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Master Thesis

Pallia-10, un outil de repérage des situations palliatives en UHCD : enquête préliminaire prospective pendant six semaines consécutives

Abstract : Emergency departments are often confronted with end-of-life situations. Early initiation of palliative care to patients in need improves their quality of life and has an impact of increasing hospital cost by reducing the length of hospital stay and avoiding possible unnecessary hospital readmissions. The Pallia 10 questionnaire is a decision-making tool to identify when the use of a palliative care team can be useful. This prospective observational study was performed at the university hospital center in Bordeaux for six consecutive weeks. Pallia 10 has been systematically applied to all patients hospitalized at the unit of short-stay observation. The data was entered on Excel and then analyzed. The main objective is to identify the number of patients requiring an evaluation by the PMSC and the secondary objectives are to raise the frequency of each item, to determine the minimum number of significant positive items and to raise the medical support and the orientation proposed. Among 456 patients, 50% presented with "a disease that will not cure in the current state of knowledge". Of these, 130 patients had at least 3 positive items, the threshold proposed for PMSC. However, only 24 of 130 patients actually benefited from palliative care. 4 items are more frequent than the others. The threshold of 3 items positive for the call to the PMSC appears significant. This original study shows that Pallia 10 is applicable to emergencies. Many patients in the emergency department are in a palliative situation and require an evaluation by the PMSC. Pallia 10 makes it possible to identify complex situations where several problems arise, in particular of an ethical nature. It appears that the patients followed for evolved or even terminal chronic pathologies such as cardiac or respiratory insufficiency but also dementia, relate to palliative care. Emergency screening identifies a key moment in the transition from healing to the palliative. The establishment of palliative care in the emergencies is an opportunity to adapt the care plan of these patients followed for chronic pathologies. The Pallia 10 is the ideal screening tool. It seems interesting to promote the Pallia 10 questionnaire in the emergencies. We propose two perspectives: the implementation of a multicenter interventional study to study and validate the Pallia 10 as a screening tool, and the study of a simplified Pallia 10 questionnaire for a simplified emergency screening.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01421726
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, December 22, 2016 - 5:17:16 PM
Last modification on : Wednesday, August 23, 2017 - 4:32:21 PM
Long-term archiving on: : Monday, March 20, 2017 - 8:53:41 PM

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Pamini Panharen. Pallia-10, un outil de repérage des situations palliatives en UHCD : enquête préliminaire prospective pendant six semaines consécutives. Médecine humaine et pathologie. 2016. ⟨dumas-01421726⟩

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