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Diagnosis methods among palliative care team

, (1) ,
1
Nathalie Denis-Delpierre
  • Function : Author
Isabelle Vinatier

Abstract

The objective of this paper was to obtain a better understanding of what it means to diagnose a person at the end of life in a palliative care unit, and more precisely what difficulties residents encounter, with the subsequent aim of contributing to improving their training in line with the current thinking of the National College of University Professors and Instructors in Palliative Care (CNEFUSP). For this work, the “diagnosis” will be seen as an activity designed to understand a situation with a view to taking action; the diagnosis incorporates the prognosis (Hoc & Amalberti, 1995). We tested a quasi-experimental situation based on a real, complex diagnosis situation in the field of palliative care with 2 professionals from 4 different categories attending the patient – the carers, nurses, residents and certificated (senior) doctors in palliative care. The results illustrate diagnostic blocks in the medical sense of the word, combining symptoms with causes systematically tested (psychological suffering, intense pain and agitation), common to the different care professionals but implemented in different ways. The residents are conducted by eliminating the most probable and the most severe hypothesis. They implement the diagnostic blocks that they have learned during their training in a more in-depth manner than the other professionals, resulting in an increased number of tests for dying patients with the psycho-social aspects being taken into account too late and to an insufficient extent. While our results highlight the difficulties experienced by residents, they clearly reflect the medical training as well as the late, and somewhat insufficient, inclusion of palliative care and multidisciplinary approach in academic teaching
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Dates and versions

halshs-01450766 , version 1 (31-01-2017)

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  • HAL Id : halshs-01450766 , version 1

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Nathalie Denis-Delpierre, Christine Vidal-Gomel, Isabelle Vinatier. Diagnosis methods among palliative care team. HEPS 2016, International ergonomics association, Oct 2016, Toulouse, France. ⟨halshs-01450766⟩
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