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Master Thesis

Évaluation de l’implication du médecin généraliste dans la prise de décision d’entrée en soins palliatifs lors d’une hospitalisation

Abstract : Introduction: Every day decisions to limit and/or forgo active treatment are being made in medical institutions. Yet, at the same time, the role of family practitioners has expanded considerably to the point of becoming the cornerstone of our health care system. Methodology: An anonymous, unpaid, internet survey of 87 family practitioners of the Isere district was organized. The main aim of the study was to assess the role played by these practitioners in the decision to limit and/or forgo active care for patients who had been admitted to hospital. A secondary objective was to gauge how eager these practitioners were to be involved in this collegial decision process and to identify key factors which might both facilitate their involvement as well as their communication with hospital staff. Findings: Family practitioners are rarely involved in the decision-making process pertaining to the end-of-life of their patients. 28% were kept informed of the decisions taken by the hospital staff but only 17% were associated to the decision itself. Yet, on average, these doctors have 1,25 patients who have been admitted to palliative care units and 70% believe that their involvement in the decision to forgo treatment is essential. For 83% of these practitioners, this simply means being consulted by the hospital and, for 55% of them, being recognized for the role they play in caring for these patients. The majority of doctors surveyed consider that direct and interactive modes of communication, such as face-to-face meetings and telephone calls, should be prefered. Even if 90% acknowledge that channels of communication between family practice and hospital do exist, it appears that the quality of these exchanges can nevertheless be improved. Conclusions: This study has shown that there is a discrepancy between the family doctors’ desire to be involved and the part that they can indeed play in determining how the end-of-life of their patients should be approached. Simple solutions, such as improved communication, anticipation and training, could easily be implemented. The work done in this thesis might profitably be supplemented by another study focusing on the way the hospital staff perceives the role played by family practitioners in end-of-life decisions.
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Master Thesis
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Submitted on : Friday, October 17, 2014 - 4:56:31 PM
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Aurélie Nicourt. Évaluation de l’implication du médecin généraliste dans la prise de décision d’entrée en soins palliatifs lors d’une hospitalisation. Médecine humaine et pathologie. 2014. ⟨dumas-01075483⟩



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