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Recommandations pour la pratique clinique de la Société française d’étude et de traitement de la douleur", "creators": [ { "creatorType": "author", "firstName": "Valéria", "lastName": "Martinez" }, { "creatorType": "author", "firstName": "Nadine", "lastName": "Attal" }, { "creatorType": "author", "firstName": "Didier", "lastName": "Bouhassira" }, { "creatorType": "author", "firstName": "Michel", "lastName": "Lantéri-Minet" } ], "abstractNote": "", "publicationTitle": "Douleurs : Evaluation - Diagnostic - Traitement", "publisher": "", "place": "", "date": "02/2010", "volume": "11", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "3-21", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1016/j.douler.2009.12.009", "citationKey": "", "url": "http://linkinghub.elsevier.com/retrieve/pii/S1624568709003503", "accessDate": "2016-03-15T13:40:28Z", "PMID": "", "PMCID": "", "ISSN": "16245687", "archive": "", "archiveLocation": "", "shortTitle": "Les douleurs neuropathiques chroniques", "language": "fr", "libraryCatalog": "CrossRef", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2016-03-15T13:40:28Z", "dateModified": "2016-03-15T13:40:28Z" } }, { "key": "JT4FBFRP", "version": 2, "library": { "type": "group", "id": 498460, "name": "OG", "links": { "alternate": { "href": "https://www.zotero.org/groups/og", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/498460/items/JT4FBFRP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/og/items/JT4FBFRP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2617617, "username": "oguinois125", "name": "Olivia GUINOIS", "links": { "alternate": { "href": "https://www.zotero.org/oguinois125", "type": "text/html" } } }, "creatorSummary": "Viel et al.", "parsedDate": "2012", "numChildren": 0 }, "data": { "key": "JT4FBFRP", "version": 2, "itemType": "journalArticle", "title": "Évaluation médico-économique des patchs de capsaïcine 8 % pour le traitement des douleurs neuropathiques chroniques (DNC) localisées", "creators": [ { "creatorType": "author", "firstName": "E.", "lastName": "Viel" }, { "creatorType": "author", "firstName": "O.", "lastName": "Bredeau" }, { "creatorType": "author", "firstName": "M.", "lastName": "Fabre" }, { "creatorType": "author", "firstName": "M.", "lastName": "Favier" } ], "abstractNote": "", "publicationTitle": "Douleurs : Evaluation - Diagnostic - Traitement", "publisher": "", "place": "", "date": "11/2012", "volume": "13", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "A90", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1016/j.douler.2012.08.246", "citationKey": "", "url": "http://linkinghub.elsevier.com/retrieve/pii/S1624568712003642", "accessDate": "2016-03-15T13:35:32Z", "PMID": "", "PMCID": "", "ISSN": "16245687", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "fr", "libraryCatalog": "CrossRef", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2016-03-15T13:35:32Z", "dateModified": "2016-03-15T13:35:32Z" } }, { "key": "WNZ857Q5", "version": 2, "library": { "type": "group", "id": 498460, "name": "OG", "links": { "alternate": { "href": "https://www.zotero.org/groups/og", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/498460/items/WNZ857Q5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/og/items/WNZ857Q5", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2617617, "username": "oguinois125", "name": "Olivia GUINOIS", "links": { "alternate": { "href": "https://www.zotero.org/oguinois125", "type": "text/html" } } }, "creatorSummary": "Ducher and Dalery", "parsedDate": "2008", "numChildren": 0 }, "data": { "key": "WNZ857Q5", "version": 2, "itemType": "journalArticle", "title": "Corrélations entre l’échelle d’idéation suicidaire de Beck, l’échelle d’évaluation du risque suicidaire RSD et l’échelle Hamilton dépression", "creators": [ { "creatorType": "author", "firstName": "J. -L.", "lastName": "Ducher" }, { "creatorType": "author", "firstName": "J.", "lastName": "Dalery" } ], "abstractNote": "Résumé\nCette étude montre que les corrélations entre les échelles d’idéation suicidaire de Beck et d’évaluation du risque suicidaire de Ducher (RSD) sont statistiquement significatives (r = 0,69 ; p < 0,0001) mais que ces deux échelles ne sont pas mieux corrélées avec l’échelle Hamilton dépression qu’avec l’échelle d’anxiété clinique de Snaith. De plus, l’utilisation d’un modèle multifactoriel avec sélection en step-wise révèle que l’item « suicide » de l’échelle Hamilton dépression explique, à lui seul, plus du tiers de la variabilité de l’échelle de Beck et de la RSD. Ainsi, la relation entre les dimensions « suicide » et « anxiété » apparaît aussi importante chez notre population de patients dépressifs que celle entre les dimensions « suicide » et « dépression ». L’amélioration plus rapide, sous fluoxétine ou sous fluvoxamine, de la RSD face à l’échelle de Beck ou de Hamilton et l’évolution parallèle de ces dernières suggèrent que certains antidépresseurs pourraient avoir une rapidité d’action sur la dimension « suicide » comparable à celle qu’ils ont sur la dimension « dépression ». Le fait que l’échelle d’évaluation du risque suicidaire objective une différence statistiquement significative entre les deux groupes de traitement renforce l’hypothèse d’une inégalité des antidépresseurs face au risque suicidaire.\nSummaryIntroduction\nMost of the people who will attempt suicide, talk about it beforehand. Therefore, recognition of suicidal risk is not absolutely impossible. Beck's suicidal ideation scale and Ducher's suicidal risk assessment scale (RSD) are common tools to help practicians in this way.\nAim of the study\nThese scales and the Hamilton's depression scale were included in an international multicentric, phase IV, double-blind study, according to two parallel groups who had been administered a fixed dose of fluvoxamin or fluoxetin for six weeks. This allowed examination of the correlations between these scales and the relations, which could possibly exist between suicidal risk, depression and anxiety.\nResults\n(a) Relationships between the Beck's suicidal ideation scale, the suicidal risk assessment scale RSD and Hamilton's depression before treatment. Before treatment, the analysis was conducted with 108 male and female depressive outpatients, aged 18 or over. Results revealed a significant positive correlation (with a Pearson's correlation coefficient r equal to 0.69 and risk p < 0.0001) between Beck's suicidal ideation scale and the suicidal risk assessment scale RSD. These scales correlate less consistently with Hamilton's depression (Beck/Hamilton's depression: r = 0.34; p = 0.0004—RSD/Hamilton's depression: r = 0.35; p = 0.0002). We observed that the clinical anxiety scale by Snaith is also strongly correlated to these two suicidal risk assessment scales (Beck/CAS: r = 0.48; p < 0.0001—RSD/CAS: r = 0.35; p = 0.0005). Besides, the item “suicide” of Hamilton's depression scale accounts for more than a third of the variability of Beck's suicidal ideation scale and the suicidal risk assessment scale RSD. According to these results, the suicidal risk evaluated by these two scales seems to be significantly correlated with anxiety as much as with depression. On the other hand, the Clinical Global Impression is fairly significantly correlated with Beck's suicidal ideation scale (r = 0.22; p = 0.02), unlike the suicidal risk assessment scale RSD (r = 0.42; p < 0.0001) and Hamilton's depression scale (r = 0.58; p < 0.0001); (b) Relationships between Beck's suicidal ideation scale, the suicidal risk assessment scale RSD and Hamilton's depression under treatment. The follow-up under treatment (fluvoxamin or fluoxetin) during six weeks revealed the significantly better sensitivity of the RSD in comparison with Beck's suicidal ideation scale and Hamilton's depression scale, showing the significantly faster improvement in the RSD (p < 0.0001). There was no significant difference between the evolution of Beck's suicidal ideation scale and Hamilton's depression scale. So, under treatment with fluvoxamin or fluoxetin, the improvement in suicidal risk appears to be as rapid as the improvement in depression. If we look at the treatment prescribed, only the suicidal risk assessment scale RSD revealed a significant difference between the two molecules, with more rapid improvement with fluvoxamin (p = 0.015) from D14.