Tesi sul tema "Personnes âgées dépendantes – soins infirmiers"
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Léone, Elsa. "La formation du personnel soignant pour une meilleure prise en charge des troubles du comportement des résidents vivant en EHPAD et présentant une démence : une perspective non médicamenteuse encourageante". Nice, 2012. http://www.theses.fr/2012NICE2019.
Testo completoAlzheimer's disease is characterized by a cognitive decline but equally behavioral disturbances being major difficulties in the taking care, affecting patients' activities of daily living, patients' and caregivers' quality of life. This background is asking the question of possible treatments and those most suitable. There are numerous non pharmacological treatment targeting various issues in dementia, nevertheless there are few proof of their efficacy especially for decrease of behavioral and psychological symptoms of dementia. This thesis aims at establishing a rigorous assessment of the effectiveness of a non pharmacological treatment and the factors to be favored, in order to offer an appropriate care and to improve care as well as the quality of life of residents with a diagnosis of dementia and living in nursing home. Our first study, TNM-EHPAD, showed benefits of a staff teaching and training program to manage “positive” behavioral disturbances in residents with a diagnosis of dementia and living in nursing home, with a significant decrease of residents’ agitation and aggressiveness. The second study, STIM-EHPAD, showed benefits of a staff teaching and training program to manage apathy, with a significant decrease of residents emotional blunting and loss of initiative. A third study was realized to determine stimuli and conditions increasing the duration of engagement of residents in an activity. This study underlines that individualized and guided interventions increase the duration of engagement and lead to a positive attitude among residents, even those with a diagnosis of apathy. From a clinical point of view up to applied research, the effectiveness of our staff teaching and training program in the care of residents with dementia and living in nursing homes was proved through this thesis. In addition, our works confirmed that care should meet individual’s needs based on the research of residents’ interests, to increase their engagement and ensure a positive attitude. Those researches have also strengthened links and collaborations between the CMRR of Nice University Hospital and the nursing homes both at departmental and national level. Tools developed in this thesis are used and disseminated within this network
Guillon, Nathalie. "Dénutrition en court séjour gériatrique : conséquences sur l'hospitalisation. Etude à partir de deux audits prospectifs sur le soutien nutritionnel". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M115.
Testo completoChaaban, Taghrid. "La Place de l’Infirmière dans la Juste Prescription des Antibiotiques en Etablissements d’Hébergement des Personnes Agées Dépendantes (EHPAD)". Thesis, Sorbonne Paris Cité, 2019. http://www.theses.fr/2019USPCD030.
Testo completoReducing overall antibiotic consumption is a major public health issue in order to avoid the emergence of resistant bacterial strains. Among the people most exposed to antibiotics are the elderly, some of whom live in long term care facilities for dependent elderly people (LTCF). The nurse is the first responder in case of suspected infections in the LTCF. Could it therefore have a place in the prescription of antibiotics and support the reduction of consumption? What could be the role of residents and/or their families in any use of antibiotics?The ATOUM program, which includes six studies, is a multimodal intervention program focused on training caregivers in LTCF. It aims at the one hand to understand the place of the nurse in prescribing, describe the role of residents and their families; and on the other hand to contribute to the development of nurses' skills, to be able to play an essential role in reducing inappropriate prescribing of antibiotic.The studies carried out show that the nurse has an essential role in the care of the elderly person in the event of suspicion of an infection. The competent nurse could have different roles in antibiotic prescribing. In addition, it appears that inter-professional collaboration requires both theoretical and professional skills on the part of the nurse. However, the nurse's participation in the prescribing decision, for a better prescription based on inter-professional collaboration, is influenced by different determinants.The different competencies for the nurse are essential to further enhance her role in the effective management of treatment and antibiotic therapy
Cottereau, Carole. "La douleur chez le sujet âgé immobile, hospitalisé pour une pathologie aiguë : étude à partir de deux audits prospectifs sur le soutien nutritionnel". Bordeaux 2, 2000. http://www.theses.fr/2000BOR2M070.
Testo completoEl, Ansari Loridan Nazha. "Décider en situation d’urgence nocturne en EHPAD (Etablissement d'Hébergement pour Personnes Agées Dépendantes) : Étude d’une innovation expérimentale d’infirmier.es de nuit". Electronic Thesis or Diss., Université de Lille (2022-....), 2023. http://www.theses.fr/2023ULILA024.
Testo completoThis thesis studies how night-shift nurses decide whether or not to resort to the hospital to deal with geriatric emergency cases in a nursing home. Clinical reasoning and decision-making among nurses are rarely documented. The “IDE de nuit” experimentation of Paerpa's projects offered the opportunity to study them through the prism of age and uncertainty in the context of an emergency. It also made it possible to study the organizational test that such an innovation constitutes. Through an interactionist and socio-cognitive approach and based on an ethnographic investigation lasting three years, we captured in situ nurses' reasoning and judgment while dealing with emergency cases in an experimental context. This research sheds light on several aspects: how care is mobilized in the service of the cure; how the emergency constitutes a social construction, which is influenced by the role played by the elderly patient and his caregivers; how the skills that drive innovation are developed and conditioned by the irreversibility of the actions and their results; how and when an organizational innovation begins and ends in an experimental context; finally, how all these elements contribute to defining the moral economy that has been made up and created around elderly people living in EHPADs, targets of this innovation.Keywords: geriatric emergency, decision-making, organizational innovation, IDE de nuit, experimentation, paerpa, le 15, SAMU, hospital, nursing assistants, EHPAD
Gassner, Christine. "Description et évaluation d'un service de soins infirmiers à domicile pour personnes âgées". Université Louis Pasteur (Strasbourg) (1971-2008), 1986. http://www.theses.fr/1986STR1M298.
Testo completoJehl, Evelyne. "Maintien à domicile des personnes âgées à Colmar : étude du service de soins infirmiers à domicile pour personnes âgées de Colmar". Université Louis Pasteur (Strasbourg) (1971-2008), 1987. http://www.theses.fr/1987STR1M247.
Testo completoHardy, Marie-Soleil, e Marie-Soleil Hardy. "Programme d'interventions infirmières pour la transition et le suivi post-hospitalisation des personnes âgées insuffisantes cardiaques". Doctoral thesis, Université Laval, 2019. http://hdl.handle.net/20.500.11794/34014.
