Le Sentiment De Culpabilité Chez Les Infirmiers Face À La Mort De Patients Au CHU Habib Bourguiba Et CHU Hadi Chaker De Sfax (Étude Descriptive Corrélationnelle)

Introduction. Le métier d’infirmier implique une confrontation quasi régulière à la morbidité. Cette confrontation, qu’elle soit occasionnelle ou fréquente, constitue un vécu trop souvent marginalisé est encore trop souvent passée sous silence (Saada et al., 2011). Son indélébilité sur le vécu du professionnel est toutefois une réalité. Elle laisse cependant son empreinte dans le parcours de ces acteurs. En effet, confronté à la mort de son patient, le professionnel de soins infirmiers peut ressentir une certaine culpabilité, du fait d’une nonchalance perçue, ce sentiment incontrôlable et insupportable influe négativement sur sa vie et son travail ce vécu devient handicapant aussi bien sur le plan professionnellement qu’en terme de vie privée. Objectif.  Cet article cherche à explorer et évaluer les relations entre le sentiment de culpabilité et les différents facteurs sociodémographiques (genre, âge, niveau d’étude, état civil, ancienneté, nombre de décès) au sein des professionnels de soins infirmiers de l’Hôpital de Sfax, les hypothèses de la recherche stipulent : Hypothèse générale : -           Il existe un lien entre le sentiment de culpabilité chez les infirmiers et leurs facteurs sociodémographiques face à la mort des patients. Hypothèses spécifiques : -           Il y a un lien entre le sentiment de culpabilité et le sexe chez les infirmiers -           Il existe un lien entre le sentiment de culpabilité chez les infirmiers et leur âge. -           Le niveau d’étude constitue un indicateur de développement du sentiment de culpabilité chez les infirmiers. -           Il existe un lien entre le sentiment de culpabilité des infirmiers participants et leurs nombres de décès des patients sous leurs charges. Méthode. En se basant sur l’inventaire de culpabilité ou Guilt Inventory Scale de Jones et al (2000), cette étude de devis descriptif-corrélationnel fut effectuée sur un échantillon de 131 infirmiers tous genres confondus, dont l’âge moyen est de 32.9 ans. L’avantage de l’outil emprunté, est qu’il offre un score global portant sur le sentiment de culpabilité à mesurer en plus d’apporter une évaluation sur les trois dimensions considérées à savoir l’état, le trait ainsi que les normes morales, ce qui est considérable en termes d’exactitude compte tenu de l’objet étudié.     Résultats. L’un des résultats les plus saillants, est que 76% (n =99) ont exprimé une forte intensité de sentiment de culpabilité. Les résultats ont montré une corrélation positive entre le sentiment de culpabilité et les facteurs suivants : l’âge, le niveau d’étude, l’ancienneté et le nombre de décès. En revanches, une indépendance a été remarquée entre le sentiment de culpabilité, le sexe des participants. Conclusion. En conclusion, les résultats de cette étude témoignent que le sentiment de culpabilité, tel qu’évalué par la Guilt Inventory Scale, est très élevé et en corrélation avec les facteurs ; âge, niveau d’instruction, ancienneté au travail, nombre de décès. Il serait recommandé de prendre en considération ces résultats et venir en aide aux infirmiers par une préparation psychologique à la mort d’un patient afin de ne pas être victime d’une dépression ou un autre trouble. Introduction. The nursing profession involves an almost regular encounter with morbidity. This confrontation, whether occasional or frequent, is too often a marginalized experience and is still too often overlooked (Saada et al., 2011). Its indelibility on the professional experience is however a reality. However, it leaves its mark on the career of these actors. Indeed, faced with the death of his patient, the nursing professional may feel certain guilt, due to a perceived nonchalance. This uncontrollable and unbearable feeling has a negative influence on his life and his work. This experience becomes disabling as well on the plan professionally than in terms of privacy. Objective. This article seeks to explore and assess the relationships between the feeling of guilt and the various sociodemographic factors (gender, age, level of education, marital status, seniority, number of deaths) among nursing professionals at the Hospital of Sfax, the research hypotheses state : General hypothesis: - There is a causal effect between the feeling of guilt among nurses and their socio-demographic factors in the face of patient death. Specific hypothesis: - There is a link between feelings of guilt and sex in nurses - There is a link between feelings of guilt in nurses and their age. - The level of education is an indicator of the development of feelings of guilt among nurses. - There is a link between the feeling of guilt of the participating nurses and their numbers of deaths of the patients under their charge. Method. Based on the Guilt Inventory Scale of Jones & al (2000), this descriptive-correlational design study was performed on a sample of 131 nurses of all genders, with an average age of 32.9 years. The advantage of the borrowed tool is that it offers an overall score relating to the feeling of guilt to be measured in addition to providing an evaluation on the three dimensions considered, namely the state, the trait as well as the moral standards, which is considerable in terms of accuracy given the object studied. Results. One of the most salient results is that 76% (n = 99) expressed a strong sense of guilt. The results showed a positive correlation between feelings of guilt and the following factors: age, level of education, seniority and number of deaths. On the other hand, an independence was noticed between the feeling of guilt, the sex of the participants. Conclusion. In conclusion, the results of this study show that the feeling of guilt, as assessed by the Guilt Inventory Scale, is very high and correlates with the factors of age, level of education, length of service at work, number of deaths. It would be advisable to take these results into consideration and help nurses with psychological preparation for the death of a patient so as not to be a victim of depression or another disorder