\nConclusion\nIn conclusion, the results of this study hypothesize that the suicidal risk, as assessed by Beck's suicidal ideation scale and the suicidal risk assessment scale RSD, appears to be consistently correlated with both the level of anxiety and depression. The study also suggests that all antidepressants may not be equally effective on suicidal risk.", "publicationTitle": "L'Encéphale", "publisher": "", "place": "", "date": "avril 2008", "volume": "34", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "132-138", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "L'Encéphale", "DOI": "10.1016/j.encep.2006.09.002", "citationKey": "", "url": "http://www.sciencedirect.com/science/article/pii/S0013700607000279", "accessDate": "2015-12-07T16:12:15Z", "PMID": "", "PMCID": "", "ISSN": "0013-7006", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "ScienceDirect", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Anxiety", "type": 1 }, { "tag": "Anxiété", "type": 1 }, { "tag": "Assessment", "type": 1 }, { "tag": "Depression", "type": 1 }, { "tag": "Dépression", "type": 1 }, { "tag": "Suicidal risk", "type": 1 }, { "tag": "Évaluation", "type": 1 }, { "tag": "ésRisque suicidaire", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2016-03-15T12:24:51Z", "dateModified": "2016-03-15T12:24:51Z" } }, { "key": "AU324U4D", "version": 2, "library": { "type": "group", "id": 498460, "name": "OG", "links": { "alternate": { "href": "https://www.zotero.org/groups/og", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/498460/items/AU324U4D", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/og/items/AU324U4D", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2617617, "username": "oguinois125", "name": "Olivia GUINOIS", "links": { "alternate": { "href": "https://www.zotero.org/oguinois125", "type": "text/html" } } }, "creatorSummary": "Purper-Ouakil", "parsedDate": "2009", "numChildren": 0 }, "data": { "key": "AU324U4D", "version": 2, "itemType": "journalArticle", "title": "Repérer et prendre en charge la dépression et les conduites suicidaires chez l’adolescent", "creators": [ { "creatorType": "author", "firstName": "D.", "lastName": "Purper-Ouakil" } ], "abstractNote": "", "publicationTitle": "L'Encéphale", "publisher": "", "place": "", "date": "juin 2009", "volume": "35", "issue": "2, Supplement 1", "section": "", "partNumber": "", "partTitle": "", "pages": "S3-S7", "series": "Psychiatrie pratique : dépression, suicide, anxiété", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "L'Encéphale", "DOI": "10.1016/S0013-7006(09)74572-5", "citationKey": "", "url": "http://www.sciencedirect.com/science/article/pii/S0013700609745725", "accessDate": "2015-12-07T16:56:53Z", "PMID": "", "PMCID": "", "ISSN": "0013-7006", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "ScienceDirect", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2016-03-15T12:24:51Z", "dateModified": "2016-03-15T12:24:51Z" } }, { "key": "RKMFB3WD", "version": 2, "library": { "type": "group", "id": 498460, "name": "OG", "links": { "alternate": { "href": "https://www.zotero.org/groups/og", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/498460/items/RKMFB3WD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/og/items/RKMFB3WD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2617617, "username": "oguinois125", "name": "Olivia GUINOIS", "links": { "alternate": { "href": "https://www.zotero.org/oguinois125", "type": "text/html" } } }, "creatorSummary": "Ducher and Terra", "parsedDate": "2006-10", "numChildren": 0 }, "data": { "key": "RKMFB3WD", "version": 2, "itemType": "journalArticle", "title": "L’échelle d’évaluation du risque suicidaire RSD possède-t-elle une valeur prédictive ?: Is the suicidal risk assessment scale RSD of predictive value ?", "creators": [ { "creatorType": "author", "firstName": "J. L.", "lastName": "Ducher" }, { "creatorType": "author", "firstName": "J. L.", "lastName": "Terra" } ], "abstractNote": "Résumé\nLa recherche de facteurs de risque suicidaire permet de définir des populations à risque. Elle ne donne pas au clinicien d’informations sur l’éventualité imminente d’un passage à