Perceived Quality of Life in Intensive Care Medicine Physicians: A French National Survey.

There is a growing interest in the quality of work life (QWL) of healthcare professionals and staff well-being. We decided to measure the perceived QWL of ICU physicians and the factors that could influence their perception. We performed a survey coordinated and executed by the French Trade Union of Intensive Care Physicians (SMR).

Evaluation of the Time Spent by Anesthetist on Clinical Tasks in the Operating Room.

Background: Changes in the health system in Western countries have increased the scope of the daily tasks assigned to physicians', anesthetists included. As already shown in other specialties, increased non-clinical burden reduces the clinical time spent with patients.

Methods: This was a multicenter, prospective, observational study conducted in 6 public and private hospitals in France.

Non-readmission decisions in the intensive care unit: A qualitative study of physicians' experience in a multicentre French study.

Purpose: Deciding not to re-admit a patient to the intensive care unit (ICU) poses an ethical dilemma for ICU physicians. We aimed to describe and understand the attitudes and perceptions of ICU physicians regarding non-readmission of patients to the ICU.

Materials And Methods: Multicenter, qualitative study using semi-directed interviews between January and May 2019.

Association of Social Network Use With Increased Anxiety Related to the COVID-19 Pandemic in Anesthesiology, Intensive Care, and Emergency Medicine Teams: Cross-Sectional Web-Based Survey Study.

Background: Critical care teams are on the front line of managing the COVID-19 pandemic, which is stressful for members of these teams.

Objective: Our objective was to assess whether the use of social networks is associated with increased anxiety related to the COVID-19 pandemic among members of critical care teams.

Methods: We distributed a web-based survey to physicians, residents, registered and auxiliary nurses, and nurse anesthetists providing critical care (anesthesiology, intensive care, or emergency medicine) in several French hospitals.

Pregnancy Rates After Surgical Treatment of Deep Infiltrating Endometriosis in Infertile Patients With at Least 2 Previous In Vitro Fertilization or Intracytoplasmic Sperm Injection Failures.

Study Objective: To assess the postoperative probabilities of pregnancy in patients with deep infiltrating endometriosis (DIE) and ≥2 previous in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) failures.

Design: Retrospective study using data prospectively recorded in the North-West Inter Regional Female Cohort for Patients with Endometriosis (CIRENDO) database.

Setting: University tertiary referral center.

What are the characteristics that lead physicians to perceive an ICU stay as non-beneficial for the patient?

Purpose: We sought to describe the characteristics that lead physicians to perceive a stay in the intensive care unit (ICU) as being non-beneficial for the patient.

Materials And Methods: In the first step, we used a multidisciplinary focus group to define the characteristics that lead physicians to consider a stay in the ICU as non-beneficial for the patient. In the second step, we assessed the proportion of admissions that would be perceived by the ICU physicians as non-beneficial for the patient according to our focus group's definition, in a large population of ICU admissions in 4 French ICUs over a period of 4 months.

Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial.

Importance: Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms.

Objectives: To assess the effect of an ICU diary on the psychological consequences of an ICU hospitalization.

Design, Setting, And Participants: Assessor-blinded, multicenter, randomized clinical trial in 35 French ICUs from October 2015 to January 2017, with follow-up until July 2017.

What are the ethical questions raised by the integration of intensive care into advance care planning?

A major goal of intensive care units (ICUs) is to offer optimal management, but for many patients admitted to the ICU, they are unlikely to yield any lasting benefit. In this context, the ICU physician remains a key intermediary, particularly when a decision regarding possible limitation or withdrawal of life-sustaining therapy becomes necessary. The possibility of admission to the ICU, and the type of care the patient would like to receive there, should be integrated into the healthcare project in agreement with the patient, regardless of the stage of disease that the patient suffers from.

Can qualitative research play a role in answering ethical questions in intensive care?

Scientific and technological progress, as well as increased patient autonomy have profoundly changed the world of healthcare, giving rise to new situations that are increasingly complex and uncertain. Quantitative paradigms, of which the main bastion is evidence-based medicine (EBM), are beginning to reach their limits in daily routine practice of medicine, and new approaches are emerging that can provide novel heuristic perspectives. Qualitative research approaches can be useful for apprehending new areas of knowledge that are fundamental to recent and future developments in intensive care.

What are the ethical aspects surrounding the collegial decisional process in limiting and withdrawing treatment in intensive care?

The decision to limit or withdraw life-support treatment is an integral part of the job of a physician working in the intensive care unit, and of the approach to care. However, this decision is influenced by a number of factors. It is widely accepted that a medical decision that will ultimate lead to end-of-life in the intensive care unit (ICU) must be shared between all those involved in the care process, and should give precedence to the patient's wishes (either directly expressed by the patient or in written form, such as advance directives), and taking into account the opinion of the patient's family, including the surrogate if the patient is no longer capable of expressing themselves.

What are the ethical issues in relation to the role of the family in intensive care?

A large proportion of patients admitted to the intensive care unit (ICU) are unable to express themselves, often due to acute illness, shock or trauma, and this precludes any communication and/or consent for care that might reflect their wishes and opinions. In such cases, the only solution for the ICU physician is to include the patient's family in the healthcare decisions. This can represent a significant burden on the family, on top of the psychological distress of the ICU environment and hospitalisation of their relatives, and many family members may suffer from anxiety, depression or symptoms of post-traumatic stress disorder (PTSD) during or after the hospitalisation and/or death of a loved one in the ICU.

Intersecting vulnerabilities in professionals and patients in intensive care.

In the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU.

The concept of a surrogate is ill adapted to intensive care: Criteria for recognizing a reference person.

Purpose: In the intensive care unit (ICU), caregivers may find it difficult to identify a suitable person in the patient's entourage to serve as a reference when there is no official surrogate.

Methods: We developed a 12-item questionnaire to identify factors potentially important for caregivers when identifying a reference person. Each criterion was evaluated as regards its importance for the role of reference.

Newborn hearing screening: analysis and outcomes after 100,000 births in Upper-Normandy French region.

Objectives: Neonatal hearing impairment is a common disorder with a prevalence of 1 to 2‰ worldwide, with significant consequences on overall development when rehabilitated too late. New-born hearing screening has been implemented in the 1990s in most European countries and the USA. The Upper-Normandy region of France has been conducting a pilot program since 1999.