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}
}
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.
Quenot, Jean-Pierre; Jacquier, Marine; Fournel, Isabelle; Meunier-Beillard, Nicolas; Grangé, Clotilde; Ecarnot, Fiona; Labruyère, Marie; Rigaud, Jean-Philippe; RESC, Study Group
Non-beneficial admission to the intensive care unit: A nationwide survey of practices Article de journal
Dans: PLoS One, vol. 18, no. 2, p. e0279939, 2023.
Résumé | Liens | BibTeX | Étiquettes: Collégialité, Organisation du système de santé
@article{Quenot2023,
title = {Non-beneficial admission to the intensive care unit: A nationwide survey of practices},
author = {Jean-Pierre Quenot and Marine Jacquier and Isabelle Fournel and Nicolas Meunier-Beillard and Clotilde Grangé and Fiona Ecarnot and Marie Labruyère and Jean-Philippe Rigaud and Study Group RESC},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894425/},
doi = {10.1371/journal.pone.0279939},
year = {2023},
date = {2023-02-02},
urldate = {2023-02-02},
journal = {PLoS One},
volume = {18},
number = {2},
pages = {e0279939},
abstract = {Introduction
In a nationwide survey of practices, we sought to define the criteria, circumstances and consequences of non-beneficial admissions to the intensive care unit (ICU), with a view to proposing measures to avoid such situations.
Methods
ICU physicians from a French research in ethics network participated in an online survey. The first part recorded age, sex, and years’ experience of the participants. In the second part, there were 8 to 12 proposals on each of 4 main domains: (1) What criteria could be used to qualify an ICU stay as non-beneficial? (2) What circumstances result in the admission of a patient whose ICU stay may later be deemed non-beneficial? (3) What are the consequences of a non-beneficial stay in the ICU? (4) What measures could be implemented to avoid admissions that later come to be considered as non-beneficial? Responses were on a 5-point Likert scale ranging from “Strongly disagree” to “Strongly agree”.
Results
Among 164 physicians contacted, 154 (94%) responded. The majority cited several criteria used to qualify a stay as non-beneficial. Similarly, >80% cited several possible circumstances that could result in non-beneficial admissions, including lack of knowledge of the case and the patient’s history, and failure to anticipate acute deterioration. Possible consequences of non-beneficial stays included stress and anxiety for the patient/family, misunderstandings and conflict. Discussing the utility of possible ICU admission in the framework of the patient’s overall healthcare goals was hailed as a means to prevent non-beneficial admissions.
Conclusion
The results of this survey suggest that joint discussions should take place during the patient’s healthcare trajectory, before the acute need for ICU arises, with a view to limiting or avoiding ICU stays that may later come to be deemed “non-beneficial”.},
keywords = {Collégialité, Organisation du système de santé},
pubstate = {published},
tppubtype = {article}
}
In a nationwide survey of practices, we sought to define the criteria, circumstances and consequences of non-beneficial admissions to the intensive care unit (ICU), with a view to proposing measures to avoid such situations.
Methods
ICU physicians from a French research in ethics network participated in an online survey. The first part recorded age, sex, and years’ experience of the participants. In the second part, there were 8 to 12 proposals on each of 4 main domains: (1) What criteria could be used to qualify an ICU stay as non-beneficial? (2) What circumstances result in the admission of a patient whose ICU stay may later be deemed non-beneficial? (3) What are the consequences of a non-beneficial stay in the ICU? (4) What measures could be implemented to avoid admissions that later come to be considered as non-beneficial? Responses were on a 5-point Likert scale ranging from “Strongly disagree” to “Strongly agree”.
Results
Among 164 physicians contacted, 154 (94%) responded. The majority cited several criteria used to qualify a stay as non-beneficial. Similarly, >80% cited several possible circumstances that could result in non-beneficial admissions, including lack of knowledge of the case and the patient’s history, and failure to anticipate acute deterioration. Possible consequences of non-beneficial stays included stress and anxiety for the patient/family, misunderstandings and conflict. Discussing the utility of possible ICU admission in the framework of the patient’s overall healthcare goals was hailed as a means to prevent non-beneficial admissions.
Conclusion
The results of this survey suggest that joint discussions should take place during the patient’s healthcare trajectory, before the acute need for ICU arises, with a view to limiting or avoiding ICU stays that may later come to be deemed “non-beneficial”.
2022
Leblanc, Séverine; Gouriot, Mylène; Charvin, Maud; Morello, Rémy
La disparition progressive de la professionnalisation de la photographie médicale dans les hôpitaux français constitue-t-elle une atteinte à l’éthique ? Article de journal
Dans: Ethique & Santé, iss. Online ahead of print, 2022.
