It is necessary to change the focus of home care for dementia patients to fit the context in which they live and to allow for periods of relief for home caregivers.
It is necessary to change the focus of home care for dementia patients towards preventing loss of autonomy and its consequences and to allow for periods of relief for home caregivers.
Context: Exposure to burnout of staff involved with elderly patients is dependent on many factors either personal or linked to the professional environment. Social stress and systemic problems created particularly by difficulties inherent in the French hospital management system and the way people feel it, lead to a risk of burnout. One illustration of this is the rise in suicides at work. Quality of life at work, harassment and psycho-social risks are intimately linked. Affective factors, such as suffering for the medical carers in response to the distress of their patients aggravate the risk of burnout. Methods: We have evaluated these parameters using a self-filled questionnaire form sent to all staff and filled in by computer, anonymously, in 4 establishments, in December 2012 and over the first semester of 2013. After the three factors studied by the ProQOL scale of quality of life at work, to do with burnout, satisfaction compassion and fatigue compassion, 5 other questions were added, connected with a feeling of harassment and several social and demographic matters. Burnout risk was retained on reaching a threshold of 30 for this ProQOL scale item. Results: After multivariate analysis including the parameters of the Stamm scale, harassment and the socio-demographic factors studied, (age, sex, seniority, profession, and work departments) 4 factors are significantly associated with the risk of burnout, one negatively, compassion satisfaction, three positively, compassion fatigue, harassment experience and seniority. Conclusions: The risk of burnout is linked to subjective factors-the way quality of life at work is perceived and harassment experienced. Some professions, such as nurses, are particularly exposed and require these risk factors to be foreseen.
Context. Alzheimer’s Disease (AD) is a neurodegenerative illness with frequency of occurrence increasing with old age. If memory impairment setting progressively in is here an element associated upfront, other neurocognitive troubles are also associated, for example, language impairment which can degenerate into aphasia. Aim of the study. To evaluate semantic and textual impairment in AD. Methods. Populationsstudied concerned 151 AD patients in consultation at Brest University Hospital. Certain sociodemographic data (sex, age, cultural levels) were collected as well as results from neuropsychological tests: (Folstein – MMSE; Dubois’s 5-word test; fluencies, Dubois’ s frontal test battery; Cornell’s scale for depression; Barbizet’s test, “The Lion’s tale”, for textual analysis. Demented patients were composed of 102 females and 49 males of average age 80.3 ± 6.91. All the tests, including the number of items memorized latterly in the Barbizet’s test are impaired all the more by Folstein’s test being altered. The formal fluency on demented patients is less impaired than the semantical lexical fluency test (scored respectively 5.74 ± 1. 09 versus 4.41 ± 2. 19;t= 5.60, p<0.01). The studied demented cohort shows more intrusions (n=36) than inversions in the delayed Lion’s tale, whether for items or for episodes in which they occur (n=19). The regressive PLS analysis shows that for the explanation of the overall scores to do with “The lion’s tale”, calculated later, only attainment of lexical fluency has any notable influence (Regression coefficient CR=0.224) or, more accessorily, the cultural level (CR=0.12). Conclusions. Attainment of category fluency and patient culture levels have effects on narrativity.
Keywords: Alzheimer’s Disease, semiotics, semantics, textuality
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