Fostering timely integrated palliative care in nursing homes through critical companionship: experiences from a Padi-Palli interventional study in France.

Background: One of the fundamental pillars of integrating a palliative approach in nursing home care is increasing professional competencies and institutional capacity. However, conventional training designs have been proven to fall short of supporting this integration. This paper details the results of a practice development intervention that used critical companionship as a learning design to facilitate the integration of a palliative approach in the care of nursing home residents in France.

"You close the door, wipe your sadness and put on a smiling face": a qualitative study of the emotional labour of healthcare professionals providing palliative care in nursing homes in France.

Background: Palliative care provided to frail and dying older persons in nursing homes results in intense emotions for residents and their relatives as well as for healthcare professionals. In France, scant attention has been given to how nursing home professionals manage their emotions when providing palliative care. This study analysed the emotional demands of providing palliative care in the nursing home context, the emotional strategies used by healthcare professionals to navigate such demands, and how these demands affect their emotional wellbeing.

Understanding why patients request euthanasia when it is illegal: a qualitative study in palliative care units on the personal and practical impact of euthanasia requests.

Context: Some patients in palliative care units request euthanasia regardless of legislation. Although studies have explored the reasons for these requests, little is known about the subjective, relational, and contextual repercussions for the patient.

Objectives: The aim of this study is to understand the purpose of euthanasia requests from the patient's viewpoint and their personal and practical impact.

Palliative sedation challenging the professional competency of health care providers and staff: a qualitative focus group and personal written narrative study.

Background: Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation.

Death wishes and explicit requests for euthanasia in a palliative care hospital: an analysis of patients files.

Background: In the current public debate in France about end-of-life and legalization of euthanasia, palliative care is considered as a suitable answer or an alternative or even a supplement to euthanasia. The debate is based on opinion surveys, partly because there is a lack of objective data about the incidence of euthanasia requests (ER) in palliative care settings. The aim of this study was to collect, classify and quantify the expressions of wishes to die (WD), based on computerized files for patients admitted to an 81-bed palliative care hospital (PCH) in Paris during 2010-2011.

[The time of dying and the time of hospital: end of life patients in emergency departments].

A significant number of seriously ill patients die in French emergency departments. A qualitative study of the care of end of life patients in two emergency departments in teaching hospitals was conducted to analyze the work of practitioners. Organizational and funding constraints exert a significant influence on the quality of care, which in some cases may become inconsistent and cause tensions among staff.

Palliative care in emergency departments: an impossible challenge?

The aim of this study was to investigate the care practices surrounding end-of-life patients and the scope for providing palliative care in two emergency department short-stay units. Two qualitative methods of investigation were used: direct ethnographic-type observation and semi-directed group interviews. The results highlight the fact that end-of-life situations inflect the practices of care and give rise to adjustments in the organization of work.

Relationships between the characteristics of oncohematology services providing palliative care and the sociodemographic characteristics of caregivers using health indicators: social support, perceived stress, coping strategies, and quality of work life.

Objective: The aim of this study was to analyze the relationships between the characteristics of the management of oncohematology services and the psychosocial determinants of caregivers' health at work including social support, stress, and coping strategies.

Design: Investigation using questionnaires was carried out about nurses and nurse aides in hematology and oncology services.

Setting: All hematology and oncology services of Western France were requested.