l’acte. Des instruments psychométriques cherchent à aider le thérapeute dans cette démarche. Parmi ceux-ci, on peut citer l’échelle d’évaluation du risque suicidaire RSD. Son inclusion dans une étude de prévention des récidives dépressives à long terme montre une validité concourante satisfaisante de la RSD avec les items « suicide » de la MADRS (ρ = 0,79 ; p = 0,0001) et de l’échelle Hamilton-dépression (ρ = 0,70 ; p = 0,0001) et moins satisfaisante avec le degré de dépression évalué par le score global de la MADRS (ρ = 0,40 ; p = 0,0001). Le suivi à court terme sous traitement démontre la sensibilité de la RSD qui s’améliore plus rapidement que la MADRS. Ceci pose certaines questions par rapport à l’augmentation du risque suicidaire décrite dans la littérature pour certains antidépresseurs. Le suivi à moyen terme permet de tester la validité prédictive de la RSD. Il confirme un niveau de risque suicidaire aggravé à partir d’un score de 7, avec le décès par suicide de 2 patients parmi les 15 qui avaient lors de leur inclusion un score entre 7 et 10 à la RSD. En revanche, aucun suicide, ni aucune tentative de passage à l’acte n’ont été à déplorer, sur les 18 mois de suivi, dans le groupe témoin des 88 patients pour lesquels la RSD était inférieure ou égale à 6 à J0 (p = 0,02 au test exact de Fisher).\nSummaryIntroduction\nA part (60 % to 70 %) of those who are going to act out their suicide consult a doctor the month before. Studies have shown the need to improve the practitioner's capacity to diagnose depression. The assessment of the suicidal risk is crucial. The search for suicidal risk factors helps to define the populations at risk. However, it doesn’t provide information concerning the possibility of acting out in the short term. And how does one react when faced with those who do not present any of the risk factors ? Psychometric instruments attempt to help the therapist in his/her reasoning.\nSuicidal risk assessment\nAmong them, the suicidal risk assessment scale RSD should be mentioned. Its objective is to estimate the seriousness of the suicidal risk, with 11 levels. It is built around a possible will to commit suicide rather than a single assessment of the frequency of suicidal ideas. Its construction in hierarchical order permits the progressive assessment of the suicidal risk, in the form of a semi-structured interview. Hence, the suicidal risk assessment scale RSD looks for the existence of death wishes (levels 1-2), of suicide ideations and its frequency (levels 3-4-5), and of a passive desire to die (level 6). Level 7 shows the onset of a decision making process, except that the patient is still inhibited by various important factors in his/her life. More often, the fear of inflicting immense suffering to his/her loved ones or for religious beliefs, is found. From level 8, determination has made way to hesitation. An active death wish exists, and although the plan remains undefined, the act is decided on. At level 9 the methods of application are developed and a plan is established. The ultimate level exists when there is a start in the preparation of the act of suicide (level 10). This hierarchical order has been confirmed by some epidemiological studies.\nMethod\nThe inclusion of the suicidal risk assessment scale RSD in a double-blind, placebo-controlled study, which tested the efficacy of fluvoxamine in reducing the risk of recurrence of depression over 18 months, appears of particular interest. In this multicentre study, patients of both sexes were included, aged between 18 and 70 years, presenting a major depressive episode with a MADRS equal to a minimum of 25, and having had a minimum of two episodes of major depression within the last five years.