Galaxy-Gen: A Tool for Building Galaxy model from XML documents

National audienceA galaxy model is a multidimensional model dedicated for XML document warehouses. It can be seen as a network of entities (i.e., dimensions) connected via nodes. After giving an overview of our four-steps semi-automated method for the generation of galaxy models which aims to build data marts from XML documents. This paper focuses on the software tool, called Galaxy-Gen that implements the proposed method. We illustrate the Galaxy-Gen functionalities and make its first assessment through two experiments. The first experiment is applied to a set of twenty XML documents taken from the academic domain. The second one addressed a set of 1691 XML documents issued from the Clef-2007 collection. The assessment is performed by comparing manual design galaxy models with those produced by the Galaxy-Gen tool. The results are very promising

Biological therapy of strontium-substituted bioglass for soft tissue wound-healing: Responses to oxidative stress in ovariectomised rats.

The authors declare that they have no conflicts of interest concerning this article.International audienceNew synthetic biomaterials are constantly being developed for wound repair and regeneration. Bioactive glasses (BG) containing strontium have shown successful applications in tissue engineering account of their biocompatibility and the positive biological effects after implantation. This study aimed to assess whether BG-Sr was accepted by the host tissue and to characterize oxidative stress biomarker and antioxidant enzyme profiles during muscle and skin healing. Wistar rats were divided into five groups (six animals per group): the group (I) was used as negative control (T), after ovariectomy, groups II, III, IV and V were used respectively as positive control (OVX), implanted tissue with BG (OVX-BG), BG-Sr (OVX-BG-Sr) and presented empty defects (OVX-NI). Soft tissues surrounding biomaterials were used to estimate superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and malondialdehyde (MDA) concentration. Our results show that 60 days after operation, treatment of rats with BG-Sr significantly increased MDA concentration and caused an increase of SOD, CAT and GPx activities in both skin and muscular tissues. BG-Sr revealed maturation of myotubes followed a normal appearance of muscle regenerated with high density and mature capillary vessels. High wound recovery with complete re-epithelialization and regeneration of skin was observed. The results demonstrate that the protective action against reactive oxygen species (ROS) was clearly observed in soft tissue surrounding BG-Sr. Moreover, the potential use of BG-Sr rapidly restores the wound skin and muscle structural and functional properties. The BG advantages such as ion release might make BG-Sr an effective biomaterial choice for antioxidative activity

Building an XML document warehouse

International audienceData Warehouses and OLAP (On Line Analytical Processing) technologies are dedicated to analyzing structured data issued from organizations' OLTP (On Line Transaction Processing) systems. Furthermore, in order to enhance their decision support systems, these organizations need to explore XML (eXtensible Markup Language) documents as an additional and important source of unstructured data. In this context, this paper addresses the warehousing of document-centric XML documents. More specifically, we propose a two-method approach to build Document Warehouse conceptual schemas. The first method is for the unification of XML document structures; it aims to elaborate a global and generic view for a set of XML documents belonging to the same domain. The second method is for designing multidimensional galaxy schemas for Document Warehouses

A Semi-automatic Approach to Build XML Document Warehouse

International audienceDocuments represent an interesting source for decisional analyses. They help decision makers to better understand the evolution of their business activities. Therefore, they merit to be warehoused for decision purposes within organizations. Generally, these documents exist in XML format and are described by multiple structures. In this paper, we present a semi-automatic approach to build the XML Document Warehouse. This approach is made up of two methods namely: Unification of structures of XML Structures, and Multidimensional modeling. More specifically, this paper focuses on the experiment and evaluation of the proposed approach for warehousing document-centric XML documents

Hypoglycemic and antioxidant effects of leaf essential oil of <it>Pelargonium graveolens</it> L’Hér. in alloxan induced diabetic rats

