[Patients hospitalized in advanced or terminal phase of a serious life-threatening disease].
OBJECTIVE: The end-point of this survey was to evaluate the number of patients in advanced or terminal phase of a life-threatening disease and hospitalised in the university hospital in Grenoble on a given day. The secondary end-points were determination of the profile of patients undergoing palliative care and the therapeutic charge they represented for the hospital in order to develop optimal medico-psycho-social responses adapted to the needs of this population, their family and friends and the teams of health professionals who treat them. METHODS: The survey was based on a questionnaire including 106 items and one open question, filled-in by a physician and the nurses of the hospital, together with the interviewer. RESULTS: Out of the 1495 patients hospitalised in the hospital centre (84% occupation), 114 patients were included in the study, i.e., 8% of the total number of patients present. Patients' mean age was of 70 (21<x<98); 40% were aged over 75. The principle motivation for hospitalisation was an acute medical problem (54%) followed by the impossibility of remaining at home (42%); 32% of the patients were hospitalised for a scheduled follow-up or treatment. The pathologies most frequently observed were cancer (61%) and neuro-degenerative disorders (28%). In our study, this category of patient exhibited a complex and heavy medico-psycho-social profile. It also revealed, when compared with a similar study conducted in 1996 at the Pitié-Salpêtrière hospital, that the identification of an advanced or terminal phase of a disease was generally late and probably prohibited the patients, their families and the nursing staff from access to specific accompaniment. COMMENTS: Our results demonstrate the need for palliative care unit (with beds) in large establishments such as the university hospital in Grenoble, in the centre of large towns. Although not all terminally ill patients require a specialised palliative care unit, we feel that the creation of such units will be mandatory in the years to come, if only because of public pressure or necessity.