Testo completoTableau d'honneur de la Faculté des études supérieures et postdoctorales, 2018-2019
Chez les personnes de 65 ans et plus, l’insuffisance cardiaque est l’une des premières causes d’hospitalisation. Les coûts reliés aux soins de l’insuffisance cardiaque sont exorbitants. Les symptômes de l’insuffisance cardiaque et les fréquentes hospitalisations compromettent grandement la transition suite à ces hospitalisations ainsi que la qualité de vie de ces personnes. Plusieurs études montrent que des programmes de soins de transition sont efficaces. Il demeure toutefois difficile de décrire les interventions spécifiques des infirmières pour arriver à ces résultats. Dans un contexte où les ressources sont limitées, documenter ces interventions s’avère nécessaire et prioritaire pour assurer leur application dans les milieux cliniques. Des interventions infirmières efficaces et appropriées favorisent une meilleure adaptation, diminuent les complications au cours de la transition et évitent des hospitalisations à répétition. Elles contribuent ainsi à diminuer l’utilisation des services et améliorer la qualité de vie de ces personnes. La présente étude s’inspire du modèle d’adaptation de Roy (2009) et des grandes fonctions infirmières de Dallaire et Dallaire (2008). Elle visait à développer, mettre à l’essai et évaluer un programme d’interventions infirmières, pour soutenir le processus d’adaptation des personnes âgées hospitalisées suite à une décompensation de leur insuffisance cardiaque, lors de la transition de l’hôpital vers le domicile. Une méthode mixte a été privilégiée. L’utilisation du processus d’élaboration et d’évaluation des interventions de Sidani et Braden (2011) a permis d’élaborer un programme d’interventions après avoir développé une compréhension approfondie des besoins des personnes âgées et clarifié les composantes des interventions infirmières. Pour ce faire, en plus d’une revue des théories explicatives et de la littérature empirique, des entrevues individuelles semi-dirigées des personnes âgées et leurs proches, des infirmières et d’autres professionnels expérimentés ont été réalisées. Une méthode d’échantillonnage théorique a assuré une représentation adéquate par sept personnes âgées et six de leurs proches. Une méthode d’échantillonnage par choix raisonné a permis de recruter neuf infirmières et cinq autres professionnels de la santé. L’analyse des données, effectuée par un processus inductif et déductif, a permis de développer un programme d’interventions détaillé et optimal. Ce dernier a été mis à l’essai à l’aide d’un devis prétest et post-test avec groupe de comparaison. Pour le pilote, dix personnes âgées hospitalisées pour une décompensation de leur insuffisance cardiaque ont été recrutées et assignées au hasard dans le groupe expérimental ou le groupe contrôle. Le programme d’interventions comprend une visite à l’hôpital, avant le départ, et cinq visites à domicile intercalées d’appels téléphoniques. À chaque séance, l’infirmière pose différentes interventions personnalisées afin de favoriser l’adaptation de la personne au niveau physiologique, psychique et spirituel, social et afin de favoriser ses relations avec les autres. La mise à l’essai montre la faisabilité et l’acceptabilité du programme d’interventions. De plus, des effets du programme d’interventions chez les personnes âgées et l’utilisation des services sont documentés. Des différences statistiquement significatives sont observées entre les deux groupes en ce qui concerne les habiletés d’autogestion de la maladie ainsi que le degré d’incertitude perçu. De plus, des tendances positives sont observées chez les participants du groupe expérimental pour le sentiment d’être prêt et l’adaptation au départ ainsi que pour la qualité de vie. Aucune différence statistiquement significative entre les deux groupes n’est observée pour l’utilisation des services, mais les données montrent que les participants du groupe expérimental ont bénéficié d’interventions ayant potentiellement évité un déplacement vers les services d’urgence et une hospitalisation. En conclusion, cette étude montre que des interventions infirmières spécifiques, qui favorisent l’adaptation globale des personnes âgées insuffisantes cardiaques en transition de l’hôpital vers le domicile, sont efficaces. Un programme d’interventions infirmières qui répond directement aux besoins et aux difficultés de cette clientèle contribue à une meilleure gestion de la maladie chronique et à une meilleure qualité de vie.
Chez les personnes de 65 ans et plus, l’insuffisance cardiaque est l’une des premières causes d’hospitalisation. Les coûts reliés aux soins de l’insuffisance cardiaque sont exorbitants. Les symptômes de l’insuffisance cardiaque et les fréquentes hospitalisations compromettent grandement la transition suite à ces hospitalisations ainsi que la qualité de vie de ces personnes. Plusieurs études montrent que des programmes de soins de transition sont efficaces. Il demeure toutefois difficile de décrire les interventions spécifiques des infirmières pour arriver à ces résultats. Dans un contexte où les ressources sont limitées, documenter ces interventions s’avère nécessaire et prioritaire pour assurer leur application dans les milieux cliniques. Des interventions infirmières efficaces et appropriées favorisent une meilleure adaptation, diminuent les complications au cours de la transition et évitent des hospitalisations à répétition. Elles contribuent ainsi à diminuer l’utilisation des services et améliorer la qualité de vie de ces personnes. La présente étude s’inspire du modèle d’adaptation de Roy (2009) et des grandes fonctions infirmières de Dallaire et Dallaire (2008). Elle visait à développer, mettre à l’essai et évaluer un programme d’interventions infirmières, pour soutenir le processus d’adaptation des personnes âgées hospitalisées suite à une décompensation de leur insuffisance cardiaque, lors de la transition de l’hôpital vers le domicile. Une méthode mixte a été privilégiée. L’utilisation du processus d’élaboration et d’évaluation des interventions de Sidani et Braden (2011) a permis d’élaborer un programme d’interventions après avoir développé une compréhension approfondie des besoins des personnes âgées et clarifié les composantes des interventions infirmières. Pour ce faire, en plus d’une revue des théories explicatives et de la littérature empirique, des entrevues individuelles semi-dirigées des personnes âgées et leurs proches, des infirmières et d’autres professionnels expérimentés ont été réalisées. Une méthode d’échantillonnage théorique a assuré une représentation adéquate par sept personnes âgées et six de leurs proches. Une méthode d’échantillonnage par choix raisonné a permis de recruter neuf infirmières et cinq autres professionnels de la santé. L’analyse des données, effectuée par un processus inductif et déductif, a permis de développer un programme d’interventions détaillé et optimal. Ce dernier a été mis à l’essai à l’aide d’un devis prétest et post-test avec groupe de comparaison. Pour le pilote, dix personnes âgées hospitalisées pour une décompensation de leur insuffisance cardiaque ont été recrutées et assignées au hasard dans le groupe expérimental ou le groupe contrôle. Le programme d’interventions comprend une visite à l’hôpital, avant le départ, et cinq visites à domicile intercalées d’appels téléphoniques. À chaque séance, l’infirmière pose différentes interventions personnalisées afin de favoriser l’adaptation de la personne au niveau physiologique, psychique et spirituel, social et afin de favoriser ses relations avec les autres. La mise à l’essai montre la faisabilité et l’acceptabilité du programme d’interventions. De plus, des effets du programme d’interventions chez les personnes âgées et l’utilisation des services sont documentés. Des différences statistiquement significatives sont observées entre les deux groupes en ce qui concerne les habiletés d’autogestion de la maladie ainsi que le degré d’incertitude perçu. De plus, des tendances positives sont observées chez les participants du groupe expérimental pour le sentiment d’être prêt et l’adaptation au départ ainsi que pour la qualité de vie. Aucune différence statistiquement significative entre les deux groupes n’est observée pour l’utilisation des services, mais les données montrent que les participants du groupe expérimental ont bénéficié d’interventions ayant potentiellement évité un déplacement vers les services d’urgence et une hospitalisation. En conclusion, cette étude montre que des interventions infirmières spécifiques, qui favorisent l’adaptation globale des personnes âgées insuffisantes cardiaques en transition de l’hôpital vers le domicile, sont efficaces. Un programme d’interventions infirmières qui répond directement aux besoins et aux difficultés de cette clientèle contribue à une meilleure gestion de la maladie chronique et à une meilleure qualité de vie.
