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Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists

INTRODUCTION: We investigated the reflections and perceptions of non-ICU physicians about anticipating the need for ICU admission in case of acute decompensation in patients with chronic disease. METHODS: We performed a qualitative multicentre study using semi-structured interviews among non-ICU spe...

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Autores principales: Taha, Alicia, Jacquier, Marine, Meunier-Beillard, Nicolas, Ecarnot, Fiona, Andreu, Pascal, Roudaut, Jean-Baptiste, Labruyère, Marie, Rigaud, Jean-Philippe, Quenot, Jean-Pierre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484637/
https://www.ncbi.nlm.nih.gov/pubmed/36121869
http://dx.doi.org/10.1371/journal.pone.0274936
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author Taha, Alicia
Jacquier, Marine
Meunier-Beillard, Nicolas
Ecarnot, Fiona
Andreu, Pascal
Roudaut, Jean-Baptiste
Labruyère, Marie
Rigaud, Jean-Philippe
Quenot, Jean-Pierre
author_facet Taha, Alicia
Jacquier, Marine
Meunier-Beillard, Nicolas
Ecarnot, Fiona
Andreu, Pascal
Roudaut, Jean-Baptiste
Labruyère, Marie
Rigaud, Jean-Philippe
Quenot, Jean-Pierre
author_sort Taha, Alicia
collection PubMed
description INTRODUCTION: We investigated the reflections and perceptions of non-ICU physicians about anticipating the need for ICU admission in case of acute decompensation in patients with chronic disease. METHODS: We performed a qualitative multicentre study using semi-structured interviews among non-ICU specialist physicians. The interview guide, developed in advance, focused on 3 questions: (1) What is your perception of ICU care? (2) How do you think advance directives can be integrated into the patient’s healthcare goals? and (3) How can the possibility of a need for ICU admission be integrated into the patient’s healthcare goals? Interviews were recorded, transcribed and analysed by thematic analysis. Interviews were performed until theoretical saturation was reached. RESULTS: In total, 16 physicians (8 women, 8 men) were interviewed. The main themes related to intensive care being viewed as a distinct specialty, dispensing very technical care, and with major human and ethical challenges, especially regarding end-of-life issues. The participants also mentioned the difficulty in anticipating an acute decompensation, and the choices that might have to be made in such situations. The timing of discussions about potential decompensation of the patient, the medical culture and the presence of advance directives are issues that arise when attempting to anticipate the question of ICU admission in the patient’s healthcare goals or wishes. CONCLUSION: This study describes the perceptions that physicians treating patients with chronic disease have of intensive care, notably that it is a distinct and technical specialty that presents challenging medical and ethical situations. Our study also opens perspectives for actions that could promote a pluridisciplinary approach to anticipating acute decompensation and ICU requirements in patients with chronic disease.
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spelling pubmed-94846372022-09-20 Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists Taha, Alicia Jacquier, Marine Meunier-Beillard, Nicolas Ecarnot, Fiona Andreu, Pascal Roudaut, Jean-Baptiste Labruyère, Marie Rigaud, Jean-Philippe Quenot, Jean-Pierre PLoS One Research Article INTRODUCTION: We investigated the reflections and perceptions of non-ICU physicians about anticipating the need for ICU admission in case of acute decompensation in patients with chronic disease. METHODS: We performed a qualitative multicentre study using semi-structured interviews among non-ICU specialist physicians. The interview guide, developed in advance, focused on 3 questions: (1) What is your perception of ICU care? (2) How do you think advance directives can be integrated into the patient’s healthcare goals? and (3) How can the possibility of a need for ICU admission be integrated into the patient’s healthcare goals? Interviews were recorded, transcribed and analysed by thematic analysis. Interviews were performed until theoretical saturation was reached. RESULTS: In total, 16 physicians (8 women, 8 men) were interviewed. The main themes related to intensive care being viewed as a distinct specialty, dispensing very technical care, and with major human and ethical challenges, especially regarding end-of-life issues. The participants also mentioned the difficulty in anticipating an acute decompensation, and the choices that might have to be made in such situations. The timing of discussions about potential decompensation of the patient, the medical culture and the presence of advance directives are issues that arise when attempting to anticipate the question of ICU admission in the patient’s healthcare goals or wishes. CONCLUSION: This study describes the perceptions that physicians treating patients with chronic disease have of intensive care, notably that it is a distinct and technical specialty that presents challenging medical and ethical situations. Our study also opens perspectives for actions that could promote a pluridisciplinary approach to anticipating acute decompensation and ICU requirements in patients with chronic disease. Public Library of Science 2022-09-19 /pmc/articles/PMC9484637/ /pubmed/36121869 http://dx.doi.org/10.1371/journal.pone.0274936 Text en © 2022 Taha et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Taha, Alicia
Jacquier, Marine
Meunier-Beillard, Nicolas
Ecarnot, Fiona
Andreu, Pascal
Roudaut, Jean-Baptiste
Labruyère, Marie
Rigaud, Jean-Philippe
Quenot, Jean-Pierre
Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists
title Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists
title_full Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists
title_fullStr Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists
title_full_unstemmed Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists
title_short Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists
title_sort anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: a qualitative study among specialists
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484637/
https://www.ncbi.nlm.nih.gov/pubmed/36121869
http://dx.doi.org/10.1371/journal.pone.0274936
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