Les directives anticipées comme outil de communication dans le dialogue sur la fin de vie et la mort entre le médecin généraliste et ses patients : enquête qualitative auprès de 16 médecins généralistes de Gironde

Abstract : Introduction: in February 2016, an evolution of the 22nd April 2005 Leonetti law has been passed on the rights of terminally-ill patients. One of the articles calls on the attending doctor advises his patients of the possibility to prepare advance directives regarding end-of-life. In the meantime the HAS published a guide for the healthcare professionals. This guide acknowledges that advance directives are helping to open the communication about end-of-life. The goal of this survey was to appraise if these if these advance directives could be used by the treating doctors as a tool to ease the talk about end-of-life conditions of their patients. Method: as a part of a qualitative survey, semi-directed interviews have been done with 16 general practitioners in Gironde between June and August 2017. Results: many hindrance hamper dialogue about end-of-life between the practitioner and his patient. Most of the doctors are in favor of the use of advances directives as a communication tool to avoid these obstacles, among other things, to open a dialogue, bring content to the discussion or at least get the patient state of mind. Doctors feel legit to offer this tool thanks to the trustworthy relationship they share with their patients. It seems that doctors more recently trained are more capable of using it than older ones who think they know better about their patients will. They all agree to say that advance directives are an excellent communication tool to use with the families. Conclusion: communication skills seem essential in an end-of-life situation, which is why we recommend to introduce a training in medical communication made by communication experts in the curriculum of medical studies. Despite the complexity of this tool and a lack of formation and information, advance directives should not been presented as an achievement of the written whishes but we advise to consider them as the introduction of a dialogue in order to receive a state of mind in regard to the end-of-life question.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01665565
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Saturday, December 16, 2017 - 11:57:11 AM
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Pierre Laborde. Les directives anticipées comme outil de communication dans le dialogue sur la fin de vie et la mort entre le médecin généraliste et ses patients : enquête qualitative auprès de 16 médecins généralistes de Gironde. Médecine humaine et pathologie. 2017. ⟨dumas-01665565⟩

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