Heart failure is one of the most common reason for hospitalization in patients aged 65 years and older. This chronic condition affects these elderly, has recurrent and progressive deterioration pattern that compromise quality of life and impose significant impacts on our health care system. Effective transitional care programs may improve clinical outcomes and reduce hospital readmissions. However, it remains difficult to describe theses complex nursing interventions to achieve these results. Very little research has examined the ways through which these programs achieve their particular effects. In a context of limited resources, documenting these interventions and mechanisms seems to be necessary to insure their application and adequacy in the clinical practice. Effective and appropriate nursing interventions reduce complications, increased the length of time between hospital discharge and readmission and reduce total number of hospitalizations. They contribute to improve the quality of life for these people while contributing to decrease the costs. Based on Roy’s adaptation model (Roy, 2009) and nursing functions model by Dallaire et Dallaire (2008), the purpose of this study was to develop, implement and evaluate a nurse transitional care program for older with chronic heart failure at the discharge of hospital. To achieve this goal, a mixed method was privileged. The systematic process proposed by Sidani et Braden (2011) was used to conceptualize and evaluate the nursing interventions program. Theories and empiric literature were used. Also, nine nurses, five health care professionals and seven older people with chronic heart failure and six caregivers participated in semi-structured interviews. An analytic method was used to conceptualize the nursing interventions program. This program was tested. Ten elderly were recruited and randomized in two groups: control and intervention. Five people tested and evaluated the nursing interventions program. The program consists of one session at hospital, before departure and five sessions at home with phones calls between homes visits. Each session includes nursing interventions to promote physiologic, psychic and spiritual, social and relational adaptation. The study results showed the feasibility and the acceptability of the nursing interventions program. The intervention group had significantly improved self-care of their chronic illness and decrease feeling of uncertainty after 30 days. Also, there was a trend toward better readiness for hospital discharge, lower post discharge coping difficulties and better quality of life in the intervention group. No significant difference was found in hospital readmission and emergency consultation. Nursing interventions program show that intervention group received more interventions that may have prevented the use of health services. This study shows that nursing interventions promote holistic adaptation of older people with chronic heart failure at discharge from hospital. Nursing interventions that respond directly to the needs and difficulties of this clientele contribute to better disease management and quality of life.
Heart failure is one of the most common reason for hospitalization in patients aged 65 years and older. This chronic condition affects these elderly, has recurrent and progressive deterioration pattern that compromise quality of life and impose significant impacts on our health care system. Effective transitional care programs may improve clinical outcomes and reduce hospital readmissions. However, it remains difficult to describe theses complex nursing interventions to achieve these results. Very little research has examined the ways through which these programs achieve their particular effects. In a context of limited resources, documenting these interventions and mechanisms seems to be necessary to insure their application and adequacy in the clinical practice. Effective and appropriate nursing interventions reduce complications, increased the length of time between hospital discharge and readmission and reduce total number of hospitalizations. They contribute to improve the quality of life for these people while contributing to decrease the costs. Based on Roy’s adaptation model (Roy, 2009) and nursing functions model by Dallaire et Dallaire (2008), the purpose of this study was to develop, implement and evaluate a nurse transitional care program for older with chronic heart failure at the discharge of hospital. To achieve this goal, a mixed method was privileged. The systematic process proposed by Sidani et Braden (2011) was used to conceptualize and evaluate the nursing interventions program. Theories and empiric literature were used. Also, nine nurses, five health care professionals and seven older people with chronic heart failure and six caregivers participated in semi-structured interviews. An analytic method was used to conceptualize the nursing interventions program. This program was tested. Ten elderly were recruited and randomized in two groups: control and intervention. Five people tested and evaluated the nursing interventions program. The program consists of one session at hospital, before departure and five sessions at home with phones calls between homes visits. Each session includes nursing interventions to promote physiologic, psychic and spiritual, social and relational adaptation. The study results showed the feasibility and the acceptability of the nursing interventions program. The intervention group had significantly improved self-care of their chronic illness and decrease feeling of uncertainty after 30 days. Also, there was a trend toward better readiness for hospital discharge, lower post discharge coping difficulties and better quality of life in the intervention group. No significant difference was found in hospital readmission and emergency consultation. Nursing interventions program show that intervention group received more interventions that may have prevented the use of health services. This study shows that nursing interventions promote holistic adaptation of older people with chronic heart failure at discharge from hospital. Nursing interventions that respond directly to the needs and difficulties of this clientele contribute to better disease management and quality of life.
Anchisi, Annick. "La personne âgée, sa famille et l'institution : le placement définitif d'un parent âgé dépendant comme passage de la maison à l'établissement de soins". Grenoble 2, 2007. http://www.theses.fr/2007GRE29003.
Testo completoEffects of advanced age cause the elderly parent loss of autonomy and independence. His family has to stand in for these losses. Through the example of body care, we highlighted the material and symbolic limits of remaining at home. The logic of the household replaces that of the lineage. To turn to professionals for nursing assistance at home is uncommon, occasional and late. Those become significant when the situation is getting worse and the only issue is to place the old parent in a medico-social establishment (MSE), especially in case of proven dementia. This placement enables better understanding of the relationships between the relatives, the parent and the staff. Apart from revealing the functions – order, exchanges, rites – which are ruling it, the entry in MSE shows also how difficult it is to undertake this transfer. To cross the doorway of the MSE calls for a particular rite which combines strategies of alliance and separation. The MSE-caregivers must find out the best ways of performing the "passage"; accordingly, they try to secure the liminal period to manipulate time. They replace the family until the moment of the final separation. They adopt the care as one's own duty, including the body care which is often the reason of the placement. During this unknown length of time from entry to death, the MSE-staff constructs a "theoretical" resident seen through patterned life story and family, a kind of operational resident inscribed in a chronological and graspable historicity. They rewrite his story. By restoring the jeopardized continuity, although in a reductive and normative way, a possible inscription of the relatives in descent's line is made possible
Chahbi, Rajaâ. "Les limites du maintien à domicile des personnes âgées : entre solidarité sociale et solidarité intergénérationnelle". Besançon, 2009. http://www.theses.fr/2009BESA1040.
Testo completoTrabut, Loïc. "Nouveaux salariés, nouveaux modèles : le maintien à domicile des personnes âgées dépendantes". Paris, EHESS, 2011. http://www.theses.fr/2011EHES0108.
Testo completoThe first part of this thesis shows that this modality of organization, in order to face up to the constraints, especially temporal ones, inherent in the care-taking of elderly persons, develops strategies of rationalization of time schedules (increased surveillance of the time spent for each activity) and job contracts (yearly calculation of working time). Hence, despite of the increased professionalism of the elderly care workers, the intermediary mode has not led to an improvement of the work conditions of the care workers. In parallel to the development of the intermediary mode, hybrid models of supply of home care, connecting the domestic model and the medical, social and industrial mode I, supported by a multitude of actors, nursing services at home, the tear that evaluates the "dependent elderly allocation" etc. -have emerged. The second part of the thesis shows that the direct employment of a home care worker, mostly a cIeaning lady, is a the origin of these mixed modes of organization. However, the latter have a varying form, just as the role of the care worker at home : the more or less important presence of the sanitary and social part depends on the degree of implication of potential helpers from the family, the level of dependence and the diversity of needs that are to satisfy to ensure the sustainability of home care. In these flexible modes of organization we show the emergence of putting in place an informal custodianship
Jaussaud, Christine. "Propositions pour un enseignement de la prescription des moyens de soutien à domicile des personnes âgées dépendantes". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M091.
Testo completoTrabut, Loïc. "Nouveaux salariés, nouveaux modèles : le maintien à domicile des personnes âgées dépendantes". Phd thesis, Ecole des Hautes Etudes en Sciences Sociales (EHESS), 2011. http://tel.archives-ouvertes.fr/tel-00656226.
Testo completoMarché, Anne Danièle Cécile. "Émotions et travail d'assistance aux soins personnels en gérontologie : se garder du dégoût, mais pas trop". Doctoral thesis, Université Laval, 2011. http://hdl.handle.net/20.500.11794/22527.
