Évaluation de la communication thérapeutique pour améliorer l’accueil du patient au bloc opératoire: étude d’impact

Résumé

Objectif

Nous avons voulu évaluer l'impact de la sensibilisation du personnel soignant à la communication thérapeutique sur l'amélioration de l'accueil du patient au bloc opératoire en chirurgie ambulatoire.

Méthode

Il s'agit d'une étude d'impact prospective, monocentrique, réalisée en chirurgie ambulatoire. Lors de la première phase, un questionnaire était effectué par l'infirmier(ère)-anesthésiste à l'arrivée du patient, permettant d'évaluer sur une échelle numérique simple le confort (ENSc) et la satisfaction et de calculer un score de communication négative ("CN"). Pendant la deuxième phase, le personnel soignant a été sensibilisé à la communication thérapeutique, consistant en partie en l'écoute, l'empathie et l'utilisation de formulations positives, après visionnage des vidéos pédagogiques. Pendant la troisième phase, après sensibilisation du personnel, le questionnaire a de nouveau été effectué. Les variables quantitatives (critère de jugement principal représenté par le nombre de patients ayant un score CN ≥ 5, ENSc, satisfaction) et qualitatives ont été comparées avant et après la phase de sensibilisation à la communication thérapeutique.

Résultats

Au total, 234 patients ont été inclus (109 avant et 125 après). Après sensibilisation du personnel à la communication thérapeutique, le score CN ≥ 5 a significativement diminué de 20 % à 6 %, ainsi que l'ENSc médiane [P₂₅-P₇₅] avant (8 [8-9] vs 8 [7-8]) et après (8 [8-9] vs 8 [7-8]) l'anesthésie. Le pourcentage de patients moins anxieux avant de commencer l'anesthésie était significativement supérieur après communication thérapeutique (32 % vs 17 %). La satisfaction a significativement augmenté après la phase de sensibilisation (8 [7-10] vs (9 [8-10]).

Conclusion

Cette étude préliminaire montre une amélioration modeste du confort et de la satisfaction des patients grâce à la communication thérapeutique. Un essai randomisé contrôlé est cependant nécessaire pour confirmer ces résultats.

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Radiosurgery of vestibular schwannoma: prognostic factors for hearing outcome using 3D-constructive interference in steady state (3D-CISS)

ConclusionOur study supports the theory of a  complex interaction causing alteration of the endolymph protein concentration and not a direct dependency on the SRS. Use of modern dosing schemes will have a positive impact on clinical outcome with preservation of hearing in patients with VS. (Source: Strahlentherapie und Onkologie)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Nuv63A

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AbstractAcute gouty arthritis is the inflammation of joint tissues in the acute form due to the deposition of monosodium urate (MSU) crystals. Regulatory T cells (Tregs) and Th17 cells play an important role in the development and progression of inflammatory diseases. However, the expression and role of Tregs and Th17 cells are not clear in this disease. Here, we investigated the changes of Tregs, Th17 cells, and Treg/Th17 ratio in spleen, as well as the inflammatory cytokines in blood and joint tissue pathology in acute gouty arthritis rat induced by MSU. We found that both the percentages of Tregs and Th17 cells in spleen increased at an early stage (6  h). Tregs decreased at 12 and 24 h, and rise again at 48 and 72 h. However, Th17 cells reached its peak at 24 h, and then decreased ...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NBCCto

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2MhsmBW

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