even empowerment. The limitations to maintaining this are the absence of medical follow-up, geographical and social isolation, the onset of a complication of the disease, the need for support and for further study of certain concepts. Conclusion: the programme enables participants to become ‘self-managers’ of their health. They want to perpetuate the effects through individualised cross-sectoral support and by participating in targeted ETP workshops.