<p>Abstract</p> <p>Background</p> <p>Rose-scented geranium (<it>Pelargonium graveolens</it> L’Hér.), which is used in traditional Tunisian folk medicine for the treatment of hyperglycaemia, is widely known as one of the medicinal herbs with the highest antioxidant activity. The present paper is conducted to test the hypoglycemic and antioxidative activities of the leaf essential oil of <it>P. graveolens</it>.</p> <p>Methods</p> <p>The essential oil <it>P. graveolens</it> was administered daily and orally to the rats at two doses of 75 mg/kg and 150 mg/kg body weight (b.w.) for 30 days. The chemical composition of <it>P. graveolens</it> essential oil, body weight, serum glucose, hepatic glycogen, thiobarbituric acid-reactive substances (TBARS), the components of hepatic, and renal and serum antioxidant systems were evaluated. The hypoglycemic effect of rose-scented geranium was compared to that of the known anti-diabetic drug glibenclamide (600 μg/kg b.w.).</p> <p>Results</p> <p>After the administration of two doses of essential oil of <it>Pelargonium graveolens</it> L’Hér. together with glibenclamide which is known by its antidiabetic activities and used as reference (600 μg/kg b.w.), for four weeks, the serum glucose significantly decreased and antioxidant perturbations were restored. The hypoglycemic effect of <it>P. graveolens</it> at the dose of 150 mg/kg b.w. was significantly (<it>p</it>< 0.05) more effective than that of glibenclamide. It is through the histological findings in hepatic and renal tissues of diabetic rats that these beneficial effects of geranium oils were confirmed.</p> <p>Conclusions</p> <p>It suggests that administration of essential oil of <it>P. graveolens</it> may be helpful in the prevention of diabetic complications associated with oxidative stress. Our results, therefore, suggest that the rose-scented geranium could be used as a safe alternative antihyperglycemic drug for diabetic patients.</p

A jojoba (Simmondsia chinensis) seed cake extracts express hepatoprotective activity against paracetamol-induced toxicity in rats

This study aimed to investigate the hepatoprotective activity of jojoba seed cake extracts against an acute paracetamol (PC) intoxication. Two aqueous extracts from jojoba (Simmondsia chinensis) seed cake, a simmondsin-rich extract (WE), and a simmondsin-hydrolyzed extract (NE) using Viscozyme L enzyme have been prepared and characterized. After enzyme treatment, simmondsin content decreased from 33.0 % to 3.0 % and glucose content increased from 16.2 % to 27.3 % reflecting simmondsin hydrolysis. Both extracts were administered to different rat groups via gavage (0.6 g/kg b.w.) before PC treatment (2 g/kg b.w.) three times a week for 3 weeks. The PC intoxication altered the serum biomarkers, the oxidative status, and the Tumor necrosis factor alpha (TNF-α), Bax and Bcl-2 protein expressions of tested animals. In addition, the histological analysis of liver tissues proved significant injury and hepatocellular necrosis. WE and NE extract showed a relatively high in vitro radical scavenging (ORAC) and averting activities (HORAC) with a polyphenol content of 3.6 % and 2.9 %, respectively. Both extracts showed a powerful in vivo hepatoprotective activity against PC-induced toxicity by improving the hepatocellular antioxidant status and blocking proteins expression (TNF-α, Bax and Bcl-2), involved in inflammation and liver damage. However, the enzymatic treatment improved the hepatoprotective activity of NE despite its lower simmondsin content and lower in vitro antioxidant capacity. This enhancement could be linked to the synergetic effect between the antioxidant components and the new hydrolytic products as glucose, uronic acids, arabinose and simmondsin-aglycons. These results suggest that jojoba waste could be potentially valorized in developing hepatoprotective drugs.This work was carried out in the frame of the project supported by the Ministry of Higher Education and Scientific Research-Tunisia (LR15CBS01) and the project EXANDAS (H2020-MSCA-RISE-2015, grant agreement No 691247)

A case of severe paraneoplastic itch resistant to antihistamines and responding to serotonin reuptake inhibitors

Abstract This article covers an interesting topic. Paraneoplastic pruritus is rare but can be severe. It can sometimes be resistant to usual treatments. In our case, it was resistant to antihistamines but was relieved by inhibitors of serotonin scrapping

Effects of Zinc Supplementation on Oxidative Stress in Patients Undergoing Maintenance Hemodialysis

Introduction: The aim of this study was to examine the effects of Zn supplementation on oxidative stress by evaluating changes in serum Copper (Cu) to Zinc (Zn) ratio, homocysteine (hCys), Glutathione (GSH), Total Bilirubin (TB) and Catalase (CAT) activity in hemodialysis patients.Methods: Seventy-seven HD patients were enrolled in a multicenter simple-blind randomized clinical trial. Only 37 HD patients completed the study. They were randomly divided into two groups and supplemented with zinc sulfate (n = 17) or placebo (n = 20) for two months. Serum Zn and Cu were measured by atomic absorption spectrophotometry. Serum hCys was measured by immunology method, serum GSH and CAT activity were assessed by spectrophotometry method and TB was measured by colorimetric method. Determinations were performed before and after supplementation.Findings: After zinc supplementation, serum Zn, serum GSH, and Serum Total Bilirubin (STB) significantly increased. Serum Cu to Zn ratio, serum hCys, and CAT activity significantly decreased in the Zn Zn-supplemented group.Conclusion: Zinc supplementation increased serum antioxidant factors such as Zn, GSH, and bilirubin and decreased serum oxidative factors such as copper to zinc ratio, hCys, and decreased CAT activity. The study results suggest that zinc supplementation may be a useful tool for the improvement of oxidative stress in HD patients