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Charles-Henri Rapin

Publications and source records attributed to Charles-Henri Rapin.

9 recordsLinked to original sources
PubMed2006

[End of life conflicts in palliative care: a systematic review of the literature].

To evaluate the extent and the quality of the research related to End of life conflicts in palliative care from 1995 to 2004. Accessible Literature of several electronic data bases (BDSP, Cinhal, Cochrane, Francis, Medline, Psychinfo, Saphir, Scopus and Web of science) as well as the grey literature. Studies published in French and English between 1995 and 2004 reporting end of life conflicts, tensions, disagreements, disputes in the context of palliative care. One hundred and two studies were included (87.2% published in English, 12.8% in French). Study designs include revues 27.4%), cross-sections 18.6% and case studies 18.6%. Reported conflicts are related to ethical issues 26.2%, to care 19.1%, to tensions between professionals and patients or families 11.1%, to team experiences 9%. Six studies 5.8% give prevalence figures of conflicts. Half of the studies 51.3% identify possible causes of conflicts: communication issues, euthanasia and suicide assistance demands, autonomy of patients, non respect of advance directives, cultural differences. Ten studies 9.8% identify specifically some effects of the conflicts: moral distress of patients; stress, burn out and guilt of health professionals; lack of trust between doctors and patients or families. Conflicts are mainly resolved through mediation and ethical discussions. Research data on end of life conflicts is scarce at all levels (quantity, quality, methods, social impact, and epistemology). A better understanding of end of life conflict might foster a more adequate management of difficult situations and ultimately a more peaceful death of patients, mourning of families and every day work of health professionals

Attitude of Health Personnel↗
PubMed2006

[End of life conflicts: perceptions of health professionals in French speaking Valais].

The aim of the study was to identify the perception health professionals in palliative care had of end of life conflicts. The nature of t he conflicts,their prevalence, intensity, causes andeffects were specially addressed. Furthermore proposals of possible solutions of conflicts were investigated. A cross-sectional study was done through a self-administered questionnaire among 460 health professionals in the French Speaking Valais. The health professionals worked either in acute care hospitals, chronic health institutions, and old people nursing homes or in ambulatory palliative care units. Among the target population 233 persons replied to the questionnaire (50.6%). Among the respondents 82.4% reported to be confronted to end of life conflicts. Conflicts were quite rare (66%) and of medium or high intensity (86%). Conflicts were of medical nature (74%) or related to ethic issues (64%). Conflicts occurred among family members (68%), medical doctors and nurses (49%) or patients et medical staff (16%). Conflicts were due mainly (50-60%) to lack of communication, ambivalence among parties, differences in value systems. Mentioned (50-60%) consequences of conflicts were the waste of resources, the physical and the psychological burnout. Possible identified solutions to conflicts were interdisciplinary seminars, internal supervision procedure and the sharing of experiences. Neither age, nor gender, professional experience, working par place, training were predictive of exposure toconflicts. End of life conflicts are a common reality. They may compromise the quality of care and may contribute to high economic and social costs. They should be put on the public health agenda as a high priority.

Adult↗
PubMed2005

["A good death": perception of health personnel in French-speaking Switzerland].

AIMS: To describe the perception of "Good death" among health personnel working in nursing homes in French-speaking Switzerland and to identify the differential explanatory factors. METHODS: A cross sectional study with a self-administered questionnaire, adapted from the "the' new measure of concept of good death", was done among health personnel in 5 nursing homes (2 in Geneva and 3 from Valais) in spring 2004. One hundred and sixty one persons participated at the study representing over 90% of the personel contacted. RESULTS: Four points were considered hallmarks of "Good death" by more than 80% of respondents: i.e. pain control, serenity and peace, presence of family members or close friends, respect of the last will. Up to 70% further consider as important elements the support of health professionals, the opportunity to transmit one's values and access to spiritual and/or religious support. Around 50% of respondents also consider as important "being able to chose the place of death", "having time to prepare one self", "staying conscious to the end" and "having control over body functions". These perceptions vary according to the place of work, the sex, the training in palliative care, the professional experience and of the number of deaths with which respondents were confronted. CONCLUSION: There seems to be converging opinions among health personel on what "Good death" should be. Public health decisions makers need to be informed on this.

Adult↗
PubMed2002

[Research note: "On the progression of the incidence of hip fractures in the elderly"].

We studied 39,896 hip fractures that occurred in Quebec during 10 years. We found an increase in the incidence of hip fracture during this period. Demographical or anthropologic factors (such as smoking, alcohol consumption, residential placement), seasonal variations or socioeconomic factors alone could not give a satisfactory explanation for such an increase of this incidence. The pandemic disease theory might on the other hand give some explanation as to this above findings in hip fractures, considering that the average level of health of the elderly in 1991 is different from that in 1981. We suggest a hip fracture watch to allow for a follow-up on the general health situation of the elderly.

Age Factors↗