Testo completoLe travail d’assistance aux soins personnels des personnes âgées en hébergement collectif est socialement assimilé au « sale boulot », à la part ingrate du travail des soins infirmiers, mais aussi, plus généralement, à la part ingrate du travail domestique auquel la société tout entière semble répugner. Il est délégué à des femmes – aussi à quelques hommes – qui ont à se défendre de l’insupportable du dégoût et de la menace éthique qu’il représente pour le « travail de care » (Molinier, 2005). À l’intérieur d’un cadre théorique intégrant théorie morale des émotions (Ben Ze'ev, 1997; Miller, 1997; Nussbaum, 2001) et psychodynamique du travail (Dejours, 1980c), la thèse a examiné comment l’intelligence créatrice (Dejours, 1993b) de préposées aux bénéficiaires se saisit du conflit émotionnel et moral qui oppose le dégoût aux valeurs du travail de care et comment elle permet de se défendre contre le dégoût. Si l’intelligence des émotions met en discussion les éléments du conflit émotionnel et que le ressort de la plasticité des émotions réside dans nos actions, alors le travail occupe une place centrale pour réduire cette contradiction. Une grille d’analyse ad hoc a été conçue à partir du modèle des oppositions structurales du domaine du dégoût et de celui de l’analyse des conduites humaines en situation de travail. Cela a permis de comprendre comment les préposées aux bénéficiaires se gardent du dégoût, dans le sens où elles s’en défendent, grâce à un ingénieux travail sur la distance subjective. Ce travail les protège de l’abomination du dégoûtant et de son effet de contamination (Rozin, Millman, & Nemeroff, 1986), elles-mêmes, leurs collègues, mais avant tout, les résidents. Mais au-delà, si elles se protègent du dégoût, elles s’en gardent aussi, isolé sur un objet de dégoût résiduel, afin d’éprouver la vitalité du collectif de travail. En mettant sous le regard de l’autre la fraude à la distance prescrite par la norme de bientraitance, les préposées en appellent au partage collectif du risque encouru. Rendre visible l’ingéniosité du travail de care concourt socialement à ouvrir un espace pour que des femmes, celles qui contribuent à rendre le monde habitable en compensant la vulnérabilité qui y règne comme condition humaine, puissent faire entendre leur voix. Mots clés : émotions au travail, dégoût, « sale boulot », « travail de care », risque moral, conflit émotionnel, coopération, gérontologie.
Emotions and work of personal care of elderly, keeping disgust down, but not too much The work of caregivers assigned to the personal care of elderly residents in institutional facilities is often thought of as “dirty work, ” part of the unrewarding aspects of nursing care, but also, more generally, part of the unrewarding aspects of domestic work which the whole society seems to loathe. This work is delegated to women – and a few men – who must deal with unbearable feelings of disgust and the ethical threat that this represents for “care work” (Molinier, 2005). Using a theoretical framework integrating both moral theory of emotions (Ben Ze'ev, 1997; Miller, 1997; Nussbaum, 2001) and psychodynamics of work (Dejours, 1980c), this thesis examines how caregivers use their creative intelligence (Dejours, 1993b) to deal with the emotional and moral conflict between the disgust they feel and the core values of care work and to preserve themselves from the disgust. If the intelligence of emotions involves elements of emotional conflict and the plasticity of emotions falls within the competence of action, thus work plays a central role in reducing the contradiction inherent in this conflict. Based on structural oppositions of disgust and from human conducts in work situations models, an ad hoc analytical grid was developed to understand how caregivers keep their feelings of disgust away, protecting themselves by adopting an ingenious approach involving subjective distance. This work protects the workers, their coworkers but in the first instance, the elderly residents, from the loathing of disgust and from its contaminating power (Rozin, 1986). Above all, while protecting themselves from disgust, caregivers keep disgust still active, isolating pollution in an object of residual disgust, in order to test the vitality of the work collective. By working in full view of others and exposing how they break with the distance prescribed by the norm of respectfulness, the caregivers appeal to the collective sharing of the risk that breaking this norm implies. Highlighting the ingenuity of care work socially contributes to opening up a space such that the voice of these women, who are striving to build a world that is fit to live in, compensating for the human vulnerability, can be heard. Keywords: emotions at work, disgust, “dirty work”, “care work”, moral risk, emotional conflict, cooperation, gerontology.
Dakey, Yawovi Ségla Kpéli. "Le développement des compétences dans le processus de prise en charge globale des personnes âgées au sein des établissements médico-sociaux : le cas des maisons de retraite". Versailles-St Quentin en Yvelines, 2009. http://www.theses.fr/2009VERS028S.
Testo completoThe ageing of the population and the growing number of very old people in loss of autonomy, represents, a real social problem. In France, retirement homes (EHPAD) are the main actors in the public policies implemented to face these demographic trends. This thesis aims at providing a framework of comprehension and guidelines for the development of professional competencies of nursing staff in retirement homes (EHPAD). In this context it is tackling the practices of work and organization which can contribute to the learning and the development of competencies, through an exploratory research which is based on case studies, the analysis of social representations of the actors and the analysis of the concrete situations of care of the elderly. Our results and analysis showed professional practices in shift with the systems of thoughts and beliefs of nurses and in addition, the complexity of the care to the elderly and ethical problems involved in this care. On the conceptual level, our research enabled us to build a model to analyze and evaluate the practices of development of competencies in the process of care of the very old people. If this model could be applied only to retirement homes in France, an investigation carried out in USA enabled us to collect information on some foreign practices of care of old people and provides a perspective to our research
Dubertrand, Stephane. "Evaluation et évolution de la perte d'autonomie de sujets âgés selon le modèle A. G. G. I. R. [Autonomie Gérontologique-Groupe Iso-Ressources]". Bordeaux 2, 1995. http://www.theses.fr/1995BOR2M042.
Testo completoFontaine, Roméo. "Le soutien familial aux personnes âgées dépendantes : Analyses micro-économétriques des comportements individuels et familiaux de prise en charge". Paris 9, 2011. http://basepub.dauphine.fr/xmlui/handle/123456789/7370.
Testo completoWith the population ageing, the expected increase in the long term care demand questions the role our societies want to entrust to family in the care provision for disabled elderly people. We use a micro-econometric framework to study individual and family caregiving behaviours. From a public policy perspective, three mains findings emerge from the analysis proposed. First, the identification of family interactions in individual caregiving decisions highlights the necessity to reconsider the idea of an inexorable decline in family support. Second, the decrease in labour supply induced by the care provision beyond a certain level points out the limits of a public policy aimed at both extending the work lives of seniors and encouraging informal care for disabled elderly people. Finally, the use au publicly funded formal care is associated with a rather modest decline in family support
Yamamoto, Mayako. "Les aides à domicile et les auxiliaires de vie sociale dans la prise en charge des personnes âgées dépendantes au Japon (1999-2006)". Paris 8, 2007. http://www.theses.fr/2007PA082852.
Testo completoThis thesis analyzes the profession of care workers home helpers and nursing aids in Japan. It retraces the social policies and the economic evolution that has brought a new sector of activity concerning the care of elderly dependants. The theoretical framework mainly refers to the works of American sociologists as Abbott, Hughes, Diamond. It sheds light on the development of the services and the creation of professional magazines. The study was conducted between 1999 and 2006, through interviews and surveys to professional education and training schools and to workplaces. The viewpoint is shaped by the task contents and the evolution of status that faces increasing job insecurity in a significant part of this sector. The research stresses the heterogeneity of the backgrounds that leads to the profession
Cool, Charlène. "Prescription médicamenteuse potentiellement inappropriée dans les établissements d'hébergement pour personnes âgées dépendantes (EHPAD)". Thesis, Toulouse 3, 2017. http://www.theses.fr/2017TOU30181/document.
