Publications et travaux de recherche
2023
Mathey, Lucas; Jacquier, Marine; Meunier-Beillard, Nicolas; Andreu, Pascal; Roudaut, Jean-Baptiste; Labruyère, Marie; Rigaud, Jean-Philippe; Quenot, Jean-Pierre; Ecarnot, Fiona
ICU stays that are judged to be non-beneficial: A qualitative study of the perception of nursing staff Article de journal
Dans: PLoS One, vol. 18, no. 8, p. e0289954, 2023.
Résumé | Liens | BibTeX | Étiquettes: Décision partagée, Organisation du système de santé
@article{Mathey2023,
title = {ICU stays that are judged to be non-beneficial: A qualitative study of the perception of nursing staff},
author = {Lucas Mathey and Marine Jacquier and Nicolas Meunier-Beillard and Pascal Andreu and Jean-Baptiste Roudaut and Marie Labruyère and Jean-Philippe Rigaud and Jean-Pierre Quenot and Fiona Ecarnot},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10414562/},
doi = {10.1371/journal.pone.0289954},
year = {2023},
date = {2023-08-10},
journal = {PLoS One},
volume = {18},
number = {8},
pages = {e0289954},
abstract = {Introduction: Non-beneficial stays in the intensive care unit (ICU) may have repercussions for patients and their families, but can also cause suffering among the nursing staff. We aimed explore the perceptions of nursing staff in the ICU about patient stays that are deemed to be "non-beneficial" for the patient, to identify areas amenable to intervention, with a view to improving how the nursing staff perceive the patient pathway before, during and after intensive care.
Methods: Multicentre, qualitative study using individual, semi-structured interviews. All qualified nurses and nurses' aides who were full-time employees in the ICU of three participating centres were invited to participate. Interviews were recorded, transcribed and analyzed using textual content analysis.
Results: A total of 21 interviews were performed from February 2020 to October 2021, at which point saturation was reached in the data. Average age of participants was 38.5±7.5 years, and they had an average of 10.7±7.4 years of experience working in the ICU. Four major themes emerged from the interviews, namely: (1) the work is oriented towards life-threatening emergencies, technical procedures and burdensome care; (2) a range of specific criteria and circumstances influence the decisions to admit patients to ICU; (3) there are significant organisational, physical and psychological repercussions associated with a non-beneficial stay in the ICU; (4) respondents made some proposals for improvements to the patient care pathway.
Conclusion: Nursing staff have a similar perception to physicians regarding admission decisions and non-beneficial ICU stays. The possibility of future ICU admission needs to be anticipated, discussed systematically with patients and integrated into healthcare goals that are consistent with the patient's wishes and preferences, in multi-professional collaboration including nursing and medical staff.},
keywords = {Décision partagée, Organisation du système de santé},
pubstate = {published},
tppubtype = {article}
}
Introduction: Non-beneficial stays in the intensive care unit (ICU) may have repercussions for patients and their families, but can also cause suffering among the nursing staff. We aimed explore the perceptions of nursing staff in the ICU about patient stays that are deemed to be "non-beneficial" for the patient, to identify areas amenable to intervention, with a view to improving how the nursing staff perceive the patient pathway before, during and after intensive care.
Methods: Multicentre, qualitative study using individual, semi-structured interviews. All qualified nurses and nurses' aides who were full-time employees in the ICU of three participating centres were invited to participate. Interviews were recorded, transcribed and analyzed using textual content analysis.
Results: A total of 21 interviews were performed from February 2020 to October 2021, at which point saturation was reached in the data. Average age of participants was 38.5±7.5 years, and they had an average of 10.7±7.4 years of experience working in the ICU. Four major themes emerged from the interviews, namely: (1) the work is oriented towards life-threatening emergencies, technical procedures and burdensome care; (2) a range of specific criteria and circumstances influence the decisions to admit patients to ICU; (3) there are significant organisational, physical and psychological repercussions associated with a non-beneficial stay in the ICU; (4) respondents made some proposals for improvements to the patient care pathway.
Conclusion: Nursing staff have a similar perception to physicians regarding admission decisions and non-beneficial ICU stays. The possibility of future ICU admission needs to be anticipated, discussed systematically with patients and integrated into healthcare goals that are consistent with the patient's wishes and preferences, in multi-professional collaboration including nursing and medical staff.
Methods: Multicentre, qualitative study using individual, semi-structured interviews. All qualified nurses and nurses' aides who were full-time employees in the ICU of three participating centres were invited to participate. Interviews were recorded, transcribed and analyzed using textual content analysis.
Results: A total of 21 interviews were performed from February 2020 to October 2021, at which point saturation was reached in the data. Average age of participants was 38.5±7.5 years, and they had an average of 10.7±7.4 years of experience working in the ICU. Four major themes emerged from the interviews, namely: (1) the work is oriented towards life-threatening emergencies, technical procedures and burdensome care; (2) a range of specific criteria and circumstances influence the decisions to admit patients to ICU; (3) there are significant organisational, physical and psychological repercussions associated with a non-beneficial stay in the ICU; (4) respondents made some proposals for improvements to the patient care pathway.
Conclusion: Nursing staff have a similar perception to physicians regarding admission decisions and non-beneficial ICU stays. The possibility of future ICU admission needs to be anticipated, discussed systematically with patients and integrated into healthcare goals that are consistent with the patient's wishes and preferences, in multi-professional collaboration including nursing and medical staff.
2020
Thibault, Léa; Boisgontier, Audrey; Charvin, Maud; Grandazzi, Guillaume; Moutel, Grégoire
Prise en charge de l’intersexuation en France Article de journal
Dans: La revue du praticien , vol. 70, no. 10, p. 1069-1075, 2020.
