{"id":1835,"date":"2008-10-01T01:00:00","date_gmt":"2008-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/deploiement-et-evaluation-prospective-sur-huit-mois-du-dispositif-dannonce-du-cancer-dans-un-service-dhepato-gastro-enterologie\/"},"modified":"2018-10-20T18:39:44","modified_gmt":"2018-10-20T16:39:44","slug":"deploiement-et-evaluation-prospective-sur-huit-mois-du-dispositif-dannonce-du-cancer-dans-un-service-dhepato-gastro-enterologie","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/deploiement-et-evaluation-prospective-sur-huit-mois-du-dispositif-dannonce-du-cancer-dans-un-service-dhepato-gastro-enterologie\/","title":{"rendered":"D\u00e9ploiement et \u00e9valuation prospective sur huit mois du dispositif d\u2019annonce du cancer dans un service d\u2019h\u00e9pato-gastro-ent\u00e9rologie."},"content":{"rendered":"

2008<\/strong><\/p>\n

R. FAROUX, JB. PRAUD, J. DIMET, JP. LAFARGUE, G. MEDINGER, M. SCHNEE – CHD La Roche sur Yon 85000<\/em><\/p>\n

Gastroent\u00e9rologie <\/strong>– \u00a02008-05-20 –\u00a0 –<\/p>\n

________________________________<\/p>\n

Buts :
\nD\u00e9crire le d\u00e9ploiement du dispositif d\u2019annonce tel qu\u2019il a pu \u00eatre mis en place dans le service de gastro-entrologie du CHD de La Roche sur Yon, quantifier la proportion de patients ayant pu en profiter et effectuer une \u00e9valuation prospective.
\nMat\u00e9riel et m\u00e9thodes :
\nEvaluation prospective sur une p\u00e9riode de huit mois concernant 62 cas cons\u00e9cutifs, \u00e0 partir des quatre populations protagonistes (m\u00e9decin r\u00e9f\u00e9rent de l’annonce, infirmi\u00e8res, patients et m\u00e9decin traitant) et effectu\u00e9e par l’interm\u00e9diaire de quatre questionnaires distincts reli\u00e9s entre eux par un num\u00e9ro d’anonymisation. Analyse de la conformit\u00e9 au cahier des charges de la mesure 40 du plan cancer.
\nR\u00e9sultats :
\nDescription de l\u2019organisation choisie. La consultation d\u2019annonce diagnostique est possiblement coupl\u00e9e \u00e0 la proposition th\u00e9rapeutique (PPS) et se d\u00e9roule en pr\u00e9sence d\u2019une infirmi\u00e8re coordonnatrice.
\nUne seconde consultation impliquant cette infirmi\u00e8re est pratiqu\u00e9e \u00e0 distance afin de reformuler les \u00e9l\u00e9ments de la premi\u00e8re consultation, d\u2018\u00e9valuer les besoins, de mettre en place soins de support et explications pratiques sur le projet de soins.
\nSur 113 nouveaux cas de cancers vus cons\u00e9cutivement, 67,2 % ont eu un temps d’annonce sp\u00e9cifique et 55 % ont eu acc\u00e8s au dispositif d’annonce complet. Parmi les 37 patients qui n\u2019ont pas eu acc\u00e8s \u00e0 ce dispositif d\u2019annonce, 30% \u00e9taient porteurs d\u2019une maladie tr\u00e8s avanc\u00e9e ayant entra\u00een\u00e9 le d\u00e9c\u00e8s pendant l\u2019hospitalisation et 46% n\u2019ont pas eu de dispositif d\u2019annonce complet par choix du m\u00e9decin r\u00e9f\u00e9rent ou difficult\u00e9s d\u2019organisation.
\nUne importante participation des quatre populations pour remplir les questionnaires (95% pour les m\u00e9decins r\u00e9f\u00e9rents, 81% pour les m\u00e9decins traitants, 98% pour les IDE et 78% pour les patients) a contribu\u00e9 \u00e0 la pertinence de l’\u00e9valuation.
\nLa dur\u00e9e moyenne entre le diagnostic de certitude et la consultation \u00e9tait de 21 jours (extr\u00eames 0 \u00e0 120 jours), 72% des patients ont trouv\u00e9 ce d\u00e9lai rapide. Dans 76% la consultation \u00e9tait post\u00e9rieure \u00e0 la RCP d\u2019environ 11 jours.
\n85% des consultations se d\u00e9roulaient sur les trois premiers jours de la semaine, en d\u00e9but d\u2019apr\u00e8s midi pour 62% et le temps moyen d\u00e9volu \u00e0 cette consultation \u00e9tait de 45 mn.
\n81% des patients \u00e9taient accompagn\u00e9s par un proche.
\nLa relation triangulaire instaur\u00e9e lors de la premi\u00e8re consultation n’a pas perturb\u00e9 les patients et le sentiment de compl\u00e9mentarit\u00e9 entre m\u00e9decins et infirmi\u00e8res a \u00e9t\u00e9 r\u00e9ciproque.
\nLes patients ont \u00e0 85% jug\u00e9 positif ou tr\u00e8s positif ce dispositif et ont appr\u00e9ci\u00e9 l\u2019espace de temps accord\u00e9, la clart\u00e9 des informations, la compl\u00e9mentarit\u00e9 m\u00e9decin-IDE, l\u2019acc\u00e8s aux soins de support, la familiarisation avec le service.
\nLes m\u00e9decins traitants ont fait l’objet d’une attention particuli\u00e8re dans la communication des informations ; Ils ont \u00e9t\u00e9 inform\u00e9s du contenu de la consultation dans 95% des cas dont 50% en temps r\u00e9el. Ils ont trouv\u00e9 \u00e0 74 % que ce dispositif leur apportait une aide appr\u00e9ciable.
\nConclusion :
\nMalgr\u00e9 le temps n\u00e9cessaire important par patient, le dispositif d\u2019annonce, une fois install\u00e9, est jug\u00e9 satisfaisant par les patients, les praticiens hospitaliers, les infirmi\u00e8res et les m\u00e9decins traitants. L\u2019am\u00e9lioration des pratiques n\u00e9cessite une organisation rigoureuse.<\/p>\n","protected":false},"excerpt":{"rendered":"

2008 R. FAROUX, JB. PRAUD, J. DIMET, JP. LAFARGUE, G. MEDINGER, M. SCHNEE – CHD La Roche sur Yon 85000 Gastroent\u00e9rologie – \u00a02008-05-20 –\u00a0 – ________________________________ Buts : D\u00e9crire le d\u00e9ploiement du dispositif d\u2019annonce tel qu\u2019il a pu \u00eatre mis en place dans le service de gastro-entrologie du CHD de La Roche sur Yon, quantifier […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[19],"class_list":["post-1835","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-19"],"yoast_head":"\nD\u00e9ploiement et \u00e9valuation prospective sur huit mois du dispositif d\u2019annonce du cancer dans un service d\u2019h\u00e9pato-gastro-ent\u00e9rologie. - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/deploiement-et-evaluation-prospective-sur-huit-mois-du-dispositif-dannonce-du-cancer-dans-un-service-dhepato-gastro-enterologie\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"D\u00e9ploiement et \u00e9valuation prospective sur huit mois du dispositif d\u2019annonce du cancer dans un service d\u2019h\u00e9pato-gastro-ent\u00e9rologie. - 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