Testo completoOlder people living in nursing homes (NHs) suffer from numerous comorbidities and functional decline. Polymedication is frequent in this population. This increases the risk of potentially inappropriate drug prescribing (PIDP), which can lead to adverse drug events such as falls and hospitalization. Most French studies did not examine PPI with a global perspective, but focused on specific drug classes. Moreover, few studies have investigated, irrespective of the individual characteristics of residents, the structural and organizational characteristics of nursing homes on the quality of drug prescribing. Thesis work aimed to develop a new indicator of PIDP, which best reflects the global medication use of residents. Thesis works have been performed using the data of the IQUARE study (Impact d'une démarche Qualité sur l'évolution des pratiques et le déclin fonctionnel des REsidents), a quasi-experimental study (trial registration number: NCT01703689) investigating the impact of an intervention based on geriatric education with NH staff on quality indicators of care. First, we developed an indicator of PIDP, combining explicit and implicit criteria, identifying 71% of PIDP in NH residents at baseline. NH organizational (access to psychiatric advice and/or to hospitalization in a psychiatric unit) and structural (presence of a special care unit for dements) variables explained part of PIDP. In a second part, in order to validate the usefulness of this PIDP detection tool, we verified the long-term clinical impact of PIDP on adverse outcomes (death, number of hospitalizations...). We did not find any significant association between PIDP and death, nor between PIDP and number of hospitalizations. Finally, the general intervention implemented in the IQUARE study significantly reduced PIDP among NH residents at 18-month follow-up. Our research has provided important aspects that should be consider when constructing further new studies seeking to change prescribing patterns and to reduce the total number of drugs taken, but also to determine the final impact of these changes on clinical outcomes
Archimbaud, Nicolas. "Vie quotidienne et soins des personnes âgées dépendantes en milieu hospitalier : une enquête filmique à l’hôpital Bretonneau (AP-HP, Paris 18ème)". Thesis, Paris 10, 2013. http://www.theses.fr/2013PA100169.
Testo completoThis thesis deals with the daily life of the elderly who are patients at the Bretonneau Geriatric hospital, in Paris 18th arrondissement. It studies how these dependent or mentally-ill elders are cared for, focusing on innovative drug-free therapies (art therapy, esthetic therapy, psychomotricity).The field survey took place between 2008 and 2010 and used the method of exploratory filming, making the camera the main tool for the research. Three documentary films were made : Day Hospital (117 min), Short Stay (67 min) and Long Stay (120 min). While shedding some light on the way the institution works, these documentaries show the everyday life of a few patients and make them the main characters of the films. The written part analyses the strategy and the results of the field survey. It stresses the ethical issues raised by the presence of the filmmaker-observer in a highly sensitive environment and with very vulnerable subjects. The detailed analyses deal with the three main themes of the films : configuration of space and of material environment, physical techniques helping with loss of autonomy, interaction rituals between caregivers and patients
Bertrand, Jean-Marcel. "Prise en charge de la dépendance des personnes agées : aspects sanitaires et sociaux, maintien à domicile". Bordeaux 1, 1995. http://www.theses.fr/1995BOR1D005.
Testo completoThe sanitary and social acceptance of the elderly and dependant person is a shake in the society. Its study requires a previous definition of the terms of dependance and loss of autonomy, as well as the elaboration of an assessment roll of the subjection it generates, which can be accepted by everyone. Home maintaining appears as an abounding system, made up by complex benefits an insufficiently focussed on dependance. The consideration of the expression of needs with the analyse of the home maintaining system makes important dysfonctions appear, as well as insufficencies an incoherencies regulations, financing complexity, and coordination difficulties. From these criticisms and from the conflicting reports of the consulted committees about this question come principles, directings and concrete suggestions out, which will may be new answers to the loss of autonomy of the elderly personne through an overall reform of our social protection system and in the respect of the freedom to choose his or her home
Bertrand, Jean-Marcel. "Prise en charge de la dépendance des personnes agées : aspects sanitaires et sociaux, maintien à domicile". Bordeaux 1, 1995. http://www.theses.fr/1995BOR40005.
Testo completoThe sanitary and social acceptance of the elderly and dependant person is a shake in the society. Its study requires a previous definition of the terms of dependance and loss of autonomy, as well as the elaboration of an assessment roll of the subjection it generates, which can be accepted by everyone. Home maintaining appears as an abounding system, made up by complex benefits an insufficiently focussed on dependance. The consideration of the expression of needs with the analyse of the home maintaining system makes important dysfonctions appear, as well as insufficencies an incoherencies regulations, financing complexity, and coordination difficulties. From these criticisms and from the conflicting reports of the consulted committees about this question come principles, directings and concrete suggestions out, which will may be new answers to the loss of autonomy of the elderly personne through an overall reform of our social protection system and in the respect of the freedom to choose his or her home
Rimbert, Gérard. "Encadrer les crises biographiques irréversibles : les contradictions dans la prise en charge des personnes âgées dépendantes". Paris, EHESS, 2006. https://tel.archives-ouvertes.fr/tel-00319197.
Testo completoAt the end of the 19th century, the collective management of old age was, fundamentally, one of the forms taken by the policies directed at the poor. The extension of the pension system enabled the emergence of the "retired", as a category of perception associated to the idea of rebirth after an active life. But a number of old people experience the progressive deterioration of their physical and mental faculties, and therefore of their autonomy in the everyday life, paving the way for dependency. Such biographical crises lead to a renewed questioning on how to manage a population of "improdutive" old people, wich is framed within the new category of thought linked to the equation of "old age" and "retirement", involving a human vision of care ("respect", "life project", "individual tailoring of care", "care giving"). Within the management structures for dependent elderly people, this evolution is especially felt through the tension between an enchanted involvement that leads to perceive care for dependent people as an opportunity to establish affective relationships and/or to satisfy humanistic leanings, and on the other hand, and the "unglamorous" realities of care giving to the elderly, wich make it difficult to maintain enchantment
Ishii, Karine. "Le système de prise en charge des personnes âgées dépendantes : le Japon un modèle pour la France ?" Thesis, Paris 9, 2015. http://www.theses.fr/2015PA090032/document.
Testo completoThis thesis focuses on the long term home care policies conducted in Japan, in order to draw lessons for France. Our analysis is developped through three topics : i) the analysis of the differences between the Japanese and the French systems in the public care organisation and in the care received by the elderly, ii) the examination of potential barriers to access to public elderly care in Japan; iii) the study of the impact of informal care on the labor participation of Japanese middle-aged women. In this regard, we carried two qualitatives studies comparing Japanese and French policies, and two microeconometrics studies of individual and family behaviour of caring in Japan. This study outlines the specificities of the policies conducted in both countries, and highlights the strenghts and weakness of the Japanese model
Dafei, Farid. "Etude et comparaison des facteurs de dépendance en moyen et long séjour". Bordeaux 2, 2000. http://www.theses.fr/2000BOR2M038.
Testo completoPelletier-Le, Marec Anne-Marie. "Les établissements d'hébergement pour personnes âgées dépendantes : long séjour et section de cure médicale : étude sur 4 établissements des Pyrénées-Atlantiques". Bordeaux 2, 1989. http://www.theses.fr/1989BOR25168.
Testo completoGargouri, Nadia. "Impact du brossage dentaire au fluorure de sodium chez les personnes âgées en perte d'autonomie vivant dans des centres d'accueil". Thesis, Université Laval, 2012. http://www.theses.ulaval.ca/2012/29003/29003.pdf.
Testo completoBéland, Caroline. "Comportements agressifs physiques associés à la démence : interactions entre les résidents et les soignants lors des soins d'hygiène". Master's thesis, Université Laval, 2005. http://hdl.handle.net/20.500.11794/43582.
