Book Description
Contexte : Depuis quelques années, la France a vu émerger de nouvelles lois, des recommandations, sur les soins palliatifs et la Démarche palliative est en plein essor dans les pratiques médicales actuelles. Le médecin généraliste est le pilier de la prise en charge de la fin de vie à domicile. Objectif : Ce travail a pour but de dégager des idées directrices sur la perception et les connaissances de la Démarche palliative par les médecins généralistes. Méthodes : Un questionnaire qualitatif a été adressé à 76 médecins généralistes enseignants ou maîtres de stage attachés à la Faculté Libre de Médecine de Lille, installés dans les départements du Nord et du Pas-de-Calais. Résultats : La définition exacte des soins palliatifs est peu connue des médecins. 100% des répondeurs ont une expérience des soins palliatifs à domicile. Les patients pris en charge étaient principalement suivis en oncologie, ou des personnes âgées, ou des patients poly-pathologiques. Face aux nombreuses difficultés rencontrées, les médecins privilégient la pluridisciplinarité, le conseil de praticiens expérimentés, et le recours à la créativité. Les médecins estiment que les conditions de prise en charge de fin de vie à domicile sont satisfaisantes. Celle-ci nécessite des aides humaines, voire techniques apportées souvent par l’hospitalisation à domicile. Le lieu le plus approprié pour la pratique des soins palliatifs est le lieu choisi par le patient, le domicile en phase ultime. Les médecins ont reçu des informations sur le thème des soins palliatifs, peu provenaient de leurs études médicales théoriques. Les références officielles sont moyennement connues des médecins généralistes. Le mouvement des soins palliatifs a permis d’optimiser la relation médecin - malade. Conclusions : Les médecins généralistes doivent s’approprier la Démarche palliative. Trois conditions sont nécessaires pour qu’ils puissent vraiment se l’approprier en pratique: volonté d’accompagner la fin de vie de son patient, participer à des formations en soins palliatifs, s’entourer de partenaires efficaces comme l’hospitalisation à domicile.
Book Description
Contexte : La HAS, sur la base de données scientifiques, cherche à promouvoir l'instauration précoce de soins palliatifs. Dans l'agglomération dunkerquoise, elle est perçue comme tardive par les acteurs du réseau de santé AMAVI. A partir de ce constat, ces derniers ont mis à disposition de médecins généralistes un outil facilitant l'identification des patients nécessitant une démarche palliative. Deux ans après sa diffusion, AMAVI a observé une sous-utilisation de cet outil par les médecins contactés. Quelle est l'opinion des médecins généralistes de l'agglomération dunkerquoise concernant la pertinence de l'utilisation de l'outil élaboré par AMAVI ? Méthode : Une analyse qualitative a été menée d'avril à juin 2021, basée sur quinze entretiens individuels semi-dirigés, réalisés jusqu'à suffisance des données, auprès de médecins généralistes installés dans l'agglomération dunkerquoise. Après retranscription puis codage avec triangulation, une analyse inductive à visée phénoménologique, inspirée de la théorisation ancrée a été effectuée à l'aide du logiciel NVivo QSR 12®. Résultats : L'utilisation de l'outil ne correspondrait pas aux principes d'une bonne démarche palliative selon les participants. Les médecins réussiraient, grâce à leur intuition, à repérer une situation palliative sans utiliser d'outil. Ils éprouvaient des difficultés à comprendre la pertinence de la question surprise. Un score leur semblait inadapté pour apprécier un besoin de soins palliatifs. Les médecins souhaitaient analyser des éléments contextuels, plutôt que par une approche biomédicale. Néanmoins, ils pourraient adapter l'utilisation de l'outil et le rendre compatible avec leur pratique. L'outil pourrait mesurer l'évolution de la situation des patients. Il aiderait à justifier une décision. Il pourrait servir à communiquer entre soignants et avec le patient. Le retard d'initiation constaté par AMAVI ne serait pas uniquement lié à un défaut d'identification. D'autres solutions que la diffusion de l'outil ont été suggérées pour favoriser l'anticipation des soins palliatifs au niveau local. Conclusion : L'analyse révèle des réserves de la part des médecins vis à vis de l'outil d'AMAVI, sans constater de refus d'utilisation de leur part. Des pistes d'amélioration des pratiques ont pu être identifiées, afin de mieux anticiper les soins palliatifs. D'autres travaux sont nécessaires pour évaluer leur impact.
Author: Nathan I. Cherny Publisher: Oxford University Press, USA ISBN: 0199656096 Category : Medical Languages : en Pages : 1281
Book Description
Emphasising the multi-disciplinary nature of palliative care the fourth edition of this text also looks at the individual professional roles that contribute to the best-quality palliative care.
Author: Richard Hain Publisher: Oxford University Press ISBN: 019882131X Category : Medical Languages : en Pages : 535
Book Description
The importance of palliative care for children facing life threatening illness and their families is now widely acknowledged as an essential part of care, which should be available to all children and families, throughout the child's illness and at the end of life. The new edition of the Oxford Textbook of Palliative Care for Children brings together the most up to date information, current knowledge, evidence, and developments of clinical practice in the field. The book is structured into four sections. 'Foundations of Care' describes core issues, the foundations on which paediatric palliative care is based. 'Child and Family Care' looks at different aspects of psychological, social, and cultural care for the sick child or young person, and their family. These chapters cover the time course of the illness, around the time of death and support for the bereaved family. 'Symptom Care' focuses on the uses of medication, specific symptoms, and their management. Finally, 'Delivery of Care' examines practical approaches to care in different environments and the needs of clinicians. Two new editors join the team from Canada and South Africa, reflecting our aims to contribute towards the development of care for children across the world, and to be a resource for both experienced clinicians and those new to the field. Comprehensive in scope, exhaustive in detail, and definitive in authority, this third edition has been thoroughly updated to cover new practices, current epidemiological data, and the evolving models that support the delivery of palliative medicine to children. This includes two new chapters, looking in detail at 'Decision Making' and 'Perinatal Care', and a new section highlighting the emerging importance of 'Palliative Care for Children in Humanitarian Crises'. This book is an essential resource for anyone who works with children worldwide.
