Favoriser la communication entre les professionnels de la santé, le patient et ses proches dans le processus de choix de soins en contexte de maladie grave : planification d'une intervention dans le cadre d'une recherche-action

Background : The involvement of patients, patients' kin and health care professionals in the communication surrounding the medical decision making process must be improved to insure health care quality. Objectives : The objective of this research was to describe how the communication between a patient, his kin and his health professionals could be improved in regards to the medical decision making process for severe illnesses. Following an action research perspective, this project also aimed to develop an intervention to facilitate this process. Method : Two rounds of four group interviews were conducted with professionals from a regional health center in northern Quebec (Centre de sante et de services sociaux de Rouyn-Noranda: CSSSRN) between 2009 and 2010. The groups represented teams from (a) the intensive care unit and the emergency room, (b) medical and surgical wards, (c) long term care and rehabilitation, (d) home care and specialized outpatient clinics. The transcripts from the first round of interviews were submitted to a thematic analysis while the ones from the second round were submitted to an analytical questioning. Results : Twenty-seven and 29 participants representing 9 health care professions participated to the interviews of the first and second rounds respectively. The first round of interviews revealed that all the health care professionals are involved in the communication associated with the medical decision making process. Strategies used by professionals to improve the participation of patients and patients' kin in the process of choosing care were identified, as well as relevant means of communication used by the professionals amongst themselves. The results inspired the development of a multidisciplinary communication tool and the revision of the decision-making tool used in the health center where the research was conducted. The second round of interviews demonstrated that a multidisciplinary communication tool could allow a better acknowledgement of the roles played by non-doctor professionals, and that a decision-making tool with goals of care rather than levels of care could improve the participation of patients, patients' kin and health care professionals in the choice of care. Finally, a reference tool guiding the communication surrounding the medical decision making process was suggested. Conclusion : This action research project allowed a better understanding of the roles played by non-doctor professionals in the communication surrounding the medical decision making process, and suggested solutions to improve the impact and the legitimacy of their involvement. Finally, three tools to improve the communication around choices of care were developed.

Name thesis:degree_name

M. Sc.

Level thesis:degree_level

Maîtrise

Discipline thesis:degree_discipline

Sciences cliniques

Grantor dc:publisher

Université de Sherbrooke

Year dc:date.issued

2011

Author dc:creator

• Sohi, Julia

Advisor dc:contributor.advisor

• Champagne, Manon

• Participation du patient
• Équipe de soins
• Décision partagée
• Communication interdisciplinaire
• Planification préalable des soins
• Choix de soins
• Patient Participation
• Patient care team
• Décision Making
• Interdisciplinary communication
• Advance directives

Language dc:language.iso

fr

Handle dc:identifier.uri

http://hdl.handle.net/11143/5961

OAI identifier oai:identifier

oai:usherbrooke.scholaris.ca:11143/5961