Résumé | Liens | BibTeX | Étiquettes: Organisation du système de santé
@article{Moutel2022cf,
title = {La disparition progressive de la professionnalisation de la photographie médicale dans les hôpitaux français constitue-t-elle une atteinte à l’éthique ?},
author = {Séverine Leblanc and Mylène Gouriot and Maud Charvin and Rémy Morello},
doi = { https://doi.org/10.1016/j.etiqe.2022.09.003},
year = {2022},
date = {2022-10-17},
urldate = {2022-10-17},
journal = {Ethique & Santé},
issue = {Online ahead of print},
abstract = {Introduction
Bien que fréquemment utilisée dans les établissements de santé, la photographie médicale fait l’objet d’aucune réglementation spécifique ou recommandations précises. L’objet de cette étude est de réaliser une enquête qualitative sur les pratiques photographiques en lien avec le respect de l’éthique médicale, de la déontologie et du droit.
Matériel et méthode
L’échantillon a été constitué de 8 professionnels de santé exerçant dans le quart ouest de la France au sein de trois CHU. Des entretiens semi-directifs ont été menés en suivant une grille construite par thématiques déductive sur 6 mois entre avril et août 2020.
Résultats
Plusieurs problématiques ont été mises en lumière avec en particulier un manque de formation et l’utilisation de matériels non adaptés, une qualité d’images toutes relatives, ainsi qu’une grande hétérogénéité qui porte atteinte en particulier au droit à l’information, au respect du consentement et à l’anonymisation.
Conclusion
L’absence de normes et l’absence de formations professionnalisantes constituent de profondes insuffisances, source de préjudices potentiels à plus ou moins long terme, aussi bien pour les patients que pour les établissements de santé touchant à l’éthique, et ce d’autant plus graves qu’ils risquent de porter atteinte à la maîtrise de l’évolution de la communication par l’image.},
keywords = {Organisation du système de santé},
pubstate = {published},
tppubtype = {article}
}
Bien que fréquemment utilisée dans les établissements de santé, la photographie médicale fait l’objet d’aucune réglementation spécifique ou recommandations précises. L’objet de cette étude est de réaliser une enquête qualitative sur les pratiques photographiques en lien avec le respect de l’éthique médicale, de la déontologie et du droit.
Matériel et méthode
L’échantillon a été constitué de 8 professionnels de santé exerçant dans le quart ouest de la France au sein de trois CHU. Des entretiens semi-directifs ont été menés en suivant une grille construite par thématiques déductive sur 6 mois entre avril et août 2020.
Résultats
Plusieurs problématiques ont été mises en lumière avec en particulier un manque de formation et l’utilisation de matériels non adaptés, une qualité d’images toutes relatives, ainsi qu’une grande hétérogénéité qui porte atteinte en particulier au droit à l’information, au respect du consentement et à l’anonymisation.
Conclusion
L’absence de normes et l’absence de formations professionnalisantes constituent de profondes insuffisances, source de préjudices potentiels à plus ou moins long terme, aussi bien pour les patients que pour les établissements de santé touchant à l’éthique, et ce d’autant plus graves qu’ils risquent de porter atteinte à la maîtrise de l’évolution de la communication par l’image.
2019
Babin, Emmanuel; Grandazzi, Guillaume
Paradoxes of the French health care system Article de journal
Dans: European Annals of Otorhinolaryngology, Head and Neck diseases, vol. 136, no. 3, p. 149-150, 2019.
Liens | BibTeX | Étiquettes: Organisation du système de santé
@article{Babin2020,
title = {Paradoxes of the French health care system},
author = {Emmanuel Babin and Guillaume Grandazzi},
url = {https://hal-normandie-univ.archives-ouvertes.fr/hal-02285981},
doi = {10.1016/j.anorl.2019.02.011},
year = {2019},
date = {2019-03-22},
journal = {European Annals of Otorhinolaryngology, Head and Neck diseases},
volume = {136},
number = {3},
pages = {149-150},
keywords = {Organisation du système de santé},
pubstate = {published},
tppubtype = {article}
}
2018
Babin, Emmanuel; Grandazzi, Guillaume
Un système paradoxant ? Soignants et prise en charge des patients en cancérologie des voies aérodigestives supérieures Chapitre d'ouvrage
Dans: Ansellem, Norbert; Bataille, Philippe (Ed.): Le cancer : un regard sociologique. Biomédicalisation et parcours de soins, p. 184-199, Paris, La découverte, 2018, ISBN: 9782707195784.
Liens | BibTeX | Étiquettes: Organisation du système de santé
@inbook{Babin2019,
title = {Un système paradoxant ? Soignants et prise en charge des patients en cancérologie des voies aérodigestives supérieures},
author = {Emmanuel Babin and Guillaume Grandazzi},
editor = {Norbert Ansellem and Philippe Bataille},
url = {https://hal-normandie-univ.archives-ouvertes.fr/hal-02149897},
isbn = {9782707195784},
year = {2018},
date = {2018-05-31},
urldate = {2018-05-31},
booktitle = {Le cancer : un regard sociologique. Biomédicalisation et parcours de soins},
pages = {184-199},
address = {Paris},
edition = {La découverte},
keywords = {Organisation du système de santé},
pubstate = {published},
tppubtype = {inbook}
}