\nResults\nThe resulting analysis carried out on 103 patients showed a satisfactory concurrent validity between the suicidal risk assessment scale RSD and the items « suicide » of the MADRS (ρ = 0.79 ; p = 0.0001) and the Hamilton Depression Scale (ρ = 0.70 ; p = 0.0001), and fairly satisfactory concurrent validity with the depression degree assessed by the MADRS overall score (ρ = 0.40; p = 0.0001). The short-term follow-up under treatment revealed enhanced sensitivity of the RSD versus the MADRS. The improvement in suicidal risk, assessed by the RSD, was faster than the improvement in depression, which is interesting from a clinical point of view. The medium-term follow-up tested the predictive validity of RSD and confirmed a greater level of suicidal risk from a score of 7 on the RSD, with the death by suicide of 2 subjects among the 15 who exhibited a score between 7 and 10 on the RSD on inclusion. On the other hand, no acting out, no attempted suicides, and no suicides were noted in the group of 88 subjects whose RSD was lower or equal to 6 on inclusion (p = 0.02 using Fisher's exact test).\nConclusion\nThus, the RSD appears of interest, from a clinical point of view, by providing a -diagnostic, or a scientific approach.", "publicationTitle": "L'Encéphale", "publisher": "", "place": "", "date": "octobre 2006", "volume": "32", "issue": "5, Part 1", "section": "", "partNumber": "", "partTitle": "", "pages": "738-745", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "L'Encéphale", "DOI": "10.1016/S0013-7006(06)76226-1", "citationKey": "", "url": "http://www.sciencedirect.com/science/article/pii/S0013700606762261", "accessDate": "2015-12-07T17:03:55Z", "PMID": "", "PMCID": "", "ISSN": "0013-7006", "archive": "", "archiveLocation": "", "shortTitle": "L’échelle d’évaluation du risque suicidaire RSD possède-t-elle une valeur prédictive ?", "language": "", "libraryCatalog": "ScienceDirect", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Assessment", "type": 1 }, { "tag": "Attempted suicide", "type": 1 }, { "tag": "Predictive validity", "type": 1 }, { "tag": "Risque suicidaire", "type": 1 }, { "tag": "Scale", "type": 1 }, { "tag": "Suicidal risk", "type": 1 }, { "tag": "Suicide", "type": 1 }, { "tag": "Tentative de suicide", "type": 1 }, { "tag": "Validité prédictive", "type": 1 }, { "tag": "Évaluation", "type": 1 }, { "tag": "ésÉchelle", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2016-03-15T12:24:51Z", "dateModified": "2016-03-15T12:24:51Z" } }, { "key": "GB9BV6N2", "version": 2, "library": { "type": "group", "id": 498460, "name": "OG", "links": { "alternate": { "href": "https://www.zotero.org/groups/og", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/498460/items/GB9BV6N2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/og/items/GB9BV6N2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2617617, "username": "oguinois125", "name": "Olivia GUINOIS", "links": { "alternate": { "href": "https://www.zotero.org/oguinois125", "type": "text/html" } } }, "creatorSummary": "Laget et al.", "parsedDate": "2007-10", "numChildren": 0 }, "data": { "key": "GB9BV6N2", "version": 2, "itemType": "journalArticle", "title": "Évaluation du potentiel suicidaire chez les adolescents : lien entre fréquence, satisfaction et moyens utilisés par différents intervenants en pédopsychiatrie", "creators": [ { "creatorType": "author", "firstName": "J.", "lastName": "Laget" }, { "creatorType": "author", "firstName": "M.", "lastName": "Abbiati" }, { "creatorType": "author", "firstName": "B.", "lastName": "Plancherel" }, { "creatorType": "author", "firstName": "M.", "lastName": "Bolognini" }, { "creatorType": "author", "firstName": "O.", "lastName": "Halfon" } ], "abstractNote": "Résumé\nLes conduites suicidaires sont une forme fréquente d'expression de la souffrance de nombreux jeunes aujourd'hui. Il est important de prendre en compte et d'évaluer ces conduites et donc de disposer de moyens d'investigation adéquats. Une étude a été menée dans un Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, dans le but de mieux cerner les modes d'évaluation actuels des différents intervenants et d'envisager l'introduction d'un guide d'aide à l'évaluation du potentiel suicidaire en milieu ambulatoire et hospitalier. Un questionnaire semi-structuré a été élaboré afin de réaliser des entretiens individuels auprès des soignants dans quatre unités cliniques. Au total, 62 professionnels (médecins, psychologues, infirmiers, enseignants spécialisés et assistants sociaux) ont participé à l'étude. Il ressort de cette étude que si les moyens utilisés pour évaluer le risque suicidaire sont considérés comme assez satisfaisants par les deux tiers des intervenants, l'évaluation du risque suicidaire reste complexe. À ce titre, il semble utile de compléter les outils déjà à disposition par un guide d'aide à l'évaluation permettant de disposer d'un outil commun dans une institution où la communication entre intervenants est indispensable.