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Master Thesis

La place du médecin traitant (MT) dans la limitation de soins

Abstract : Introduction: WHLS are important decisions supervised by medical boards and the law. The debate of the end of life is complex and questions the role of the GP. Methods: analytical, epidemiological, observational, quantitative, and single centre type of study. Data collection of end-of-life decisions took place between August 2012 and September 2014. Selected GP were questioned by means of a questionnaire from December 2014 till June 2015. The main objective of the study was to determine the prevalence of the general practitioner consultation in the determination of limitation of life support within the framework of a hospital project that evaluate increasing therapeutic care within Gabriel Martin's hospital centre (Saint-Paul, Reunion). The secondary goal consisted in determining the knowledge and the use of the anticipated directives, the surrogate decision maker but also in estimating the traceability of these decisions. Results: 56 GP, 48 % rate answer. The study founds GP got approach, in the determination of a limitation support, in 21 % of the cases. In 9 % of the cases, the family practitioner actually participated in the discussion. In 64 % of the cases, the questioned family doctors have no knowledge of the anticipated directives of their patient. On the contrary, in 61 % of the cases, a surrogate decision maker is known and noted in their medical record. GP did not keep in writing the decision of limitation fixed at the time of the study because in 64 % of the cases, there is no track of this decision in their patient case. Conclusion: Real lack of agreement between GP and hospital. Simple solutions can be implemented: better communication between hospital and GP, training in palliative care, anticipated directives, tools like ETICS.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01261642
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Submitted on : Monday, January 25, 2016 - 4:24:39 PM
Last modification on : Wednesday, August 23, 2017 - 4:32:31 PM
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Émilie Bédani. La place du médecin traitant (MT) dans la limitation de soins. Médecine humaine et pathologie. 2015. ⟨dumas-01261642⟩

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