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Book Description
Objectifs : L'objectif de cette étude est de déterminer les critères discriminants de faisabilité du retour à domicile des patients en soins palliatifs. Le réseau ville-hôpital OÏKIA a expérimenté une liste de 10 critères de faisabilité. Méthodes : L'étude a permis d'analyser 293 dossiers du 01/07/2003 au 30/09/2004 ; elle a retrouvé 77 patients pour lesquels le retour à domicile a été réfuté par la coordination du réseau, et 14 patients réhospitalisés précocement dans les 15 jours suivant la sortie de l'hôpital, mettant en cause l'évaluation de la faisabilité du retour à domicile. Résultats : Les résultats montrent 6 critères discriminants : l'accord des soignants sur le projet de soin du patient, l'accord du patient et/ou de sa famille, la composition d'une équipe pluridisciplinaire, le contrôle des symptômes, la continuité des soins, l'organisation de la réunion de coordination avant la sortie. L'expérience du réseau OÏKIA comparée à la revue de la littérature, démontre l'importance de critères complémentaires tels que la bonne rédaction des ordonnances et des courriers de sortie, la mise en place d'un projet social dès l'hospitalisation, et l'apport du cahier de liaison. Conclusion : L'étude des critères de faisabilité et l'expérience clinique en soins palliatifs, rendent indispensables l'anticipation et l'organisation du retour à domicile des patients, éléments essentiels de la qualité des soins, dans le respect de la volonté du patient et de sa famille.
Book Description
Objectifs : L'objectif de cette étude est de déterminer les critères discriminants de faisabilité du retour à domicile des patients en soins palliatifs. Le réseau ville-hôpital OÏKIA a expérimenté une liste de 10 critères de faisabilité. Méthodes : L'étude a permis d'analyser 293 dossiers du 01/07/2003 au 30/09/2004 ; elle a retrouvé 77 patients pour lesquels le retour à domicile a été réfuté par la coordination du réseau, et 14 patients réhospitalisés précocement dans les 15 jours suivant la sortie de l'hôpital, mettant en cause l'évaluation de la faisabilité du retour à domicile. Résultats : Les résultats montrent 6 critères discriminants : l'accord des soignants sur le projet de soin du patient, l'accord du patient et/ou de sa famille, la composition d'une équipe pluridisciplinaire, le contrôle des symptômes, la continuité des soins, l'organisation de la réunion de coordination avant la sortie. L'expérience du réseau OÏKIA comparée à la revue de la littérature, démontre l'importance de critères complémentaires tels que la bonne rédaction des ordonnances et des courriers de sortie, la mise en place d'un projet social dès l'hospitalisation, et l'apport du cahier de liaison. Conclusion : L'étude des critères de faisabilité et l'expérience clinique en soins palliatifs, rendent indispensables l'anticipation et l'organisation du retour à domicile des patients, éléments essentiels de la qualité des soins, dans le respect de la volonté du patient et de sa famille.
Book Description
Les unités de soins palliatifs prennent en charge des patients qui présentent des maladies graves et évolutives, en phase avancée voire terminale. La plupart des patients admis décèdent dans le service, toutefois le retour à domicile n'est pas exclu pour ceux dont les symptômes restent peu évolutifs. Le retour à domicile en fin de vie est particulièrement difficile à mettre en place ; ainsi, nous avons voulu chercher quels pouvaient être ses facteurs de réussite. Nous avons réalisé une étude rétrospective incluant tous les patients rentrés à domicile (n=26) après une hospitalisation en unité de soins palliatifs entre janvier 2005 et décembre 2006, en analysant leur caractéristiques cliniques et leurs conditions socio-environnementales, puis nous avons utilisé un questionnaire, destiné à connaître l'évolution des patients, auprès des intervenants du domicile (coordinations de soins palliatifs et médecins traitants). Nous avons défini nos critères de réussite en fonction de la durée de vie suivant la sortie, de l'absence de ré-hospitalisation en urgence et de l'absence d'épuisement familial. Notre analyse retrouve 18 retours réussis contre 8 échecs. Certains facteurs sociaux et environnementaux sont primordiaux pour la qualité et la réussite du retour à domicile : en particulier la présence d'un entourage familial dense et volontaire, avec conjoint et enfant(s) et le suivi du patient et de sa famille par une coordination de soins palliatifs. En revanche, le secteur de résidence (urbain ou rural et semi-rural) et la durée moyenne de séjour dans l'unité de soins palliatifs ne semblent pas avoir d'influence sur la réussite d'un retour à domicile. Cette enquête montre donc qu'un retour à domicile après une hospitalisation en soins palliatifs est actuellement possible mais nécessite de bien prendre en compte ces facteurs prédictifs afin de minimiser le risque d'échec.
Author: World Health Organization Publisher: World Health Organization ISBN: 9241547006 Category : Health & Fitness Languages : en Pages : 284
Book Description
Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
Author: Richard Donnelly Publisher: John Wiley & Sons ISBN: 1444312405 Category : Medical Languages : en Pages : 117
Book Description
Structural and functional abnormalities of arteries and veinsmanifest clinically in a broad spectrum of disorders, includinganeurysmal disease, atherosclerosis, vasculitis, venousinsufficiency, microvascular complications, thrombo-embolism andlower limb ulceration. Many of these are common and/orchronic conditions which present for initial assessment by primaryhealth care workers. This new edition is a practical guide to the most commonlypresenting disorders, and provides a structured approach toclinical assessment, investigations and management. The lastfew years have seen major changes in the use of non-invasive orminimally-invasive techniques, e.g wider use of CT and MRangiography, and increasing use of percutaneous interventions forcarotid, lower limb and reno-vascular disease. The ABC of Arterial and Venous Disease (Second Edition)explains the underlying technology and the applications of newminimally-invasive methods, especially CT and MRI, and provides anup-dated, evidence-based guide to the modern day management ofpatients with common, life-threatening diseases involving differentparts of the circulation. This authoritative, full-colour, illustrated ABC is anideal reference for the primary care, non-specialist practitionerto base effective management and prevention programmes.