\n\nNowadays adolescents often express mourning by suicidal behaviour. It is therefore important to be able to provide suitable investigation tools. A study was carried out at a Department of Adolescent Psychiatry in the French-speaking region of Switzerland with the aim of gaining a better understanding of the present assessment techniques and in order to propose the introduction of a guide for the assessment of suicidal behaviour in both out and in patient units. A semi-structured questionnaire was developed in order to proceed to individual interviews in four clinical units. 62 professionals (medical doctors, psychologists, nurses, specialised teachers and social workers) participated in the study. The results show that during the three months before the study, 2/3 of the care providers had performed suicide risks assessments between one and ten times. Suicide risks must therefore be considered as a serious problem for the majority of care providers. Comparing the different interventions, it was observed that nurses and medical doctors performed suicide risk assessments more often than psychologists and social workers and that they generally took less time to do so. The study showed that the different techniques for performing suicide risk assessments corresponded to those quoted in almost all research studies relating to suicide risk factors: psychopathology, a previous suicide attempt, problems in the family, life events and negative social environment. When should suicide risks be assessed? For most of the participants in the study, a systematic suicide risk assessment is recommended for all patients and is a requirement for patients with a history of a suicidal risk. Among suicide risk assessment techniques, the most frequently quoted is that of a discussion with the team of care providers. Even if the care providers' level of satisfaction is relatively high, other potential techniques are also mentioned such as an interview guide, and ad hoc training and tests. It is interesting to note that only one care provider mentioned the use of a questionnaire whereas 30 care providers would have liked to introduce one. It is well known that questionnaires cannot predict a suicide attempt, but they can help provide an assessment of suicide risks in order to help care for patients. Care providers generally mentioned that they appreciated having time for discussions with patients and would like having even more time. The majority of care providers reported that they were relatively satisfied with their suicide risk assessment techniques but that they would have liked to have the possibility of using a more systematic assessment technique. In this context, it seems useful to complement existing techniques with a guide to help assess suicide risks in order to provide a common tool in institutions where communications between care providers is essential. The assessment technique developed by Terra and Séguin featuring specific training and a guide for helping to assess suicide risks was introduced in our Clinical Department to help care providers better assess this important problem.", "publicationTitle": "Annales Médico-psychologiques, revue psychiatrique", "publisher": "", "place": "", "date": "octobre 2007", "volume": "165", "issue": "8", "section": "", "partNumber": "", "partTitle": "", "pages": "556-561", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Annales Médico-psychologiques, revue psychiatrique", "DOI": "10.1016/j.amp.2006.12.015", "citationKey": "", "url": "http://www.sciencedirect.com/science/article/pii/S000344870700131X", "accessDate": "2015-12-07T17:05:11Z", "PMID": "", "PMCID": "", "ISSN": "0003-4487", "archive": "", "archiveLocation": "", "shortTitle": "Évaluation du potentiel suicidaire chez les