Testo completoGuérin, Laura. "Manger ensemble : mourir ensemble : ethnographie du repas collectif en Ehpad". Paris, EHESS, 2016. http://www.theses.fr/2016EHES0121.
Testo completoBased on an ethnographic approach, this dissertation work constitutes an inquiry into the upholding of collective meals within French nursing homes dedicated to the care of dependent elderly populations (Ehpad). Recommended by public health policies and the professional literature as a token of care and sociability, the communal meal is none the less a daily trial within establishments, which commands practical adjustments in order to match, to the extent possible, the social expectations it crystallizes. Because each day it requires residents to be gathered, concentrates community living, we examine it as a particular socializing arrangement for the dependent elderly population. Hence the two lines of analysis we have favored. Firstly, we intend to grasp the Ehpad communal meal as the result of a specific labor: a set of ways of doing and saying that affecl residents, the focal aims of which laying with incorporating food and maintaining social arrangements. Secondly, by analyzing professional embarrassment that this work involves, as well as matching forms ol oppositions on residents' part, we overcome the mere medicalization of behaviors. Inquiry materials comprise participant observation in three establishments as an intern within the restaurant services, together with an analysis of professional best practices written by the French higher health authority and the French national agency for the evaluation of social and medico-social services. Through a review of the biomedical literature, apprehending the gap between norms and practices is placed in a widen reference space, where undernourishment is being built in a scholarly fashion. At last, a historical perspective of the Ehpad meal, through considering late XlXth century hospice meals as well as resulting medical theories on great-age nutrition, brings out the evolutions of elderly's treatment through consumptions. Across this dissertation, we have inquired into the government of bodies, in its disposition to produce hopes as foi maintaining the material and symbolic life of individuals known to be vulnerable and to soon face death
Coutton, Vincent. "Dynamiques actuelles et perspectives d'évolution des coûts de prise en charge de la dépendance des personnes âgées en France". Paris, Institut d'études politiques, 2004. http://www.theses.fr/2004IEPP0041.
Testo completoLee, Shao-Fen. "Enquêter sur la capacité à se soucier des autres. Le travail des aides-soignantes en institution pour personnes âgées dépendantes en France et à Taïwan". Thesis, Paris, EHESS, 2019. http://www.theses.fr/2019EHES0045.
Testo completoThis thesis is on the liberty and the agency care-workers have in their professional and personal lives. From a comparative study of the work done by nurse assistants and the same function providers (faisant-fonction) in institutions for the dependent elderly in France and Taiwan, I would like to show that the “capability to care for others” is intimately linked to the “capability to care for oneself”.This inquiry is based on four active participant observations in traineeships, two in each country, and 52 interviews with care-workers, institution directors and other professionals in the field of care. The comparative approach unveils the opposing contexts in terms of social, political and cultural regulations in these two countries. This observation also enlightens the way in which various factors condition the conversion of the resources available to nurse assistants in an effective accomplishment of the care. These conversion factors are institutional (public policies), organizational (care institutions) and biographical (care-workers). Therefore it is a multi-scale approach that the thesis takes. The intersection of the relationship between the workers and their work and the relationship between the workers and their status of employment constitutes a variety of care work patterns. The configuration of these work patterns reflects how the “capability to care for others” differs depending on the various degrees of their job security and precariousness. The comparison of the care-workers’ career paths with “stabilized” and “precarious” employment status also reveals their different “capability to care for oneself” regarding their agency in their professional development. This thesis also shows that the inequalities in the care workers’ professional development result from the interaction between the logics of the collective and normative regulations and the subjective logics the workers have towards their lives.Redefining the contemporary care work as a justice and social responsibility issue, this research challenges the political discourse which simplifies the relevant problems in the care of the dependant elderly and the care-workers’ conditions from the individualistic perspective of professionalism
Pallez-Lartiguevieille, Florence. "Douleur en gériatrie : auto évaluation de la douleur et appréciation de la prise en charge thérapeutique par les patients hospitalisés". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M160.
Testo completoChevalier, Anne-Marie. "Analyse du processus interactionnel entre les soignants et les personnes souffrant de démence qui présentent des comportements verbalement agressifs lors des soins d'hygiène du matin". Master's thesis, Université Laval, 2005. http://hdl.handle.net/20.500.11794/43533.
Testo completoPark, Haemi. "Organiser le maintien à domicile des personnes âgées dépendantes : une comparaison du travail des professionnels en France et en Corée". Thesis, Lille 3, 2013. http://www.theses.fr/2013LIL30045.
Testo completoWith the establishment of the Individual Public Allowance for Autonomy (APA) in France in 2002 and the Long Term Care (LTC) insurance in Korea in 2008, the management and the support for the dependence of the elderly population became a major issue of contemporary social policy in these two nations faced with the phenomenon of aging. Despite demographic, historical, cultural, political, economical and social contrasting contexts, they have installed devices in common with modes that appear close or substantially similar to cope with the increasing needs of the elderly. By adopting a comparative approach between France and Korea, this thesis sought to analyze the work of social gerontological professionals in charge of these devices for the elderly dependent who stay at home. For this, the application procedure of the APA in France and the LTC in Korea and the organization of the socio-medical asistance for the dependent elderly at home were studied. In both France and Korea, the professionals who are involved with the home care services are multiple. Some are working in the "front line" (home helpers, care assistance, home nurses) and others are occupied with the coordination, the supervision/organization of the foregoing (front line workers) in the "second line". This research focuses on the impact of devices which are placed on the work of professionals, especially those who are concerned with various tasks in the second line and their necessary - and difficul t- coordination. How the different policies and the strategic relationship between these various participating professionals sometimes diverge and how the conflicts intrinsic to their actions and practice within complex organizational realities are settled were investigated and explored. The observation was carried out in one area within each country : Hellemmes-Lille in France and Cheongju-Cheongwon in Korea
Beloni, Pascale. "Des représentations sociales de la vieillesse aux expériences vécues : impact sur l'accompagnement dans les structures d'hébergement pour personnes âgées". Thesis, Limoges, 2019. http://www.theses.fr/2019LIMO0037/document.
Testo completoThe ageing of the population is a challenge in terms of accompanying physical and / or psychic dependence of the elderly subject.An epidemiological study whose approach is multidisciplinary, and which uses the tools of anthropology by emphasizing the qualitative approach, conducted on ten retirement homes in France (Limousin and Reunion Island) was intended to improve knowledge about experiences of seniors and families of Alzheimer’s residents, students and healthcare professionals.To achieve this goal, socio-cultural representations / lived experiences of the study population were explored as well as the entry decision, daily life and care taken prescribed, perceived and actual in EHPAD (acronym for nursing home in French).Thus, the results show that the entry into accommodations structures is multifactorial and influences the adaptation strategies of residents. The forced living context, framed by operating rules referring to community life, the “old” community, has an impact on the process of socializing the elderly person. Living in a retirement home is a radical socio-cultural change. Besides, practicing in a retirement home for health professionals is a work on professional posture and identity because of the conflict between representations of old age and lived experiences. This involves development of skills related to relational knowledge. In addition, for health students, doing an internship in EHPAD means discovering an institution that is a real place to live and potentially work.Finally, the EHPAD upsets the representations of old age, which questions the support of the entry into EHPAD discussed in this work
Hamdani, Fatima Ezzahra. "Une approche d'aide à la décision de la prise en charge des personnes âgées". Thesis, Lyon, 2018. http://www.theses.fr/2018LYSES059.