Author: Irene Papanicolas Publisher: McGraw-Hill Education (UK) ISBN: 033524727X Category : Medical Languages : en Pages : 418
Book Description
International comparison of health system performance has become increasingly popular, made possible by the rapidly expanding availability of health data. It has become one of the most important levers for prompting health system reform. Yet, as the demand for transparency and accountability in healthcare increases, so too does the need to compare data from different health systems both accurately and meaningfully. This timely and authoritative book offers an important summary of the current developments in health system performance comparison. It summarises the current state of efforts to compare systems, and identifies and explores the practical and conceptual challenges that occur. It discusses data and methodological challenges, as well as broader issues such as the interface between evidence and practice. The book draws out the priorities for future work on performance comparison, in the development of data sources and measurement instruments, analytic methodology, and assessment of evidence on performance. It concludes by presenting the key lessons and future priorities, and in doing so offers a rich source of material for policy-makers, their analytic advisors, international agencies, academics and students of health systems.
Author: Alice Villalobos Publisher: John Wiley & Sons ISBN: 0470344075 Category : Medical Languages : en Pages : 402
Book Description
Half the population of dogs and cats aged 10 and over will die of neoplasia. The bonds that clients have developed with their older pets are especially strong and drive the increasing demand for more proficient and highly compassionate medical treatment of companion animals diagnosed with cancer. This book offers more than just a competent clinical approach to the most common tumors in dogs and cats. This book also offers a focus on the special needs of geriatric pets and their owners. Amply illustrated with dozens of case studies representative of those regularly encountered in practice, Canine and Feline Geriatric Oncology will provide readers with the tools needed to diagnose and treat aging pets with cancer, and to help clients make the best decisions for themselves and for the animals with whom they share their lives. Canine and Feline Geriatric Oncology is a unique resource. It is a useful oncology reference for specialists, veterinarians in general practice, veterinary technicians, and clinic staff. The many "what ifs" that the practitioner inevitably faces in interactions with clients and their aging pets with cancer are presented and discussed. Special Features: * Focuses on the special needs of geriatric pets and their caregivers; * Offers direction in the diagnosis and treatment of aging pets with cancer; * Addresses many of the "what ifs" that arise in interactions with clients and aging pets with cancer; * Amply illustrated with full color throughout; * A valuable reference for practicing veterinarians, technicians, hospital staff, and professionals involved in supportive counseling for pet caregivers.
Author: Gary Francione Publisher: Temple University Press ISBN: 1439905126 Category : Law Languages : en Pages : 276
Book Description
Argues that the way humans treat animals results from the contradiction between the ideas that animals have some rights, but that they are also property, and offers ways to resolve the conflict.
Author: World Health Organization Publisher: ISBN: 9789241548120 Category : Medical Languages : en Pages : 166
Book Description
These guidelines have been developed to support countries to relieve pain in their paediatric populations. These guidelines address persisting pain in children caused by conditions such as cancer, HIV/AIDS, sickle-cell disease, burns, trauma, and phantom limb pain. Recommendations -- developed following a careful and transparent appraisal of available evidence -- are presented for the pharmacological treatment of mild, moderate and severe pain. The guidelines include chapters on the various systems used to classify pain and on the evaluation of pain, which reviews the available tools for routine pain measurement in children. Provision of sustainable pain relief within health care systems is covered in a separate chapter. Since morphine and other opioid analgesics -- required for the relief of moderate-to-severe pain in children -- are listed under the 1961 UN Single Convention on Narcotic Drugs, the new guidelines include an annex explaining the Convention's requirements for the handling and procurement of opioid analgesics for the relief of pain.
Author: World Health Organization Publisher: World Health Organization ISBN: 9789241544825 Category : Analgesia Languages : en Pages : 74
Book Description
The second edition of a guide, which introduced a simple, yet highly effective method for the relief of cancer pain. Thoroughly revised and updated, the new edition further refines the WHO method, which advocates the use of a small number of relatively inexpensive drugs, including morphine. Revisions draw on experiences with millions of patients around the world as well as new knowledge about the specific pain syndromes unique to cancer. Completely new are chapters describing the international system by which morphine and other opioids are made available for medical purposes. The book has two parts. Part one provides a practical guide to the relief of cancer pain, concentrating on drug treatment as the mainstay of pain management. The most extensive section sets out detailed guidelines for the selection and prescribing of non-opioid analgesics, opioid analgesics, drugs for neuropathic pain, and adjuvant drugs for the treatment of adverse effects, the enhancement of pain relief and the management of concomitant psychological disturbances. Information ranges from explanations of how specific drugs work, through the precautions to take in the presence of certain disorders, to a list of factors that influence the effectiveness of opioids. Concerning the use of opioids, readers are reminded that psychological dependence does not occur in cancer patients and that the only correct dose of morphine is the one that relieves the pain. Part two provides a guide to opioid availability. A discussion of the reasons why opioids continue to be underprescribed or difficult to obtain is followed by an explanation of the Single Convention on Narcotic Drugs.
Author: Amandine Roux
Author: Amandine Roux
Author: Sylvia Guiliano
Author: World Health Organization
Author: Richard Donnelly
Author: Irene Papanicolas
Author: Alice Villalobos
Author: Gary Francione
Author: R. V. G. Clarke
Author: World Health Organization
Author: World Health Organization