[Delirium, a poorly understood syndrome]. / Le delirium, un syndrome mal connu.

The word delirium is a more appropriate term than agitation or confusion to describe clinical realities that are common in intensive care units, postoperative units, geriatric units and palliative care units. Its recognition by carers will allow more appropriate care and treatment.

[Sharing concern for pain in the interaction of care]. / Partager le souci de la douleur dans l'interaction du soin.

Faced with complaints from patients in their day-to-day practice, health professionals are the main actors in the assessment and management of pain. Empathetic listening to the patient is an essential component in the patient's adherence to and participation in the therapeutic project developed by a multidisciplinary team.

A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France.

BACKGROUND: Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. METHODS: Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. RESULTS: Nurses recognize their role as being witnesses to the patient's experience through their constant presence. This is in line with their professional values and gives them an "alert role" that can anticipate a patient-centered palliative approach. The physician's positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, "rethinking care within a team environment" allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses "balance" while providing personal and professional support. CONCLUSIONS: The Physician's positioning and attitude toward palliative approach sets the tone for its early implementation and determines the behavior of different staff members within healthcare service. "Recognition at work", specifically "recognition of the individual role of nurse" is an essential concept for understanding what causes the delay in the implementation of a palliative approach. Interprofessional training (physicians and nurses) could optimize sharing expertise. Registered nurses consider MPCT as a "facilitating intermediary" within the healthcare service improving communication. Restoring a balance in sharing care and decision between physicians and other caregivers lead care teams to an anticipated and patient-centered palliative approach according to guidelines.

[Pain is complex!] / La douleur : c'est complexe !

Health professionals are confronted daily with the expression of pain feared and/or perceived by patients. Sometimes it can be related to care. In all cases, they strive to to take care of all its components and to prevent it. A doctor, invested in palliative care, offers an interesting perspective of situations and emotions that can be combined to feed a complex painful dimension.

[Observational study of delirium in palliative care]. / Enquête observationnelle sur le delirium palliatif.

Caregivers know that the agitation and movements to reject sheets and clothes is found in some patients with cancer in the palliative phase. An observational study was carried out with the aim of refining the short-term prognosis clinical approach and to organise more suitably adapted care.