Testo completoIn France, elderly care is primarily intended for people aged 65 and over. It consists of hospital care (intra-hospital), and elder home care (extra-hospital) for patient in the territory closest to his / her own home. It organizes through the interweaving of several devices involving various actors (Ishii, 2013). The concept of Elder Home Care summarizes all practices implemented to support elderly people to continue living independently, despite their disabilities and aging. It constitutes an efficient alternative to reduce the pressure in hospital admissions (Crowley et al., 2016), and give the opportunity to improve elderly care continuity after their discharges from hospitals (Xiao et al. 2018). However, elder hospital care refers to the medical care, diagnostic testing, intensive treatment, or surgeries provided to the patient throughout the hospitalization process. The multiplicity of stakeholders, combined with the dynamic, unstructured information spread over a large amount of information systems, result in a new situation in which decision support systems become essential when making daily operational and collective decisions. Firstly, this paper introduces a decision support Framework that enables home care organizations to deploy their available resources more effectively with a multi-agent system paradigm. The addressed operational collective decision problem concerns the assignment and coordination of home caregivers from different organizations. Secondly, a decision support methodology for intra-hospital care based on quantitative techniques, and statistical method, is proposed. This methodology, allows the evaluation of elderly care pathways behavior
Calmels, Bruno. "Évaluation de la prise en charge de l'incontinence urinaire récente dans un service de moyen séjour gériatrique". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M075.
Testo completoRaybois, Mathieu. "Santé, créativité, temporalité : une analyse en clinique du travail et en ergonomie de l’activité des soins en EHPAD". Thesis, Lille 3, 2013. http://www.theses.fr/2013LIL30048.
Testo completoThis thesis questions the care activity of elderly in a residential establishment for older dependent people. The question about the health of the professionals is examined through analyses of the work's activity. The examination of the links between the notion of health and the theories about the work shows the importance of creativity. The recreated activity pertains to the care givers' health by many ways. Besides this point, the research-Action reveals the necessity of investigating the numerous implications of time in the activity. Strongly constrained, the activity is collectively reorganized around time management. But refocusing on the daily time, the care givers' activity seems to occult the care. During the relationships, the care is reinvested. But there are other dimensions of time too that are summoned : exchange's time, life's time, professional's story and familiar's story... From these times and stories, the activity could be recreated by any care giver. The end of this research aims to discuss and reconsider the complicated connection between the caregivers' activity and times, the different creativity's appearances invested, and also the question of the collective
Sauzé, Bruno. "Prévention des escarres en gériatrie : enquête prospective et nutritionnelle, charge de travail du personnel soignant". Bordeaux 2, 1994. http://www.theses.fr/1994BOR2M024.
Testo completoFalez, Freddy. "Contribution à la validation d'instruments de mesure de la dépendance des personnes âgées". Doctoral thesis, Universite Libre de Bruxelles, 2006. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210817.
Testo completoIntroduction.
Le premier chapitre de l’introduction expose les problèmes posés à la sécurité sociale par le vieillissement de la population et plus particulièrement par le développement de la dépendance des personnes âgées. Ces problèmes sont illustrés par l’évolution des dépenses en soins de santé pour les aides aux actes de la vie journalière en institutions d’hébergement des personnes âgées, et à domicile.
Le deuxième chapitre décrit les instruments d’évaluation qui sont étudiés dans la présente dissertation. En effet, en Belgique, le financement des soins à la dépendance est réalisé sur base d’une évaluation à l’aide d’une échelle de l’INAMI ;une allocation à la personne âgée peut être obtenue par les personnes âgées dont la dépendance est alors évaluée à l’aide de l’échelle de la prévoyance sociale que nous appellerons aussi APA. Nous les comparons à l’outil d’évaluation utilisé en France et dénommé AGGIR pour autonomie gérontologique, groupes iso-resources.
Méthodes et populations.
Méthodes.
Nous validons les trois instruments sur le plan du construit à l’aide la Classification Internationale du Fonctionnement (CIF) de l’OMS. La validité est évaluée de différentes manières :validité concurrentielle entre les trois instruments ;validité concomitante des trois instruments par comparaison aux temps de soins nécessaires par les méthodes de corrélation, leur capacité de discriminer des catégories de dépendance ;la fidélité des instruments est également étudiée.
Populations
Quatre enquêtes ont été réalisée :la première en institutions de personnes âgées, la seconde à domicile, la troisième à domicile et la quatrième en institutions de personnes âgées avec la collaboration de différents professionnels :infirmières soignantes, infirmiers conseils de mutualité et l’auteur de la dissertation.
Résultats.
La troisième partie de la dissertation expose les résultats démographiques et des tests de validation.
Discussion.
La quatrième partie évalue les résultats. L’échelle de l’INAMI est de conception ancienne pour son contenu. Sa validité est suffisante pour étudier les charges en soins de populations de patients mais insuffisantes pour l’évaluation des besoins individuels, car elle n’évalue pas les besoins pour les actes instrumentaux de la vie journalière.
L’échelle APA a une mauvaise validité de contenu ;sa validité de construit est la moins bonne des trois instruments étudiés. Sa fidélité est médiocre. Cette échelle est à déconseiller.
La grille AGGIR a une validité de contenu moderne et bonne, une bonne validité de construit et une bonne fidélité.
Conclusions.
Des trois instruments étudiés, la grille AGGIR est la plus performante et permet à la fois le financement des soins à des populations des patients et l’évaluation de critères d’éligibilité pour l’octroi d’avantages sociaux.
Doctorat en sciences médicales
info:eu-repo/semantics/nonPublished
Truong, Thi Bich Thanh. "Home Automation Monitoring for Assisted Living Services and Healthcare". Lorient, 2010. http://www.theses.fr/2010LORIS204.
Testo completoWith the development of technology and information, there are more and more opportunities and challenges for healthcare and assistance services for disabled people as well as the elderly. In this context, this PhD work proposes and demonstrates a new solution for home monitoring. Our approach is based on the idea that existing home automation and multimedia services provide some relevant information to be used as available sensors for remote monitoring. Through the analysis of user habits, our work includes two steps. In the first step, we automate a scenario identification, based on a combination of data mining, AI, graph theory and operational research algorithms to offer scenarios self adapting to user capabilities, while facilitating user access to the services. In the second step, this sensor information is used for alert management based on the anomaly detection, meaning a deviation of usual habits. These two steps provide a low level and non-intrusive personal monitoring while giving people more autonomy and confidence in their environments. A simulation model is developed in a first stage for the generation of user database without waiting for months monitoring user activities. This simulation data allows us to develop, tune and evaluate different aspects of our approach, before being applied in a real context. Then an experimentation through the IR recording is realized to monitor the user activities. The results of these real data allow us to evaluate the performance as well as the efficiency of our solution
Reerink-Boulanger, Juliette. "Services technologiques intégrés dans l’habitat des personnes âgées : examen des déterminants individuels, sociaux et organisationnels de leur acceptabilité". Thesis, Rennes 2, 2012. http://www.theses.fr/2012REN20004/document.
