13 results on '"Lapiana JM"'
Search Results
2. Doctor's opinions on euthanasia, end of life care, and doctor-patient communication: telephone survey in France.
- Author
-
Peretti-Watel P, Bendiane MK, Pegliasco H, Lapiana JM, Favre R, Galinier A, and Moatti JP
- Published
- 2003
- Full Text
- View/download PDF
3. Ketamine analgesic effect by continuous intravenous infusion in refractory cancer pain: considerations about the clinical research in palliative care.
- Author
-
Salas S, Frasca M, Planchet-Barraud B, Burucoa B, Pascal M, Lapiana JM, Hermet R, Castany C, Ravallec F, Loundou A, Auquier P, Duffaud F, and Baumstarck K
- Subjects
- Adult, Aged, Double-Blind Method, Female, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Analgesics administration & dosage, Biomedical Research, Infusions, Intravenous, Ketamine administration & dosage, Neoplasms physiopathology, Pain, Intractable drug therapy, Palliative Care
- Abstract
Background: The literature has described the use of ketamine as an adjuvant treatment for opioid-refractory cancer pain. None of these studies have used the drug in a palliative care patient population., Aims: The primary objective of the study was to assess the efficacy of continuous intravenous infusion of ketamine in patients suffering from cancer pain refractory to opiates who had been admitted to palliative care units. Secondary objectives were to assess patients' satisfaction with and tolerance of ketamine., Methods: A randomized, double-blind, placebo-controlled study was designed, and the study setting included seven French adult palliative care units. Inclusion criteria were age ≥18 years, and cancer pain refractory to standard opiates. Evaluations were conducted at randomization (baseline), at ketamine or placebo introduction time (T0), and at 2 hours (T1), 24 hours (T2), and 48 hours (T3) after T0. The primary evaluation criterion was pain efficacy assessed using a patient self-rated Numeric Pain Intensity Scale (NPIS) at T1. The main secondary evaluation criteria were daily morphine dose, symptom evaluation (Edmonton Symptom Assessment Scale [ESAS]), and patient satisfaction (Pain Treatment Satisfaction Scale [PTSS])., Results: Twenty patients were analyzed (11 received ketamine and 9 received placebo). Self-reported pain did not differ between the two groups, as the symptoms continued to evolve during the study period. The tolerance for ketamine was satisfactory., Conclusion: The present study did not confirm the efficacy of the ketamine-morphine combination in refractory cancer pain. The results suggest that specific populations could be "good responders" for this therapeutic approach. Further studies should be performed that take into account the difficulties of conducting clinical research in the palliative care context.
- Published
- 2012
- Full Text
- View/download PDF
4. District nurses' attitudes toward patient consent: the case of mechanical ventilation on amyotrophic lateral sclerosis patients: results from a French national survey.
- Author
-
Peretti-Watel P, Bendiane MK, Galinier A, Favre R, Ribiere C, Lapiana JM, and Obadia Y
- Subjects
- Adult, Age Factors, Female, France, Humans, Living Wills, Male, Middle Aged, Nurse-Patient Relations, Religion, Sex Factors, Tracheotomy statistics & numerical data, Amyotrophic Lateral Sclerosis nursing, Attitude of Health Personnel, Nurses, Respiration, Artificial nursing, Terminal Care methods
- Abstract
Purpose: In France, a recent law emphasizes patient rights and prohibits unwanted therapies in end-of-life care. As end-of-life home care is increasing, we aimed to assess French district nurses' attitudes toward terminally ill patients' autonomy., Materials and Methods: We used data from a nationwide telephone survey conducted in 2005 among a random sample of French district nurses (n = 602). Nurses' attitudes were assessed with a clinical case describing a patient (randomly defined as a male or a female aged 50 years) having amyotrophic lateral sclerosis (ALS) who urgently needs mechanical ventilation. Nurses were asked whether patient consent was necessary before performing intubation/tracheotomy, and the analysis took into account various covariates, including nurses' religiosity, nurses' attitudes toward living wills, and patient sex., Results: Overall, 44% of nurses considered that an ALS patient with respiratory failure should always be intubated (53% for a female patient, 40% for a male patient, P < .01), and after intubation, 27% upheld tracheotomy without considering patient consent as a necessary prerequisite (39% among male nurses, 30% among female nurses, P < .05). Poor communication with terminal patients and hostility toward living will were also predictive of willingness to perform both mechanical ventilation and tracheotomy without patient consent., Conclusions: A significant part of French district nurses may have a disturbing propensity to support intubation and tracheotomy with insufficient attention paid to the patient's will. Further research should investigate potential causal factors (such as increased workload) as well as sex-related attitudes in nurse-patient relationship.
