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Biomedical subjects

F Pochard

Publications and source records attributed to F Pochard.

17 recordsLinked to original sources
PubMed2001

Meeting the needs of intensive care unit patient families: a multicenter study.

Intensive care unit (ICU) caregivers should seek to develop collaborative relationships with their patients' family members, based on an open exchange of information and aimed at helping family members cope with their distress and allowing them to speak for the patient if necessary. We conducted a prospective multicenter study of family member satisfaction evaluated using the Critical Care Family Needs Inventory. Forty-three French ICUs participated in the study. ICU characteristics, patient and family member demographics, and data on satisfaction were collected. Factors associated with satisfaction were identified using a Poisson regression model. A total of 637 patients were included in the study, and 920 family members completed the questionnaire. Seven predictors of family satisfaction were found: one family-related factor, namely, family of French descent and six caregiver-related factors, namely, no perceived contradictions in information given by caregivers; information provided by a junior physician; patient to nurse ratio </= 3; knowledge of the specific role of each caregiver; help from the family's own doctor; and sufficient time spent giving information. Predictors of satisfaction are amenable to intervention and deserve to be investigated further with the goal of improving the satisfaction of ICU patients' family members.

Adult↗
PubMed2000

Half the families of intensive care unit patients experience inadequate communication with physicians.

OBJECTIVE: Effective communication of simple, clear information to families of intensive care unit (ICU) patients is a vital component of quality care. The purpose of this study was to identify factors associated with poor comprehension by family members of the status of ICU patients. DESIGN: Prospective study. SETTING: University-affiliated medical intensive care unit. PATIENTS AND METHODS: A total of 102 patients admitted to an ICU for >2 days. INTERVENTION: The representatives of 76 patients who were visited by at least one person during their ICU stay were interviewed. RESULTS: Mean patient age was 54+/-17 yrs and mean Simplified Acute Physiology Score II at admission was 40+/-20. The representative was the spouse in 47 cases (62%). Among representatives, 25 (33%) were of foreign descent and 12 (16%) did not speak French. Mean duration of the first meeting with a physician was 10+/-6 mins. In 34 cases (54%), the representative failed to comprehend the diagnosis, prognosis, or treatment of the patient. Factors associated with poor comprehension by representatives included patient-related, family-related, and physician-related factors. Patient-related factors included age <50 yrs (p = .03), unemployment (p = .01), referral from a hematology or oncology ward (p = .006), admission for acute respiratory failure (p = .005) or coma (p = .01), and a relatively favorable prognosis (p = .04). Family-related factors were foreign descent (p = .007), no knowledge of French (p = .03), representative not the spouse (p = .03), and no healthcare professional in the family (p = .01). Physician-related factors were first meeting with representative <10 mins (p = .03) and failure to give the representative an information brochure (p = .02). Moreover, after the first meeting, caregivers accurately predicted poor comprehension by representatives (p = .03). CONCLUSIONS: Patient information is frequently not communicated effectively to family members by ICU physicians. Physicians should strive to identify patients and families who require special attention and to determine how their personal style of interrelating with family members may impair communication.

Communication↗
PubMed1998

Syndrome E.

Explore the source record for details and available documents.

Holocaust↗
PubMed1995

Subjective psychological status of severely ill patients discharged from mechanical ventilation.

OBJECTIVE: To evaluate psychological status in consecutive survivors of ICU who needed mechanical ventilation (MV). DESIGN: Prospective study. SETTING: Twenty-four bed intensive care unit. PATIENTS: Fifty-four mechanically ventilated patients were considered for the study; 43 patients were included, but 11 refused or were unable to fill in the form. INTERVENTIONS: A 32-question form was filled out by the patients 48-96 hours after weaning from mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: The mean characteristics of the patients were: age 51.6 years, simplified acute physiologic score (SAPS) 14, organ system failure (OSF) 1.57, OMEGA score 277, length of stay 29 days, length of mechanical ventilation 14 days. Thirty-three required sedation, 30 analgesia, 20 paralysis. The results were as follows: Pain: 13 suffered intolerable pain with a mean intensity of pain during care of 3.5/10. Comfort: 25 felt an inability to communicate, 18 were bothered by noise and 15 by light, while nine feared to be abandoned by staff. Sleep disorders: 28 remember dreaming with a personal judgement about these dreams (0 = pleasant, 10 = nightmare) of 7.6/10; 17 noticed increasing sleep disorders during their stay. Anxiety: 22 felt diffuse anxiety disorder and 16 described intense fear of dying at least once. Mood: 38 felt physical depression and 18 intellectual depression. Delirium or confusion: 33 had delirium or a confused state at the time of weaning and nine suffered hallucinations. Nine correctly appreciated their length of stay and 18 knew the date when they were interviewed. CONCLUSIONS: These results showed that psychological status is poor in ventilated ICU patients, which should be considered in their care.

