Évaluation de la pratique pneumologique des soins palliatifs chez les patients suivis pour une bronchopneumopathie chronique obstructive

Abstract : Introduction: the Numerous studies on poor communication and altered quality of life of chronic obstuction pulmonary disease (COPD) patient, leads to the conclusion that overall palliative management of COPD remains to be improved. The aim of this study was to describe the pulmonologist’s practice of palliative care in order to understand the obstacles to a palliative approach of COPD patients. Material and method: an informatic survey was sent to all the pulmonologists whose email appeared in the 2017, french society of pulmonology’s directory. Results: 287 responses were obtained. 81.88% of pulmonologists say that they distinguish a palliative phase from “sometimes to often” for COPD patient. The first reason given (68.77%) was the difficulty of defining when to start palliative care. Aspects of the palliative approach wich is the most problematic for pulmonologists is the discussion of death conditions, and the impression that the COPD patient has a low demand for information. Half of the pulmonologists inform about resuscitation, and the proposal for advance directives for only 20% of their patients for whom they would not be "surprised if he dies" during the year. Conclusion: the uncertainty of when to begin the palliative approach in the COPD patient and the communication appear to be the main obstacles to an optimal palliative approach.
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Master Thesis
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Amaïa David. Évaluation de la pratique pneumologique des soins palliatifs chez les patients suivis pour une bronchopneumopathie chronique obstructive. Médecine humaine et pathologie. 2018. ⟨dumas-01845269v2⟩

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