- Published
- 2008
- Full Text
- View/download PDF
5. French district nurses' opinions towards euthanasia, involvement in end-of-life care and nurse patient relationship: a national phone survey.
- Author
-
Bendiane MK, Galinier A, Favre R, Ribiere C, Lapiana JM, Obadia Y, and Peretti-Watel P
- Subjects
- Community Health Nursing, Euthanasia psychology, France, Humans, Multivariate Analysis, Surveys and Questionnaires, Attitude of Health Personnel, Euthanasia ethics, Home Care Services ethics, Nurse-Patient Relations ethics, Terminal Care ethics
- Abstract
Objectives: To assess French district nurses' opinions towards euthanasia and to study factors associated with these opinions, with emphasis on attitudes towards terminal patients., Design and Setting: An anonymous telephone survey carried out in 2005 among a national random sample of French district nurses., Participants: District nurses currently delivering home care who have at least 1 year of professional experience. Of 803 district nurses contacted, 602 agreed to participate (response rate 75%)., Main Outcome Measures: Opinion towards the legalisation of euthanasia (on a five-point Likert scale from "strongly agree" to "strongly disagree"), attitudes towards terminal patients (discussing end-of-life issues with them, considering they should be told their prognosis, valuing the role of advance directives and surrogates)., Results: Overall, 65% of the 602 nurses favoured legalising euthanasia. Regarding associated factors, this proportion was higher among those who discuss end-of-life issues with terminal patients (70%), who consider competent patients should always be told their prognosis (81%) and who value the role of advance directives and surrogates in end-of-life decision-making for incompetent patients (68% and 77% respectively). Women and older nurses were less likely to favour legalising euthanasia, as were those who believed in a god who masters their destiny., Conclusions: French nurses are more in favour of legalising euthanasia than French physicians; these two populations contrast greatly in the factors associated with this support. Further research is needed to investigate how and to what extent such attitudes may affect nursing practice and emotional well-being in the specific context of end-of-life home care.
- Published
- 2007
- Full Text
- View/download PDF
6. Disclosure of prognosis to terminally ill patients: attitudes and practices among French physicians.
- Author
-
Peretti-Watel P, Bendiane MK, Obadia Y, Lapiana JM, Galinier A, Pegliasco H, Favre R, and Moatti JP
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Organizations, Prognosis, Sex Factors, Attitude of Health Personnel, Family Practice, Medical Oncology, Neurology, Terminally Ill psychology, Truth Disclosure
- Abstract
Background: Disclosure of the prognosis to terminally ill patients is a strong prerequisite for integrating the physical, psychological, spiritual, and social aspects of end-of-life care., Objective: This study aimed to assess French physicians' general attitudes and effective practices (with patients followed up to death recently) toward such disclosure., Design/subjects: We used data from a cross-sectional survey conducted among a national sample of 917 French general practitioners, oncologists, and neurologists., Results: A majority of respondents opted for prognosis disclosure only at patients' request, very few opted for systematic disclosure without patient's request, and a significant minority opted for systematic concealment. Concerning deceased patients described by respondents, 44.5% of competent patients were informed of prognosis by their physician, 27.3% were informed by someone else, 9.0% refused to be informed, and 19.2% were simply not informed. Concealment was more frequent for older patients, and physicians involved in a nongovernmental organization (NGO) for patients' support were more likely to disclose the prognosis, even without patient's request., Conclusions: Disclosure of the prognosis to terminally ill patients is still far from systematic in France. Further research is needed to better understand the motivations of French physicians' disclosure practices, which are probably culturally shaped.
- Published
- 2005
- Full Text
- View/download PDF
7. [Doctors' opinions on palliative care: results from a French survey on physicians attitudes and practices].
- Author
-
Ben Diane MK, Galinier A, Pegliasco H, Lapiana JM, Favre R, Peretti-Watel P, and Obadia Y
- Subjects
- Adult, Communication, Female, France, Health Care Surveys, Humans, Male, Middle Aged, Physician's Role, Attitude of Health Personnel, Health Knowledge, Attitudes, Practice, Palliative Care
- Abstract
Objective: To examine practitioners' opinions on palliative care., Method: Statistical analyses were carried out on data collected from 1000 physicians recruited to participate in a study on knowledge, attitudes and practices with respect to palliative care ("Palliative Care 2002"). A cluster analysis (CAH) was conducted based on responses to nine questions in order to identify homogeneous and contrasting profiles of opinions on palliative care., Results: Two distinctly different categories of profiles emerged. The first one had a restrictive approach to palliative care (n = 387; 38.7%), while the second one supported its expansion (n = 613; 61.3%)., Conclusion: A newly revised communication campaign which favoured and recognised palliative care could assist in the dissemination of related practices among physicians.
