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Master Thesis

Souhaits de la personne malade en situation palliative à domicile concernant les discussions anticipées sur le lieu de son décès

Abstract : Abstract : wishes of the sick person in palliative situation at home regarding to the discussions about the place of death. Background and aim: Most French people’s wish is to die at home, but few of them fulfill their will. The patient expression of his will concerning the place of his death promotes the congruence between preferred and actual place of death, but doctors rarely know about these wishes. The aim of this study is to value how a person in home palliative situation considers approaching his end of life and place of death with their general practitioner (GP). Method: a qualitative study was carried out by individual semi-directed interviews in the home of people suffering from an incurable pathology with a prognosis between 4 weeks and 2 years. Results: 15 interviews were conducted from May to July 2018. Most interviewed person want to die at home, close to the family, but the need to preserve them and to be accompanied seems to be more important. They expect the GP to show interest and to approach end-of-life and place of death with availability, listening, and goodwill. The emergence of three profiles (paternalistic, autonomist and intermediate) illustrates the way in which they consider these discussions with their GP. Discussions and Perspectives: the diversity of the interviewees wishes asks the GP to adapt the doctor-patient relationship to each "profile" in order to reach a therapeutic alliance. Beyond better training and recognition of spent time, a dedicated consultation could allow the GP to create favorable conditions to give the patient an opportunity to approach this sensitive subject, and to respect his wishes.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02513270
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Amaia Bidart. Souhaits de la personne malade en situation palliative à domicile concernant les discussions anticipées sur le lieu de son décès. Médecine humaine et pathologie. 2019. ⟨dumas-02513270⟩

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