Recherche en soins palliatifs : intérêt des méthodes qualitatives

Rul, Brigitte; Carnevale, Franco A.

doi:10.1016/j.medpal.2014.07.001

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…The main risks in qualitative research on palliative care and end-of-life include super ciality, countertransference and the researcher's eviction mechanism in relation to his own experience (55,56). To minimise these potential biases we set up an approach based on the principle of re exivity (33).…”

Section: Study Participantsmentioning

confidence: 99%

Is palliative care a utopia for older patients with organ failure, dementia or frailty? A qualitative study through the prism of emergency department admission

Bourmorck,

Pétré,

de Saint-Hubert

et al. 2024

Preprint

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Background Nearly three out of four older people will use the emergency department (ED) during their last year of life. However, most of them do not benefit from palliative care. Providing palliative care is a real challenge for ED clinicians who are trained in acute, life-saving medicine. Our aim is to understand the ED’s role in providing palliative care for this population. Methods We designed a qualitative study based on 1) interviews – conducted with older patients (≥75 years) with a palliative profile and their informal caregivers – and 2) focus groups – conducted with ED and primary care nurses and physicians. Palliative profiles were defined by the Supportive and Palliative Indicators tool (SPICT). Qualitative data was collected in French-speaking Belgium between July 2021 and July 2022. We used a constant inductive and comparative analysis. Results Five older patients with a palliative profile, four informal caregivers, 55 primary and ED caregivers participated in this study. A priori, the participants did not perceive any role for the ED in palliative care. In fact, there is a widespread discomfortwith caring for older patients and providing palliative care. This is explained by multiple areas of tensions. Palliative care is an approach fraught with pitfalls, i.e.: knowledge and know-how gaps, their implementation depends on patients’(co)morbidity profile and professional values, experiences and type of practice. In ED, there are constant tensions between emergency and palliative care requirements, i.e.: performance, clockwork and needs for standardised procedures versus relational care, time and diversity of palliative care projects. However, even though the ED’s role in palliative care is not recognised at first sight, we highlighted four roles assumed by ED caregivers: 1) Investigator, 2) Objectifier, 3) Palliative care provider, and 4) Decision-maker on the intensity of care. Their main perspective is that ED caregivers could be the identifiers of early palliative profile. Conclusions Even if there are still major obstacles to implementing palliative care for older patients upon admission to the emergency department, ED caregivers already assume certain roles, although they do not recognise them as such. In the future, ED caregivers might also endorse the role of early identifier.

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Section: Study Participantsmentioning

confidence: 99%

Is palliative care a utopia for older patients with organ failure, dementia or frailty? A qualitative study through the prism of emergency department admission

Bourmorck,

Pétré,

de Saint-Hubert

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The main risks in qualitative research on palliative care and end-of-life include superficiality, counter-transference and the researcher's eviction mechanism in relation to his own experience [ 56 , 57 ]. To minimise these potential biases we set up an approach based on the principle of reflexivity [ 35 ].…”

Section: Main Findingsmentioning

confidence: 99%

Is palliative care a utopia for older patients with organ failure, dementia or frailty? A qualitative study through the prism of emergency department admission

Bourmorck,

Pétré,

de Saint-Hubert

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

Background Nearly three out of four older people will use the emergency department (ED) during their last year of life. However, most of them do not benefit from palliative care. Providing palliative care is a real challenge for ED clinicians who are trained in acute, life-saving medicine. Our aim is to understand the ED’s role in providing palliative care for this population. Methods We designed a qualitative study based on 1) interviews – conducted with older patients (≥ 75 years) with a palliative profile and their informal caregivers – and 2) focus groups – conducted with ED and primary care nurses and physicians. Palliative profiles were defined by the Supportive and Palliative Indicators tool (SPICT). Qualitative data was collected in French-speaking Belgium between July 2021 and July 2022. We used a constant inductive and comparative analysis. Results Five older patients with a palliative profile, four informal caregivers, 55 primary and ED caregivers participated in this study. A priori, the participants did not perceive any role for the ED in palliative care. In fact, there is widespread discomfort with caring for older patients and providing palliative care. This is explained by multiple areas of tensions. Palliative care is an approach fraught with pitfalls, i.e.: knowledge and know-how gaps, their implementation depends on patients’(co)morbidity profile and professional values, experiences and type of practice. In ED, there are constant tensions between emergency and palliative care requirements, i.e.: performance, clockwork and needs for standardised procedures versus relational care, time and diversity of palliative care projects. However, even though the ED’s role in palliative care is not recognised at first sight, we highlighted four roles assumed by ED caregivers: 1) Investigator, 2) Objectifier, 3) Palliative care provider, and 4) Decision-maker on the intensity of care. A common perception among participants was that ED caregivers can assist in the early identification of patients with a palliative profile. Conclusions Currently, there is widespread discomfort regarding ED caregivers caring for older patients and providing palliative care. Nonetheless, ED caregivers play four roles in palliative care for older patients. In the future, ED caregivers might also perform the role of early identifier.

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“…This procedure has the advantage of privileging the expression of the subject's own thought (Paillé & Mucchielli, 2021). This approach is also relevant to identify theoretical elements, such as risk and protective factors (Rul & Carnevale, 2014).…”

Section: Orcid Idmentioning

confidence: 99%

Women’s Homelessness and the Justice System: A Study of Desistance and Social (Re)integration Among Canadian Women Who Used or Did Not Use Criminal Activities to Survive

Moffet-Bourassa,

F.-Dufour

2024

Criminal Justice and Behavior

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Women experiencing homelessness (WEH) are a marginalized group who often lack support services, leading them to adopt alternative survival strategies that leave them at risk of being victimized and becoming involved with the justice-system. To better understand this problem, we analyzed the adaptive strategies Canadian WEH use to survive. Comparing the life histories of WEH who turned to criminal activities ( n = 4) with WEH who demonstrated prosocial resilience ( n = 4) makes it possible to identify protective and risk factors for criminal behavior and to propose adaptive strategies that can be used to support these women to adopt a prosocial lifestyle. The results provide a framework for understanding the needs of WEH, filling a gap that results from the focus on men needs in most scientific literature and by many resources, and suggesting that meeting those needs may reduce the likelihood that WEH will become involved with the justice-system.

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Recherche en soins palliatifs : intérêt des méthodes qualitatives

Cited by 6 publications

References 16 publications

Is palliative care a utopia for older patients with organ failure, dementia or frailty? A qualitative study through the prism of emergency department admission

Is palliative care a utopia for older patients with organ failure, dementia or frailty? A qualitative study through the prism of emergency department admission

Is palliative care a utopia for older patients with organ failure, dementia or frailty? A qualitative study through the prism of emergency department admission

Women’s Homelessness and the Justice System: A Study of Desistance and Social (Re)integration Among Canadian Women Who Used or Did Not Use Criminal Activities to Survive

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