La dialyse à domicile : quelles motivations et quels retentissements sur le couple ?

Roques, Marjorie; Proia-Lelouey, Nadine

doi:10.3917/dia.210.0111

Cited by 6 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Alors que la prévalence des patients qui ont été traités en hémodialyse à domicile (HDD) au début des années 70 atteignait parfois 20 % [1], [2] , celle-ci a décru rapidement au début des années 80 pour des raisons multiples : le retentissement sur le couple [3], la nécessité d'un temps de formation de plusieurs semaines, l'arrivée de centres d'autodialyse, la nécessité de présence du conjoint, la possibilité en France de l'assistance d'une infirmière libérale [4] pour les patients en dialyse péritonéale non autonomes, ont abouti à faire de cette dernière pratiquement la seule méthode de domicile. L'apparition récente de nouvelles machines d'hémodialyse à domicile et le développement de l'hémodialyse quotidienne ont relancé l'intérêt et la volonté d'un nombre croissant d'équipes de développer cette technique d'autant plus que la nécessité de présence du conjoint n'apparait plus indispensable en Belgique [5]et est demandée en France par certaines associations.…”

Section: Introductionunclassified

Transition between peritoneal dialysis and home hemodialysis in Belgium and France in the RDPLF

Verger

Fabre²

2020

Bull Dial Domic

View full text Add to dashboard Cite

A renewed interest in home hemodialysis has emerged in recent years, favored by the availability of new dialysis machines and encouraging publication about daily hemodialysis. Since 2013, the RDPLF has become a home dialysis registry that records the data of patients treated with peritoneal dialysis and those treated with home hemodialysis, all techniques combined. Nine Belgian centers and fifty seven French centers communicate information about their patients treated by hemodialysis at home. In the RDPLF centers, 56% of Belgian home hemodialysis patients are treated with daily hemodialysis, in France 83% of home patients are on daily dialysis. This French difference however is not representative of the whole country but can be explained through recruitment of new centers already involved in peritoneal dialysis and convinced by the interest of continuaous daily treatment. In both countries, 13% of home hemodialysis patients have been previously treated with peritoneal dialysis with an interim period of in-center hemodialysis or transplantation. The median duration of in center hemodialysis is 10 months with extremes ranging from 2 months to 25 years. PD patients treated secondarily in home hemodialysis are mainly young, non-diabetic and independent patients. Early information in patients who have a risk of peritoneal dialysis failure, and the provision of materials allowing both techniques would reduce or abolish a transient transfer to in center hemodialysis and would ensure home care in patients who prefer.

show abstract

Section: Introductionunclassified

Transition between peritoneal dialysis and home hemodialysis in Belgium and France in the RDPLF

Verger

Fabre²

2020

Bull Dial Domic

View full text Add to dashboard Cite

show abstract

“…Nous comprenons aisément comment le conjoint malade peut être affecté par la dépendance à vie au traitement et éventuellement à son/sa partenaire. L'ambivalence des sentiments amour/haine présente dans toute relation, se trouve alors majorée par la relation soignant/soigné qui s'instaure au sein du couple (13). L'inquiétante étrangeté (14), c'est-à-dire l'étrange sentiment que le familier se transforme en étranger, que ce qui était connu devient inconnu, se potentialise via la confrontation aux atteintes du corps et aux stigmates de la maladie (15).…”

Section: Quelques Donnees Issues D'une Revue De La Litteratureunclassified

“…Nous pointerons dans ce cadre les risques d'évolution pathologique d'un couple que nous avons exposés par ailleurs (17,13). Ces risques d'évolution s'inscrivent sur un continuum allant de l'impuissance à la toute-puissance, ces deux pôles pouvant constituer l'avers et le revers d'une même médaille.…”

