Caregivers reluctance to use palliative care practices: Construction of a causal model

peer reviewedObjective To identify any reason for healthcare professionals to resist to provide palliative care and to understand the main interactions between these factors, in order to develop a further work project which could modify them. Definition of resistance The passivity or the unconscious refusal, to reproduce behaviours and/or acts corresponding to the basic principles of the palliative approach when facing palliative patients. Target group Healthcare professionals, i.e all professionals who take care of patients suffering from an advanced or incurable disease. These are doctors, nurses, nursing auxiliaries, and also physiotherapists, psychologists, home carers, etc. Family members of the patient or volunteers were excluded from the target group. Method The causal analysis consists in building a causality tree of a specific problem within a team. The presentation under the form of a tree allows the reading of the identified factors, from the closest to the most distant. The causal analysis is a time-consuming method, but it will form the basis of further work of our team. Result The obtained model is an orderly repertory of the factors which contribute to the cause of the problem. Conclusion The members of the analysis unit have shared their knowledge to create a tool. This tool will be used to determine actions in order to reduce directly or indirectly the resistance to provide palliative care.Objectif Cerner l’ensemble des facteurs de la résistance des soignants à pratiquer les soins palliatifs et appréhender les interactions principales entre ces facteurs dans le but de développer un projet de travail ultérieur, susceptible de les modifier. Définition de la résistance La passivité ou le refus inconscient, devant un patient « palliatif », à mettre en œuvre des attitudes et/ou des actes appris qui s’inscrivent dans les principes de base de l’approche palliative. Public cible Les soignants, c’est-à-dire l’ensemble des professionnels qui s’occupent des patients atteints d’une maladie grave ou incurable. Il s’agit des médecins, des infirmiers, des aides-soignantes mais aussi des kinésithérapeutes, des psychologues, des gardes à domicile, des aides familiales, etc. Sont exclus du public cible les membres de la famille du patient et les volontaires. Méthode L’analyse causale qui consiste à construire, en équipe, un arbre de causalité d’un problème spécifique. La présentation sous forme d’arbre permet la lecture des différents facteurs recensés, des plus proches aux plus éloignés. L’analyse causale est une méthode consommatrice de temps, mais elle va constituer le fondement du travail ultérieur de la Plate-forme. Résultat Le modèle obtenu est un répertoire ordonné des facteurs qui participent à la cause du problème. Conclusion Les membres de la cellule d’analyse ont mis leurs savoirs en commun pour créer un outil de référence. Cet outil servira à définir des actions pour modifier directement ou indirectement la résistance des soignants à appliquer les soins palliatifs

Sélection immunologique des donneurs de moelle osseuse.

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Regulation of interferon-gamma during the mixed lymphocyte reaction.

Journal Articleinfo:eu-repo/semantics/publishe

Computer-aided human leukocyte antigen association studies: A case study for psoriasis and severe alopecia areata

We present an integer programming model for human leukocyte antigen (HLA) association studies based on the parsimony criterion. The model is simple, compact, easy to implement, and able to handle datasets containing up to 200 phenotypes. Computational experiments carried out on patients affected by psoriasis and severe alopecia areata show that the model is consistent with the experimental haplotype frequencies, showing, for the considered diseases at least, a high reliability of the predictions. These promising results provide perspective on computer-aided association studies and encourage the development of efficient exact computational approaches for haplotype estimation. © 2010 American Society for Histocompatibility and Immunogenetics.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Mathematical models for HLA association studies: A case study for psoriasis and severe alopecia areata

info:eu-repo/semantics/publishe

Detection of blood chimerism after lung transplantation: superiority of nested as compared to standard polymerase chain reaction amplification.

Case ReportsComparative StudyJournal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe

HLA DR subtypes induce IL-6 and TNF-alpha production in the primary mixed lymphocyte reaction.

Comparative StudyJournal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe