Soignants d’unités de soins palliatifs confrontés à une demande d’euthanasie : étude qualitative pilote

Bousquet, Anne; Guirimand, Frédéric; Aubry, Régis; Leboul, Danièle

doi:10.1016/j.medpal.2015.06.005

Cited by 3 publications

(1 citation statement)

References 2 publications

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“…They proposed elaborating on this request and on what might generate it, such as ambivalence, feelings of guilt, the experience that death is 'unbearable', etc. The literature also suggests that in these cases, carers experience a feeling of powerlessness [50], calling into question their skills and the institution's capabilities. Some relatives felt a lack of availability from the carers and a feeling of loneliness after the patient died; some mentioned that the support they received was not entirely satisfactory.…”

Section: Evocation Of Death and The Wish To Hasten Deathmentioning

confidence: 99%

Support practices by an interdisciplinary team in a palliative-care unit for relatives of patients in agonal phase

Mélin¹,

Amieva

Frasca³

et al. 2020

BMC Palliat Care

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Background In the absence of extant recommendations, the aim of this study was to formalise support practices used by an interdisciplinary team in a palliative-care unit (PCU) for the relatives of patients in the agonal phase preceding death. The secondary objective was to understand the expectations of relatives during this phase in terms of the support provided by professionals and volunteers. Methods Thirty-two people took part in this study; all were interviewed through focus groups (FGs). Each FG comprised one category of individuals working in the PCU: nurses, care- assistants, doctors, psychologists, other professionals, palliative-care volunteers, and relatives. Groups were surveyed using an interview guide, and the interviews were recorded and transcribed to enable identification and characterization of all practices. Care practices were classified into four categories: current consensual practices (i.e. performed by all team members), occasional consensual practices, non-consensual practices (performed by one or a few participants), and practices to be developed. Results In total, 215 practices were mentioned by professionals and palliative-care volunteers: 150 current consensual practices, 48 occasional consensual practices, 1 non-consensual practice, 16 practices yet to be developed, and 29 practices for relatives. Many practices were mentioned by different categories of participants; thus, after cross-checking, the number of practices decreased from 215 to 52. A list of practices deemed desirable by all was drawn up and then validated by the entire interprofessional team. These practices were organised around four themes: providing care and ensuring comfort; communicating, informing, and explaining; interacting; and mobilising interdisciplinary skills. Conclusions These results underline the importance of the quality of care provided to patients, the attention given to the relatives themselves, and they highlight the importance of the helping relationship. Following this study, which established a list of varied practices aimed at supporting the relatives of patients in agonal phase, it will be important to set up a broader study seeking to establish a consensus on these practices with an interprofessional group of experts from other PCUs using broad surveys and an adapted methodology. Such studies will make it possible to develop training modules for teams working with relatives.

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Section: Evocation Of Death and The Wish To Hasten Deathmentioning

confidence: 99%

Support practices by an interdisciplinary team in a palliative-care unit for relatives of patients in agonal phase

Mélin¹,

Amieva

Frasca³

et al. 2020

BMC Palliat Care

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Understanding why patients request euthanasia when it is illegal: a qualitative study in palliative care units on the personal and practical impact of euthanasia requests

Leboul¹,

Bousquet²,

Chassagne

et al. 2022

Palliat�Care

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Context: Some patients in palliative care units request euthanasia regardless of legislation. Although studies have explored the reasons for these requests, little is known about the subjective, relational, and contextual repercussions for the patient. Objectives: The aim of this study is to understand the purpose of euthanasia requests from the patient’s viewpoint and their personal and practical impact. Methods: We conducted in-depth interviews with patients requesting euthanasia, their family members, and health care providers in 11 French palliative care units. A thematic analysis of the data was performed. Results: In total, 18 patients were interviewed within 48 h of the request being made; 1 week later, 9 patients were interviewed again. Five main themes emerged: assuming the possibility of transgressing the forbidden, a call for unbearable suffering to be recognized, encouragement to change clinical practice, reclaiming a sense of freedom over medical constraints, and imagining a desirable future for oneself. Conclusions: A request for euthanasia appears to be a willful means to remove oneself from the impasse of an existence paralyzed by suffering. It creates a space for discussion, which promotes negotiation with patients on care practices and therapeutics, and strengthens patients’ sense of autonomy. Investigating the relationship between the evolution of euthanasia requests within the palliative care setting could be beneficial. It is important to encourage health care professionals to adopt a readiness to listen by interacting with patients in a way that is not momentarily action-oriented but rather focused on proactive discussion.

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2021

Le Journal Des Psychologues

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Soignants d’unités de soins palliatifs confrontés à une demande d’euthanasie : étude qualitative pilote

Cited by 3 publications

References 2 publications

Support practices by an interdisciplinary team in a palliative-care unit for relatives of patients in agonal phase

Support practices by an interdisciplinary team in a palliative-care unit for relatives of patients in agonal phase

Understanding why patients request euthanasia when it is illegal: a qualitative study in palliative care units on the personal and practical impact of euthanasia requests

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