- Published
- 2005
- Full Text
- View/download PDF
8. Morphine prescription to terminally ill patients with lung cancer and dyspnea: French physicians' attitudes.
- Author
-
Bendiane MK, Peretti-Watel P, Pegliasco H, Favre R, Galinier A, Lapiana JM, and Obadia Y
- Subjects
- Analgesics, Opioid administration & dosage, Dyspnea etiology, Humans, Lung Neoplasms complications, Morphine administration & dosage, Terminal Care statistics & numerical data, Terminally Ill, Analgesics, Opioid therapeutic use, Attitude of Health Personnel, Dyspnea drug therapy, Lung Neoplasms drug therapy, Morphine therapeutic use, Practice Patterns, Physicians' statistics & numerical data, Terminal Care methods
- Abstract
This study aimed to investigate factors associated with analgesic use of morphine in end-of-life care. French general practitioners (GPs) and oncologists (N = 719) were asked whether they would prescribe morphine as first-line therapy to patients with terminal lung cancer suffering from dyspnea associated with cough and great anxiety. Overall, 54 percent of oncologists and 40 percent of GPs stated that they would prescribe morphine in the presented case. This prescriptive attitude correlated with physicians' age, professional background, communication skills, and attitude toward terminally ill patients. The findings of this study indicate that improving analgesic use of opioids in end-of-life care is not only a matter of enhancing technical skills acquired through training or experience but also a matter of improving communication and empathy between physicians and patients.
- Published
- 2005
- Full Text
- View/download PDF
9. Opinions toward pain management and palliative care: comparison between HIV specialists and oncologists.
- Author
-
Peretti-Watel P, Bendiane MK, Galinier A, Lapiana JM, Favre R, Pegliasco H, and Obadia Y
- Subjects
- Adult, Cluster Analysis, Female, HIV Infections physiopathology, Health Knowledge, Attitudes, Practice, Humans, Logistic Models, Male, Middle Aged, Surveys and Questionnaires, Attitude of Health Personnel, Medical Oncology, Pain Management, Palliative Care methods, Venereology
- Abstract
Despite the introduction of HAART, pain is still a common symptom in people living with HIV/AIDS. For these persons, pain management supplied by palliative care teams may support standard HIV care. This study compares opinions toward palliative care of 83 HIV specialists and 217 oncologists (French national survey: Palliative Care 2002). Data were collected by phone questionnaire. A cluster analysis was carried out in order to identify contrasted profiles of opinions toward palliative care. A logistic regression was performed to test the relationships between identified clusters and physicians' characteristics. With a two-cluster partition, we observed a profile corresponding to a restrictive conception of palliative care. Within this profile, physicians were more prone to consider that palliative care should be used only for terminally-ill patients, and only after all curative treatments have failed, with a restrained prescriptive power for physicians providing palliative care. This conception was associated with reluctance toward morphine analgesia. Once controlled for other physicians' characteristics, HIV specialists were more likely than oncologists to endorse this restrictive conception (OR=1.9, CI 95% [1.1; 3.3]). Thus French HIV specialists should be more informed about the utility of providing palliative care, even for patients who are not in terminal stage.
- Published
- 2004
- Full Text
- View/download PDF
10. The prescription of opioid analgesics to terminal cancer patients: impact of physicians' general attitudes and contextual factors.
- Author
-
Peretti-Watel P, Bendiane MK, Obadia Y, Favre R, Lapiana JM, and Moatti JP
- Subjects
- Adult, Drug Prescriptions statistics & numerical data, Family Practice statistics & numerical data, Female, France, Health Care Surveys, Humans, Logistic Models, Male, Medical Oncology statistics & numerical data, Middle Aged, Morphine therapeutic use, Pain etiology, Terminal Care, Analgesics, Opioid therapeutic use, Attitude of Health Personnel, Neoplasms complications, Pain drug therapy, Practice Patterns, Physicians' statistics & numerical data
- Abstract
Objective: This study aimed to examine factors associated with the prescription of opioid analgesics to terminal cancer patients, including physicians' general attitudes toward morphine and contextual factors., Methods: A survey was conducted among a sample of French general practitioners (GPs) and oncologists. Respondents were asked to describe the last three terminally ill patients they had followed up to death., Results: Overall, 526 GPs and oncologists (global response rate: 57%) described 1,082 cancer patients, among whom 85.4% received opioid analgesics. Among other significant predictors (patient age, cancer type, family assistance), this prescription was less frequent for female patients followed by male physicians (OR = 0.53), and more frequent for patients followed by physicians trained in palliative care (OR = 2.70). On the other hand, physicians' attitudes toward morphine were not associated with prescription of morphine and other opioid analgesics., Significance of Results: Although nonprescription of opioid analgesics is only a crude proxy measure for undertreatment of cancer pain, our findings suggest the need to develop training in palliative care in order to standardize practices among GPs and specialists. Our results also highlight the necessity to study pain assessment as an interaction between the physician and the patient, and to consider patients' and physicians' respective genders as a key variable within this interaction.