adolescents", "language": "", "libraryCatalog": "ScienceDirect", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adolescence", "type": 1 }, { "tag": "Assessment", "type": 1 }, { "tag": "Prevention", "type": 1 }, { "tag": "Prévention", "type": 1 }, { "tag": "Suicide Attempts", "type": 1 }, { "tag": "Tentatives de suicide", "type": 1 }, { "tag": "Évaluation", "type": 1 }, { "tag": "ésAdolescence", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2016-03-15T12:24:51Z", "dateModified": "2016-03-15T12:24:51Z" } }, { "key": "TMBRDIVI", "version": 2, "library": { "type": "group", "id": 498460, "name": "OG", "links": { "alternate": { "href": "https://www.zotero.org/groups/og", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/498460/items/TMBRDIVI", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/og/items/TMBRDIVI", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2617617, "username": "oguinois125", "name": "Olivia GUINOIS", "links": { "alternate": { "href": "https://www.zotero.org/oguinois125", "type": "text/html" } } }, "creatorSummary": "Bernardy-Prud’homme et al.", "parsedDate": "2011", "numChildren": 0 }, "data": { "key": "TMBRDIVI", "version": 2, "itemType": "journalArticle", "title": "Prise en charge des suicidants. Quel apport d’une démarche d’audit clinique ciblé ?", "creators": [ { "creatorType": "author", "firstName": "A.", "lastName": "Bernardy-Prud’homme" }, { "creatorType": "author", "firstName": "A.", "lastName": "Braillon" }, { "creatorType": "author", "firstName": "H.", "lastName": "Noël" }, { "creatorType": "author", "firstName": "F. -X.", "lastName": "Chaine" }, { "creatorType": "author", "firstName": "J.", "lastName": "Bruyelle" }, { "creatorType": "author", "firstName": "G.", "lastName": "Loas" }, { "creatorType": "author", "firstName": "G.", "lastName": "Dubois" } ], "abstractNote": "RésuméIntroduction\nLa tentative de suicide (TS) est une situation fréquente et grave. L’objet de ce travail est d’étudier l’apport de la méthode de l’audit clinique ciblé (ACC) pour l’amélioration de cette prise en charge et ce, dans le cadre d’une action régionale.\nMéthodes\nL’ACC a été conduit dans 12 établissements picards (huit de médecine, chirurgie et obstétrique, trois spécialisés en psychiatrie, un de proximité) entre 2004 et 2006. Le référentiel établi par l’Agence nationale d’accréditation et d’évaluation en santé, dans le cadre d’un plan national, comportait 16 critères (issus des recommandations de 1998) et intéressait trois champs : l’organisation de la prise en charge pendant le séjour (n = 10), les contacts avec l’environnement du patient (n = 2) et la préparation de la sortie (n = 4). Les équipes médicales et soignantes des unités d’urgences et des unités de psychiatrie ont bénéficié d’un accompagnement par un chef de projet et un médecin qualiticien. Tous les centres devaient analyser 30 dossiers lors d’un premier tour et mettre en place des actions d’amélioration, elles-mêmes évaluées lors d’un second tour.\nRésultats\nTous les établissements ont satisfait au protocole. Au premier tour, trois critères (début de la prise en charge aux urgences, examen somatique, coordination des soins durant le séjour) avaient une conformité de 100 % dans au moins la moitié des établissements. Trois autres critères (évaluation sociofamiliale et environnementale, contacts préalables à la sortie du patient, « vérification » de la venue du patient au rendez-vous de suivi) avaient une conformité inférieure à 50 % dans au moins la moitié des établissements. Les actions d’amélioration ont été conduites pour trois critères en moyenne par établissement. Au second tour, le taux de conformité (moyenne des établissements) n’était amélioré de plus de 10 % que pour trois critères. Il s’était légèrement dégradé pour trois autres critères.\nConclusion\nLa faisabilité de la méthode a été excellente grâce à l’accompagnement, mais l’amélioration de la prise en charge semble limitée.\nSummaryBackground\nSuicide attempt is a serious condition that is frequent in France. Picardie ranks fifth in France for suicide (418 deaths in 2005 for 1 890 000 inhabitants). Suicide attempt is one of the priorities of the regional public health program. The National Agency for Accreditation and Evaluation in Health (Anaes) has designed targeted clinical audits (TCA) on various conditions to promote this method as the basic tool for quality improvement.