Section: Quelques Donnees Issues D'une Revue De La Litteratureunclassified

La dialyse à domicile : une dynamique interactive complexe pour les couples

Roques¹,

Proia-Lelouey²

2018

Bull Dial Domic

Self Cite

View full text Add to dashboard Cite

(English abstract at the end) La dialyse à domicile est reconnue comme étant la technique la moins coûteuse. Pourtant, elle est la moins choisie en France. Pourquoi la France se montre-t-elle frileuse quant au choix de cette technique ? Nous nous centrons, dans cet article, sur les aspects psychologiques de la prise en charge, par les conjoints, des patients hémodialysés à domicile. A ce sujet, les études sont contradictoires, certaines rapportent un mal-être des couples, tandis que d’autres mettent en évidence une meilleure qualité de vie pour les deux partenaires. Après avoir émis une critique concernant la méthodologie utilisée dans certains travaux qui évacuent la part subjective et certains éléments cliniques qualitatifs pourtant essentiels pour comprendre le phénomène, nous avons fait l’hypothèse que trois niveaux imbriqués méritent d’être pris en compte, jusqu’à être décisifs dans le choix de la dialyse : la dynamique psychologique de chacun des partenaires, la dynamique du couple et l’investissement psychologique du domicile. Nous concluons sur l’idée selon laquelle l’intégration du conjoint dans la prise en charge du malade peut être un atout pour les suites du traitement, sous réserve de certaines conditions : premièrement, une évaluation de la dynamique psychique du couple afin de limiter les échecs thérapeutiques et la souffrance psychologique ; deuxièmement, une sensibilisation des médecins et des soignants à ces questions, car le couple peut développer une relation d’autant plus pathologique que le traitement se fait à huit clos ; enfin, l’ouverture d’un espace de parole afin que les couples puissent exprimer leurs difficultés et être rassurés. Abstract Home dialysis is recognized as the least expensive technique. Yet it is the least chosen in France. Why is France being cautious about the choice of this technique? In this article, we focus on the psychological aspects of spousal management of home hemodialysis patients. In this regard, the studies are contradictory, some report a discomfort in couples, while others highlight a better quality of life for both partners. After criticizing the methodology used in some of the works that remove the subjective and some qualitative clinical elements that are essential to understanding the phenomenon, we hypothesized that three nested levels deserve to be taken into account, up to to be decisive in the choice of dialysis: the psychological dynamics of each partner, the dynamics of the couple and the psychological investment of the home. We conclude on the idea that the integration of the spouse in the care of the patient can be an asset for the continuation of treatment, subject to certain conditions: first, an assessment of the psychic dynamics of the couple to limit the therapeutic failures and psychological suffering; secondly, raising the awareness of doctors and caregivers about these issues, because the couple can develop a relationship which is all the more pathological as the treatment is done in camera; finally, the opening of a space of speech so that couples can express their difficulties and be reassured. Cette revue est mise à disposition selon les termes de la Licence Creative Commons Attribution 4.0 International.

show abstract

“…The importance of the relational realm of the friendly and loving environment for patients emerges chiefly in research focused on the quality of life of sick people (Cupa, 2002;Morelon et al, 2005;Belasco et al, 2006;Draskic et al, 2011;Czyzewski et al, 2018;Schouten et al, 2020). Some works focusing on the relatives of patients with chronic kidney disease have also been published (Kaye et al, 1989;Devins et al, 1997;White and Grenyer, 1999;Gee et al, 2005;Belasco et al, 2006), and there has been a succession of further articles in recent years (Roques and Proia-Lelouey, 2015;Gilbertson et al, 2019;Jean-Dit-Pannel and Thomas, 2019 among others). These studies describe how the sick person not only finds support from their partner, contributing to their well-being, but also underline the draining effect this can have on that family member (Kaye et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

Couples Coping With the Serious Illness of One of the Partners

Riazuelo

2021

Front. Psychol.

View full text Add to dashboard Cite

Chronic kidney failure is a serious somatic disease. Addressing the issue of living with a chronic disease means fully considering the patients’ entourage, their families, and those close to them, especially their children and spouses.Objectives: The present paper focuses on the couple’s psychological experience when one of them suffers from a chronic disease, in this instance kidney disease. In particular, how is the spouse affected by the treatment provided? The aim is not only to see how care for sick people can be improved, but also, more specifically, how relatives and especially partners can receive attention.Methodology: A qualitative approach is not only adopted, being based on the psychotherapeutic follow-up of the partners of patients with chronic kidney disease, but also of the patients themselves, addressing the matter of their life as a couple. Three couples were considered, and two case studies are presented here. The issues that cut across these different situations are examined.Results and Discussion: Some couples show considerable resourcefulness. However, over the years, that capacity for adaptation and inventiveness can also be interrupted by the periods of greater suffering and even despair, especially when the somatic pathology becomes chronic. Many spouses talk about how living with a sick partner weighs down on them, causing severe fatigue. Some aspects of the illness can also become traumatic. The disease regularly disrupts the daily life of the couple and the family. This leads to a reworking of family relations. Each couple has its own history with the condition. As it emerges, it can disrupt the bonds of filiation, especially when the illness is hereditary. Making psychological care more accessible to the partners involved constitutes a major challenge for our hospital care systems.

show abstract

La dialyse à domicile : quelles motivations et quels retentissements sur le couple ?

Cited by 6 publications

References 22 publications

Transition between peritoneal dialysis and home hemodialysis in Belgium and France in the RDPLF

Transition between peritoneal dialysis and home hemodialysis in Belgium and France in the RDPLF

La dialyse à domicile : une dynamique interactive complexe pour les couples

Couples Coping With the Serious Illness of One of the Partners

Contact Info

Product

Resources

About