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Master Thesis

Démarche clinique avant une sédation profonde continue maintenue jusqu’au décès : à propos de la souffrance réfractaire en phase terminale : expérience de médecins d'unité de soins palliatifs en nouvelle aquitaine en 2019-2020

Abstract : Motivation: following the publication of the Clayes Leonetti law of February 2, 2016, palliative care unit physicians (USP) must define suffering as refractory to initiate deep and continuous sedation maintained until death (SPCMJD). Objectives: observing the practices of USP doctors to define refractory suffering. Problematic: some patients, whose life prognosis is engaged in the short term, are presenting relieving difficulties for refractory suffering, Choice of methodology: a qualitative study was chosen by carrying out 16 semi-structured telephonic interviews. Main results: doctors assess refractory suffering in its multidimensional approach, use a multidisciplinary assessment, repeated interviews, and use a psychologist or psychiatrist in the face of a psychological or existential suffering. Conclusion and implications for the studied field: this study highlighted that the assessment of suffering in its multidimensional approach, multiprofessional assessment, carrying out repeated interviews, recourse to the psychologist or a psychiatrist in the face of an existential or psychological suffering) were applied by doctors in the USP, but not identified by the pratictioners themselves as a typical clinical approach. The recommendations might be raised following this study are to continue current practices in this direction, established in the USP, already issued by SFAP, and applied by doctors and their teams, to emphasize the importance of characterizing the terminal phase sometimes missing but compulsory within the legal framework of SPCMJD.
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https://dumas.ccsd.cnrs.fr/dumas-02972317
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, October 20, 2020 - 12:23:11 PM
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Baptiste Suzzoni. Démarche clinique avant une sédation profonde continue maintenue jusqu’au décès : à propos de la souffrance réfractaire en phase terminale : expérience de médecins d'unité de soins palliatifs en nouvelle aquitaine en 2019-2020. Médecine humaine et pathologie. 2020. ⟨dumas-02972317⟩

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