\nAim\nWe investigated the contribution of TCA for improving the quality of care of suicide attempt within a regional framework in Picardie.\nMethods\nTCA were conducted in 12 state hospitals (eight Surgical Medicine and Obstetrics, three specialized in psychiatry, one local) between 2004 and 2006. The standards from the Anaes had 16 criteria in three fields: care on admission (n = 10); assessment of family and social environment (n = 2); management for after hospital care (n = 4). A project manager and a MD certified in health care quality supported the medical (MD certified in acute care and in psychiatry) and nursing staff of the emergency wards. All the wards analyzed 30 patients’ files for the first cycle, set up and implemented improvement actions and then performed the second cycle of data collection.\nResults\nAll wards fully satisfied the protocol with 30 patients’ files per cycle and two cycles. In all wards the teams consisted of physicians (both certified for emergency or psychiatry) and others care providers (nurses, psychologists, social workers, secretary). For the first cycle, three criteria (patient assessment, somatic examination and coordination) met the 100% target for more than half of the wards while three criteria (sociofamily and environmental evaluation, management for after hospital care, monitoring of follow-up) did not conform by more than 50% in more than half of the wards. All wards implemented changes after the first cycle with a total of 29 interventions, each one specifically devoted to improving a particular criterion. Intervention included better coordination and communication, protocol design and reminders, and information tools. The second cycle showed modest and mixed changes. After the interventions only one criteria reached the 100% target in one ward; the degree of conformity decreased in nine cases (with a mean of −23%) and increased in 16 cases (+19%). Globally, three criteria improved by less than 10% while three slightly decreased.\nDiscussion\nG. Shaw introduced clinical audits in 1989 to boost a poorly performing system within the “clinical governance” framework, a condition quite different from the French healthcare system in 2005. Therefore, the validation of clinical audit in a different context appeared necessary. Anaes has not yet published the evaluation of this method in a peer reviewed journal. Observed changes are modest and mixed. Moreover, the true impact on care delivery appears limited and one cannot rule out that the observed improvements are in fact related to an improvement in traceability or due to Hawthorne's effect. Quality improvement methods must be evaluated and validated by scientific methods such as for new treatments with clinical research.\nConclusion\nThe feasibility of the method was excellent, due to the methodological and technical support, however the method did not significantly improve the quality of care.", "publicationTitle": "L'Encéphale", "publisher": "", "place": "", "date": "mai 2011", "volume": "37, Supplement 1", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "S27-S35", "series": "Therapeutique", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "L'Encéphale", "DOI": "10.1016/j.encep.2010.06.001", "citationKey": "", "url": "http://www.sciencedirect.com/science/article/pii/S0013700610001545", "accessDate": "2015-12-07T17:06:47Z", "PMID": "", "PMCID": "", "ISSN": "0013-7006", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "ScienceDirect", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Audit clinique", "type": 1 }, { "tag": "Clinical audit", "type": 1 }, { "tag": "Jeunes suicidants", "type": 1 }, { "tag": "Practice improvement", "type": 1 }, { "tag": "Prise en charge hospitalière", "type": 1 }, { "tag": "Suicide attempt", "type": 1 }, { "tag": "Évaluation des pratiques", "type": 1 }, { "tag": "ésAmélioration des pratiques", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2016-03-15T12:24:51Z", "dateModified": "2016-03-15T12:24:51Z" } } ]