Adult↗
PubMed1991

Hemodialysis for acute renal failure in patients with hematologic malignancies.

OBJECTIVE: To assess the prognosis of patients with hematologic malignancies in acute renal failure who require hemodialysis. DESIGN: Retrospective study. SETTING: ICU. PATIENTS: Forty-three consecutive patients. METHODS: Prognostic analysis using both univariate and multivariate (stepwise regression) methods. RESULTS: Fifteen (35%) patients recovered from acute renal failure and 12 (28%) were discharged from the ICU. The prognosis of patients with acute renal failure linked to sepsis is poorer than the prognosis of the patients with acute renal failure from other etiologies. Only one patient survived in the former group (n = 26) and 11 in the latter group (n = 17); p less than .0001 in multivariate analysis. When accompanied by associated respiratory failure, mortality rate was higher (93% vs. 33%; p less than .0001). The Simplified Acute Physiology Score (SAPS) calculated within the first 24 hr of admission was significantly (p less than .001) related to mortality when the SAPS was greater than or equal to 13. The presence of neutropenia and the type of hematologic malignancy were not related to a worse prognosis. Tolerance to hemodialysis appeared good, and complications were rare.

Acute Kidney Injury↗
PubMedDate not supplied

[Questionnaire on professional satisfaction with psychiatric emergency services: the professionals' opinion].

Professional's satisfaction concerning medical wards to which they address their patients are scarce, but is part of quality evaluation. The primary care network criticizes often the access to specialized psychiatric cares in emergency. The rapid emergency crisis team (ERIC) is a mobile emergency and post-emergency crisis team depending from public services. It has for purpose to offer early access to specialized care before admission to psychiatric hospital, which general practitioners or other members of social network alert it for a crisis psychiatric situation. The aim of this study was to evaluate the adequacy of ERIC to the needs of professionals, and to improve the collaboration within the network. We performed a mailed study using a questionnaire to 150 general practitioners, 25 private psychiatrists, 7 social circonscriptions, and 5 police departments depending on our intervention's catchment area. Forty-two percent of the professionals answered. Emergency psychiatric crisis situations are scarce, and professional's satisfaction is excellent. ERIC is considered as useful, and the accessibility is underlined. However, information transmitted at the end of the intervention is criticized by the professionals. This study allows to improve some of the procedures and will help to an evolution of our functioning. Moreover, it allows to propose a strategy of prevention oriented to early access to specialized cares.

Catchment Area, Health↗
PubMedDate not supplied

[Suicidal action and sacrificial violence: systemic and anthropological hypothesis].

Studies concerning suicidal behavior show practical limitations of epidemiology and risk factor analysis. Suicidal behaviour is usually considered as a consequence of mental disease, but suicide cannot be studied without addressing the context of the acting-out. Suicide attempt can be interpreted as a thematic relational act, in which the central phenomenon is anger. Using the anthropological hypothesis of scapegoating described by René Girard and a theoretical systemic approach, we propose a vision of suicide attempts in a micro-social context, offering a new interpretation of the acting-out. Application of the hypothesis to the suicidal context shows that suicidal behavior may be considered as a relationship modality. The understanding of rivalry mechanisms and integration of care in a context which takes account of the complexity of suicidal behaviour offers the possibility of developing potentially valuable approaches to prevention.

Acting Out↗
PubMedDate not supplied

[Anxiety and depressive disorders in cardiovascular diseases].

Cardiovascular diseases are often associated with anxiety and depression. The literature gives different interpretations of this comorbidity. Psychopathological factors have been successively studied as risk factors, comorbid disorders and factors influencing the prognostic. The authors describe the incidence and the prevalence of anxiety and depression, first in coronary heart disease and secondly before cardiac surgery. The prognostic significance of these psychological factors is also reviewed. Physiopathological hypothesis and practical application in clinical practice are proposed.

Adaptation, Psychological↗
PubMedDate not supplied

[Security and home emergency psychiatric interventions].

Sectorisation of cares leads professionals to a confrontation with violent home patients. These interventions need a maximal security for professionals. Emergency Mobile Crisis Team (ERIC) has more than 6,000 crisis home interventions' experience. The aim of this study was to assess violent situations during a 42 months experience. We present 70 situations of danger for professionals, and their consequences. Difficulties lead to procedural safety measures, which are presented. Prevention of violence during intervention needs an acute preparation, a clear evaluation of context, and passive or active securisation measures. Occurrence of acting-out is low, but situations considered as dangerous are frequent. We propose some pragmatic issues to increase security in crisis home interventions.

Accidents, Occupational↗