Testo completoThis research work is grounded in the development and evaluation of congregate housing concept carried by MEDeTIC non profit organization. Its purpose is to answer the need of elderly people who wish to successfully age in place by providing evolutionary ambient assisted living services at home. In order to support MEDeTIC developments, the ambition of our work was to engage a psychosocial diagnosis of elderly people needs concerning home, technologies and services. Through the focus of psychosocial and ergonomics tools, these three sources of innovations are conjointly analyzed in the present dissertation in order to identify what is hindering and driving congregate housing implementation (studies A1, A2, A3). Providing acceptability issues, this thesis firstly analyzes on the one hand service functionalities compatibility with activity limitations encountered by elderly people (study B1) and on the other hand familiar experience with technologies (study B2). Secondly, experiments C1 and C2 focus on model prediction and on individual (i.e. age, experience), socials (i.e. care givers opinions) and organizational (i.e. voluntary service usage settings) determinants in order to apprehend cognitive and social processes that drive usage of technical services by the elderly. Based on our findings, practical recommendations are address to MEDeTIC non profit organization in order to foster its evolution
Kohler, Robert. "Etat des lieux de la Médiation animale dans les Etablissements d'hébergement pour personnes âgées dépendantes en France : De la théorie vers la conception d’un cahier des charges". Thesis, Lyon 3, 2011. http://www.theses.fr/2011LYO30044.
Testo completoWe are researching the implications of animal assisted therapy within a social care facility in an attempt to respond to the legal and managerial controversies surrounding the scheme. Our research is part of a societal trend towards recognizing the citizen rights of dependent elderly people, and in particular their social and cultural rights. We are studying important questions relating to the power of ageing people to make their own decisions about their lives. That is our main aim in researching the use of companion animals, which may be a revealing tool when used in an institutional setting.We will begin our work by discussing the practical and theoretical implications of the plan to introduce a trained dog into a nursing home for dependent elderly people. We will first discuss the issues related to the knowledge and understanding of the users which will be highlighted through animal assisted therapy (1st part). Secondly, we will develop the managerial implications related to the implementation of this idea in an institutional framework and the possibility of introducing a new space for reflection and the construction of meaning (2rd part). These elements will be used to develop specifications for the animal assisted therapy project
Guion, Vincent. "Prise en charge de la douleur et de la fin de vie en EHPAD : prévention, anticipation et accès aux soins palliatifs". Thesis, Toulouse 3, 2020. http://www.theses.fr/2020TOU30107.
Testo completoNursing home residents (NHRs) accounted for a quarter of all decedents in France in 2015, 87% of which died from predictable causes. About 130,000 NHRs could require palliative care at the end of life every year. Yet, previous works suggested about a fourth of these NHRs were in "a severe physical discomfort" in their last week of life and nursing home medical directors' training on end of life management was scarce. In addition, one fourth of NHRs get transferred to hospital in emergency in their last two weeks of life or die in hospital. Palliative care in NHRs needs to be developed in its dimensions of prevention, anticipation, and access to care. The objective of the first study was to determine whether a strong intervention involving auditing and feedback plus a cooperative work between a hospital geriatrician and the nursing home (NH) staff around quality indicators of care compared to a light intervention involving auditing and feedback only decreases the number of residents with a pain complaint. We also investigated whether this type of intervention improves pain management in NHs. The objectives of the second study were to describe the trajectories of functional ability of NHRs before the emergency department (ED) transfer, during hospital stay, and after hospital discharge, and to examine the determinants of both functional ability and mortality after a transfer to ED. The objectives of the third study were to describe the joint trajectories of pain, dyspnea, fever, confusion, agitation, and fatigue in NHRs from a week before their transfer to ED until the week following their discharge back to NH, and identify predictive factors of symptomatic outcomes. Data from the IQUARE and FINE studies were used to address these objectives. Statistical analyses included survival models, mixed-effects logistic and linear models and latent-class mixture models. Our results support that a general geriatric intervention based on education and professional support to NH staff not only improved the quality of pain management in the IQUARE study but was also associated with a lower number of residents who complained about pain. Almost one-half of NHRs declined on their functional ability or died after being transferred to ED in the FINE study, but the majority either remained stable or even improved. Functional decline across trajectory groups was mainly driven by transfer characteristics, such as condition during transfer (number of distressing symptoms, fracture, or stroke) and care pathway after ED (length of hospital stay and discharge department). Functional trajectories allow us to better understand the resilience capacities of residents facing the challenging stress of a transfer to ED. The course of symptom burden in the FINE study shows distinct trajectories depending on the nature of symptoms: specific symptoms were well alleviated, but non-specific symptoms, i.e. related to comorbidities or disease burden, were frequently uncontrolled.[...]
Quibel, Clémence. "Les proches aidants de personnes âgées résidant en EHPAD : influence du parcours de l’aidant sur son vécu et son implication". Electronic Thesis or Diss., Bourgogne Franche-Comté, 2024. http://www.theses.fr/2024UBFCH001.
Testo completoIt is estimated there are between 8 and 11 million informal caregivers in France today. Of these, 3.9 million provide regular assistance to a 60-aged people or over living at home, and 720,000 living in an institution.If the family carers support at home begins to be recognized, its continuation after the entry into nursing home of the helped loved one is much less so. However, studies on family carers in nursing homes show that some of them maintain their involvement, with levels of stress, anxiety and depression similar to those experienced when the loved one lived at home. Some tasks carried out at home disappear with the entry into nursing home, but some are kept and new ones appear.We wondered about the influence of the family carers course on his experience and his involvement once his loved one entered into nursing home.Through semi-structured interviews conducted in Bourgogne-Franche-Comté, we analyzed the course of 28 caregivers of elderly people living in nursing home.The awareness of having reached its limits in home support, support provided by a professional to take the decision to enter into nursing home, involvement in the life of the establishment, noting negligences or, on the contrary, noting that the staff is attentive to the “little things that count” are elements linked to a positive or negative experience with the establishment and/or with the loved one.Concretely, these keys can represent as many brakes to lift or levers to activate for a better quality of life for caregivers in nursing homes
Belzil, Guylaine. "Escalade et résistance aux soins d'hygiène associée à la démence : Perspective interactionnelle sur l'impact des comportements des soignants". Thesis, Université Laval, 2012. http://www.theses.ulaval.ca/2012/29055/29055.pdf.
Testo completoCourty, Bénédicte. "L'épuisement professionnel des soignants en gériatrie". Bordeaux 2, 2003. http://www.theses.fr/2003BOR21030.
Testo completoWhat about the suffering of geriatrics personnel ? It appears to be plural, frequently mentioned and denounced, however rarely examined in research. It is one thing to state it, to relay it, to talk about it. However, it is another to examine it closely, subdivide it into its principal components. We chose to study this topic based on a literature review of burn-out, and in a helplessness-hopelessness theory perspective. Trait anxiety was assessed using the STAI-Y (Spielberger, 1983), and depression was assessed using the CESD (Radloff, 1977). The 150 participants were recruited during a survey in geriatrics throughout the country. Our results demonstrate the existence of a continuum between anxiety-depression comorbodity and burn-out. This relationship is even stronger, and more significant when motivation is used as a mediator. The helplessness-hopelessness theory (Alloy et al. , 1989) offers directions for the understanding of burn-out in geriatrics personnel in that it brought us to consider resignation as a passive coping strategy when confronted to the threat of burn-out. Our findings allow us to understand the discrepancy between caregivers' expectations, and the everyday reality they are confronted to in their profession. We believe that this discrepancy becomes a vulnerability factor as it grows
Bourdel-Marchasson, Isabelle. "Etude métabolique, fonctionnelle et interventionnelle de la dénutrition du patient âgé hospitalisé". Bordeaux 2, 2000. http://www.theses.fr/2000BOR28737.
Testo completoReich-Bonnafous, Emmanuelle. "Etude et limites de la prestation spécifique dépendance pour les personnes âgées. Prise en charge complémentaire possible à l'aide d'une association de coordination en dordogne". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M133.
Testo completoTrepied, Valentine. "Devenir dépendant : approche sociologique du grand âge en institution". Paris, EHESS, 2015. http://www.theses.fr/2015EHES0045.
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