Author: Christophe Monnot Publisher: Springer ISBN: 3319772619 Category : Social Science Languages : en Pages : 229
Book Description
This volume describes and maps congregations of Christian confessions and denominations, as well as groups with Jewish, Buddhist, Muslim, Hindu, and various other spiritual faiths, in different European countries. Consisting of three parts, it presents concrete sociological studies addressing how established and not established, old and new congregations of various faiths create a new kind of religious diversity at the country level; how religious congregations are challenged and thrive in large cities; and how religious congregations change in the 21st century. The book enlightens by its descriptive analysis and the theoretical questions it raises concerning the religious transformations happening all over Europe. It addresses issues of religious diversity in the cities of Europe by presenting large studies conducted in cities such as Barcelona in Spain, and Aarhus in Denmark. By means of large-scale censuses taken in areas such as North Rhine-Westphalia in Germany and in countries like Switzerland and Italy, the book shows how the historically established churches restructure their congregations and activities. It clarifies for the new gatherers where and how a new diversity of religious congregations is in the process of being established. Finally, the book covers two important topical issues: pluralisation and secularisation. It provides new data on religious diversity, painting a new picture of secularisation: the impact and structural consequences of the long-term decrease of membership in the established churches.
Author: Roberto Cipriani Publisher: Springer ISBN: 3319578944 Category : Social Science Languages : en Pages : 278
Book Description
This book explores the concept of diffused religion as it is found in contemporary society, resulting from a vast process of religious socialisation that continues to pervade our cultural reality. It provides a critical engagement with a framework of non-institutional religion that is based on values largely shared in society by being diffused through primary and secondary socialisation. Cipriani also contends that these very values which give form to diffused religion can also be seen in themselves as their own kind of religion. As a result, they go beyond secularisation and favour the religious continuum extending around the world of diffused religions. This work will be of great interest to scholars in the Sociology of Religion and to anyone wanting to learn more about the social aspects of religion.
Author: Karline McLain Publisher: Indiana University Press ISBN: 0253220521 Category : Language Arts & Disciplines Languages : en Pages : 265
Book Description
Combining entertainment and education, India's most beloved comic book series, Amar Chitra Katha, or "Immortal Picture Stories," is also an important cultural institution that has helped define, for several generations of readers, what it means to be Hindu and Indian. Karline McLain worked in the ACK production offices and had many conversations with Anant Pai, founder and publisher, and with artists, writers, and readers about why the comics are so popular and what messages they convey. In this intriguing study, she explores the making of the comic books and the kinds of editorial and ideological choices that go into their production.
Author: Justin Amery Publisher: ISBN: 0199567964 Category : Family & Relationships Languages : en Pages : 448
Book Description
Childen's palliative care has developed rapidly as a discipline, as health care professionals recognize that the principles of adult palliative care may not always be applicable to children at the end of life. The unique needs of dying children are particularly evident across Africa, where the scale of the problem is overwhelming, and the figures so enormous that they are barely comprehensible: over 400,000 children in Africa died from AIDS in 2003, and out of the 166,000 children a year diagnosed with cancer, 85% of these are in the developing world. Despite the enormous need, provision of children's palliative care in Africa is almost non-existent, with very few health workers trained and confident to provide care for dying children. The challenges of providing palliative care in this setting are different to those in more developed countries, contending with the shortage of physical and human resources in addition to the vast scope of the care needed. Written by a group with wide experience of caring for dying children in Africa, this book provides practical, realistic guidance by improving access to, and delivery of, palliative care in this demanding setting. It looks at the themes common to palliative care--including communication, assessment, symptom management, psychosocial issues, ethical dilemmas, end of life care, and tips for the professional on compassion and conservation of energy--but always retains the focus on the particular needs of the health care professional in Africa. While containing some theory, the emphasis is on practical action throughout the book. Children's Palliative Care in Africa provides health care professionals working in Africa, and other resource-poor settings, with the confidence, knowledge, and capacity to improve care for the terminally ill child in constrained and demanding environments.
Author: Hugh MacPherson (Ph. D.) Publisher: ISBN: 9780443050497 Category : Medical Languages : en Pages : 482
Book Description
Written by THE leading lights in the field of integrating acupuncture into a Western medical system, this book bridges the gap between the theoretical foundations of acupuncture and its application in a modern Western clinical context. Each case history focuses on the complexities and dilemmas of treatment that are tackled, providing valuable insights by experienced practitioners into the management of a course of acupuncture treatment.
Author: Claudine Lavalard-Jaud
Author: Céline Dyl
Author: Baptiste Desoutter
Author: Nathan I. Cherny
Author: Richard Hain
Author: Christophe Monnot
Author: Roberto Cipriani
Author: Karline McLain
Author: Justin Amery
Author: Hugh MacPherson (Ph. D.)