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Master Thesis

Quels sont les facteurs freinateurs à la réalisation des directives anticipées pour la communauté depuis la loi Claeys-Leonetti ? Une analyse thématique basée sur une revue de la littérature grise

Abstract : Anticipated directives correspond to a written document comprising medical care instructions in the event that his writer is no longer able to express them. This system was updated by the Claeys-Leonetti law in February 2016. Only few French patients have written their anticipated guidelines. What are or could be the factors hindering the achievement of AD since the Claeys-Leonetti law ? Method : a literature review was carried out on documents published between the 1st of January 2016 and the 31st of December 2017 using the adapted PRISMA guide. The web search engine Google scholar was used as it indexes a wide array of literature sources which were congruent with our research. Search equation was “anticipated directive” and “community” and “ethics”., exclusion criteria were (i) published before the 1st of January 2016, (ii) no reference to the French law, (iii) anticipated directives were not the main topics, (iv) the community was not mentioned, (v) ethics was not mentioned. Inclusion criteria corresponded to the identification of hindering factors for the achievement of ADs. Documents were compiled in thematic and hermeneutic analyses. These analyses led to the conception of a heuristic scheme depicting identified concepts via double blind coding followed by a comparison between axial codes. Results :139 documents were found, 13 corresponded to duplicate copies and were deleted, 19 were not excluded, 16 were included in the thematic analyses (3 finally not included) and comprised 6 book extracts, one book, one study report, 5 publications, a dissertation and a thesis manuscript. 100 axial codes were identified and grouped into 19 sub-themes divided into 11 main themes: Individual sphere, care sphere, communication, temporality, opposability, interpretation, elaboration, psychic and spirituality, law and society. Conclusion : the main obstacle is the opposability character of the ADs. Many other limiting factors exist and can be legal, ethical, sociological, and practical. They concern all actors implied in the anticipated guidelines, from the individual to the public sphere. Education of health professionals about ADs should be promoted. Research protocols to facilitate access, feasibility and relevance of ADs constitute the perspectives of this work.
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Master Thesis
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Submitted on : Tuesday, September 7, 2021 - 9:57:44 AM
Last modification on : Monday, October 11, 2021 - 2:23:10 PM

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Marine Zambonino. Quels sont les facteurs freinateurs à la réalisation des directives anticipées pour la communauté depuis la loi Claeys-Leonetti ? Une analyse thématique basée sur une revue de la littérature grise. Sciences du Vivant [q-bio]. 2019. ⟨dumas-03336251⟩

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