Résumé | Liens | BibTeX | Étiquettes: Décision partagée, Refus de soins
@article{Thibault2020,
title = {Prise en charge de l’intersexuation en France},
author = {Léa Thibault and Audrey Boisgontier and Maud Charvin and Guillaume Grandazzi and Grégoire Moutel },
url = {https://www.larevuedupraticien.fr/article/prise-en-charge-de-lintersexuation-en-france},
year = {2020},
date = {2020-12-01},
urldate = {2020-12-01},
journal = {La revue du praticien },
volume = {70},
number = {10},
pages = {1069-1075},
abstract = {Dans un souci de normalisation pour éviter une stigmatisation ultérieure, la prise en charge des personnes intersexuées a longtemps reposé sur une chirurgie très précoce et des traitements traumatisants et non consentis par les enfants eux-mêmes. Une analyse des enjeux éthiques de cette situation permet de réfléchir à une réorganisation du parcours de soins tenant compte du choix de la personne.},
keywords = {Décision partagée, Refus de soins},
pubstate = {published},
tppubtype = {article}
}
Dans un souci de normalisation pour éviter une stigmatisation ultérieure, la prise en charge des personnes intersexuées a longtemps reposé sur une chirurgie très précoce et des traitements traumatisants et non consentis par les enfants eux-mêmes. Une analyse des enjeux éthiques de cette situation permet de réfléchir à une réorganisation du parcours de soins tenant compte du choix de la personne.
Benoit, Alexandra; Grynberg, Michael; Morello, Rémy; Sermondade, Nathalie; Grandazzi, Guillaume; Moutel, Grégoire
Does a web-based decision aid improve informed choice for fertility preservation in women with breast cancer (DECISIF)? Study protocol for a randomized controlled trial Article de journal
Dans: BMJ Open, 2020.
Résumé | Liens | BibTeX | Étiquettes: Décision partagée, Information
@article{Benoit2020,
title = {Does a web-based decision aid improve informed choice for fertility preservation in women with breast cancer (DECISIF)? Study protocol for a randomized controlled trial },
author = {Alexandra Benoit and Michael Grynberg and Rémy Morello and Nathalie Sermondade and Guillaume Grandazzi and Grégoire Moutel},
doi = {10.1136/bmjopen-2019-031739},
year = {2020},
date = {2020-02-10},
urldate = {2020-02-10},
journal = {BMJ Open},
abstract = {Introduction: Chemotherapy may cause infertility in young survivors of breast cancer. Various fertility preservation techniques increase the likelihood of survivors becoming genetic mothers. Disclosure of cancer diagnosis may impact decision making about fertility preservation. This protocol will develop and test the effectiveness of a web-based decision aid for helping women with breast cancer to make well-informed choices about fertility preservation.
Methods and analysis: This study will be conducted in three phases using mixed methods. In phase I, the aim is to develop a web-based patient decision aid (PDA) in French with a steering committee and using a focus group of five women already treated for breast cancer. In phase II, the face validity of the decision aid will be assessed using questionnaires. In phase III, the PDA will be assessed by a two-arm randomised controlled trial. This will involve a quantitative evaluation of the PDA in clinical practice comparing the quality of the decision-making process between usual care and the PDA. The primary outcome will be informed choice and its components. The secondary outcomes will be decisional conflict and anxiety. Data will be collected during and after an oncofertility consultation. Phase III is underway. Since September 2018, 52 participants have been enrolled in the study and have completed the survey. We expect to have results by February 2020 for a total of 186 patients.},
keywords = {Décision partagée, Information},
pubstate = {published},
tppubtype = {article}
}
Introduction: Chemotherapy may cause infertility in young survivors of breast cancer. Various fertility preservation techniques increase the likelihood of survivors becoming genetic mothers. Disclosure of cancer diagnosis may impact decision making about fertility preservation. This protocol will develop and test the effectiveness of a web-based decision aid for helping women with breast cancer to make well-informed choices about fertility preservation.
Methods and analysis: This study will be conducted in three phases using mixed methods. In phase I, the aim is to develop a web-based patient decision aid (PDA) in French with a steering committee and using a focus group of five women already treated for breast cancer. In phase II, the face validity of the decision aid will be assessed using questionnaires. In phase III, the PDA will be assessed by a two-arm randomised controlled trial. This will involve a quantitative evaluation of the PDA in clinical practice comparing the quality of the decision-making process between usual care and the PDA. The primary outcome will be informed choice and its components. The secondary outcomes will be decisional conflict and anxiety. Data will be collected during and after an oncofertility consultation. Phase III is underway. Since September 2018, 52 participants have been enrolled in the study and have completed the survey. We expect to have results by February 2020 for a total of 186 patients.
Methods and analysis: This study will be conducted in three phases using mixed methods. In phase I, the aim is to develop a web-based patient decision aid (PDA) in French with a steering committee and using a focus group of five women already treated for breast cancer. In phase II, the face validity of the decision aid will be assessed using questionnaires. In phase III, the PDA will be assessed by a two-arm randomised controlled trial. This will involve a quantitative evaluation of the PDA in clinical practice comparing the quality of the decision-making process between usual care and the PDA. The primary outcome will be informed choice and its components. The secondary outcomes will be decisional conflict and anxiety. Data will be collected during and after an oncofertility consultation. Phase III is underway. Since September 2018, 52 participants have been enrolled in the study and have completed the survey. We expect to have results by February 2020 for a total of 186 patients.