Rédaction des directives anticipées chez les patients vivant en EHPAD : évaluation et impact de la mise en place expérimentale de deux consultations dédiées

Abstract : Introduction: anyone of legal age can draft advance directives in the event that they are unable to express their wishes one day. On 31st December 2015, 585,560 people in France attend a nursing home for dependent elderly people (EHPAD). In 2018, according to a survey led by the National Palliative Care Center at the BVA institute, only 11% of people over the age of 50 declare that they have already « drafted » their advance directives. 58% of respondents do not know the device. The main objective of this study was to measure the impact of information on the advance directives and to assist in their drafting in a person living in a nursing home. Methods: a prospective, monocentric, before / after interventional study was performed in the EHPAD ward of Mauléon local hospital. It was ran from April 16, 2018 to July 15, 2018. The study was conducted during two consultations carried out by the EPHAD nursing staff (nurse, caregiver, psychologist, psychomotor therapist): a first consultation of information on the advance directives and a second one for an assistance in drafting them. Results: 31 residents were included. According to the Mc Nemar test, there is statistically significant difference between the proportion of advance directive drafting performed before (6.5%) and after (61.3%) the consultation protocol with a p value of 0.00011. No resident wanted to change their advance directives. 30 residents (96.8%) identified a trusted person after the study. Conclusion: to broach the advance directives in EHPADs, a protocol of two information and writing assistance consultations has increased the number of advance directives written by residents.
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Master Thesis
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Fabienne Lahargoue. Rédaction des directives anticipées chez les patients vivant en EHPAD : évaluation et impact de la mise en place expérimentale de deux consultations dédiées. Médecine humaine et pathologie. 2018. ⟨dumas-02064386⟩

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