- Published
- 2003
11. French physicians' attitudes toward legalisation of euthanasia and the ambiguous relationship between euthanasia and palliative care.
- Author
-
Peretti-Watel P, Bendiane MK, Galinier A, Favre R, Lapiana JM, Pégliasco H, and Moatti JP
- Subjects
- Adult, Chi-Square Distribution, Euthanasia ethics, Female, France, Health Knowledge, Attitudes, Practice, Humans, Male, Medical Oncology education, Medical Oncology ethics, Medical Oncology legislation & jurisprudence, Middle Aged, Multivariate Analysis, Needs Assessment, Neurology education, Neurology ethics, Neurology legislation & jurisprudence, Palliative Care ethics, Physicians ethics, Physicians legislation & jurisprudence, Physicians, Family education, Physicians, Family ethics, Physicians, Family legislation & jurisprudence, Physicians, Family psychology, Practice Guidelines as Topic, Surveys and Questionnaires, Attitude of Health Personnel, Attitude to Death, Euthanasia legislation & jurisprudence, Palliative Care legislation & jurisprudence, Physicians psychology
- Abstract
In 1999, the French Parliament established a "right to palliative care", which reactivated public debate about euthanasia. In order to investigate jointly physicians' attitude toward palliative care and euthanasia, we conducted a cross-sectional survey of a national sample of French GPs, oncologists, and neurologists. Overall, 917 physicians participated in the survey. Significant proportions of respondents, especially among GPs and neurologists, considered that palliative sedation and withdrawing life-sustaining treatments (WLST) were euthanasia. Multivariate analysis showed that the physicians who had special medical training in palliative care, and those who distinguish palliative sedation and WLST from euthanasia were more likely to oppose legalisation of euthanasia. Thus, French physicians' attitude to the legalisation of euthanasia is strongly influenced by whether or not they distinguish palliative care from euthanasia. Improved palliative care requires better training of the entire medical profession, and clearer guidelines about which end-of-life care practices are legally and ethically acceptable.
- Published
- 2003
12. [Opinion of general and specialized physicians toward euthanasia. Results from the French survey on attitudes and practices against palliative care, 2002].
- Author
-
Ben Diane MK, Peretti-Watel P, Lapiana JM, Favre R, Galinier A, Pegliasco H, and Obadia Y
- Subjects
- Data Collection, Humans, Attitude, Euthanasia, Family Practice, Medicine, Specialization
- Abstract
Objectives: To evaluate opinion of physicians about the legalization of euthanasia according to their professional characteristics, their attitudes toward morphine, their attitudes toward communication with end-of-life patients, and their perception of specific types of terminal care., Method: Univariate and multivariate analyses were carried out from data collected among 1.000 general practitioners, oncologists, neurologists and HIV specialists (French cross-sectional survey on palliative care, 2002)., Results: 42.5% of physicians agreed with the statement that euthanasia should be legalized as it is already the case in the Netherlands. Inadequate prescription of morphine and calling terminal sedation as active euthanasia were associated with a favorable opinion toward legalization of euthanasia., Conclusion: Specific training on pain management and terminal sedation would help physicians to have a better view of the problem of euthanasia.
- Published
- 2003
13. [Terminal care of patients by the general practitioner and the specialist. Results of a French survey "Attitudes and practices in palliative treatment--2002"].
- Author
-
Ben Diane MK, Pegliasco H, Galinier A, Lapiana JM, Favre R, Peretti-Watel P, and Obadia Y
- Subjects
- Adult, Family Practice, Female, France, Health Knowledge, Attitudes, Practice, Health Surveys, Humans, Male, Medicine, Middle Aged, Morphine administration & dosage, Morphine adverse effects, Pain drug therapy, Specialization, Attitude of Health Personnel, Palliative Care methods, Patient Care Team, Terminal Care methods
- Abstract
Objective: Assess the attitude of the practitioners with regard to the management of patients at the end of their lives, depending on the physician/patient communication and treatment of pain. Method Statistical analysis of the data collected among 1,000 practitioners recruited for a survey on knowledge, attitudes and practices regarding palliative care in 2002., Results: The practitioners who felt "ill at ease" in the management of patients at the end of their life often had a poor opinion regarding morphine and did not systematically their patients of the therapeutic aims., Conclusion: Greater awareness by the practitioners of palliative care would help to improve the quality of care supplied to terminally ill patients.
- Published
- 2003
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.