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Recours Non Urgents Aux Services Durgences Et Acces Au Medecin Generaliste Etude Realisee Dans Le Service Durgences Antoine Beclere Clamart 92
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Book Synopsis Etude descriptive des patients « non urgents » adultes et pédiatriques consultant au service d'accueil des urgences de Semur-en-Auxois aux heures d'ouverture des cabinets de médecine générale by : Nicolas Fatus
Download or read book Etude descriptive des patients « non urgents » adultes et pédiatriques consultant au service d'accueil des urgences de Semur-en-Auxois aux heures d'ouverture des cabinets de médecine générale written by Nicolas Fatus and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : La fréquentation des services d'urgence ne cesse de croitre depuis de nombreuses années, et une proportion importante de patients consulte pour un motif de médecine générale. L'objectif principal de cette étude était de déterminer les justifications qui amènent ces patients à consulter pour un motif de médecine générale dans le service d'urgences plutôt que leur médecin traitant. Méthodes : Etude prospective, observationnelle, transversale, monocentrique, menée au sein du service des urgences du centre hospitalier Robert MORLEVAT de Semur-en-Auxois, réalisée sur une durée de 18 jours sur trois semaines, aux horaires habituels d'ouverture des cabinets de médecine générale, et incluant une population pédiatrique et adulte. Un questionnaire était remis par l'IAO au patient ou aux parents de l'enfant consultant pour un motif de médecine générale aux heures d'ouverture des cabinets de médecine générale. Résultats : Dans notre étude, l'âge médian était de 33 ans et la tranche d'âge la plus représentée était la population pédiatrique (29,8 %), suivie des 18-35 ans (24,2 %). Il y avait 27,9 % de passages non urgents en journée et seulement 50,3 % de ces patients avaient essayé de joindre leur médecin traitant. Les principaux motifs de consultation étaient la traumatologie (28,0 %), l'infectiologie (21,7 %) et les symptômes rhumatologiques (19,3 %). Les principales raisons invoquées étaient l'indisponibilité du médecin traitant ou un rendez-vous trop tardif (39,7 %) et la disponibilité des examens complémentaires et des spécialistes sur place (31,1 %). 86,3 % auraient accepté d'être réorientés vers un médecin généraliste attaché au service d'urgences. Conclusion : Seulement un patient sur deux a essayé de consulter son médecin traitant avant de consulter aux urgences pour un motif non urgent. Les patients n'ayant pas tenté de joindre leur médecin traitant pensaient avoir quelque chose de grave ou une nécessité d'examens complémentaires. Un travail sur l'éducation du patient doit être réalisé par le médecin traitant et le service d'accueil des urgences.
Book Synopsis Etude descriptive des patients « non urgents » adultes et pédiatriques consultant au service d'accueil des urgences de Semur-en-Auxois aux heures d'ouverture des cabinets de médecine générale by : Nicolas Fatus
Download or read book Etude descriptive des patients « non urgents » adultes et pédiatriques consultant au service d'accueil des urgences de Semur-en-Auxois aux heures d'ouverture des cabinets de médecine générale written by Nicolas Fatus and published by . This book was released on 2021 with total page 57 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : La fréquentation des services d'urgence ne cesse de croitre depuis de nombreuses années, et une proportion importante de patients consulte pour un motif de médecine générale. L'objectif principal de cette étude était de déterminer les justifications qui amènent ces patients à consulter pour un motif de médecine générale dans le service d'urgences plutôt que leur médecin traitant. Méthodes : Etude prospective, observationnelle, transversale, monocentrique, menée au sein du service des urgences du centre hospitalier Robert MORLEVAT de Semur-en-Auxois, réalisée sur une durée de 18 jours sur trois semaines, aux horaires habituels d'ouverture des cabinets de médecine générale, et incluant une population pédiatrique et adulte. Un questionnaire était remis par l'IAO au patient ou aux parents de l'enfant consultant pour un motif de médecine générale aux heures d'ouverture des cabinets de médecine générale. Résultats : Dans notre étude, l'âge médian était de 33 ans et la tranche d'âge la plus représentée était la population pédiatrique (29,8 %), suivie des 18-35 ans (24,2 %). Il y avait 27,9 % de passages non urgents en journée et seulement 50,3 % de ces patients avaient essayé de joindre leur médecin traitant. Les principaux motifs de consultation étaient la traumatologie (28,0 %), l'infectiologie (21,7 %) et les symptômes rhumatologiques (19,3 %). Les principales raisons invoquées étaient l'indisponibilité du médecin traitant ou un rendez-vous trop tardif (39,7 %) et la disponibilité des examens complémentaires et des spécialistes sur place (31,1 %). 86,3 % auraient accepté d'être réorientés vers un médecin généraliste attaché au service d'urgences. Conclusion : Seulement un patient sur deux a essayé de consulter son médecin traitant avant de consulter aux urgences pour un motif non urgent. Les patients n'ayant pas tenté de joindre leur médecin traitant pensaient avoir quelque chose de grave ou une nécessité d'examens complémentaires. Un travail sur l'éducation du patient doit être réalisé par le médecin traitant et le service d'accueil des urgences.
Book Synopsis Déterminants socio-économiques du recours au médecin généraliste après un passage aux urgences by : Julie Rotival
Download or read book Déterminants socio-économiques du recours au médecin généraliste après un passage aux urgences written by Julie Rotival and published by . This book was released on 2017 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: Au sein de notre système de soins, certaines caractéristiques socio-économiques sont associées à des inégalités de santé et de recours aux soins. Une association a été retrouvée entre la continuité des soins ambulatoires et le recours aux services d'urgence (SU). L'objectif de notre étude était d'explorer les déterminants du recours au médecin traitant (MT) après un passage dans un SU. Nous avons mené une étude observationnelle, monocentrique, sur une cohorte de patients adultes des urgences non hospitalisés. Nous avons recueillis les caractéristiques socio-économiques, cliniques et de suivi ambulatoire. Tous les patients inclus étaient rappelés à un mois. Des statistiques descriptives puis un modèle de régression logistique multivarié ont été réalisés. Parmi les 243 patients inclus, 122 (50%) ont consultés leur MT. Parmi ces MT, 75 (31%) étaient dans les arrondissements limitrophes du SU. L'âge (p=0.0001), un mauvais état de santé perçu (p=0.001), une pathologie chronique (p=0,021), avoir au moins une limitation fonctionnelle (p=0.020), un examen biologique (p=0,012) ou un scanner (p=0,012), un motif médical( (p=0,041), des horaires non restreints de consultation (p=0.001) et une prescription d'arrêt de travail (p=0.029) étaient associés à un pourcentage de consultation plus important. En analyse multivariée, l'âge (aOR=1.03), un mauvais état de santé perçu (aOR=2.95) et la prescription d'un arrêt de travail (aOR=3,25) étaient associés à une augmentation de la probabilité de recourir au MT. Parmi les patients ayant consulté leur MT, 57 (23%) ont apporté leur compte rendu des urgences (CRU). Le recours au MT concerne seulement la moitié des patients après un recours au SU. Dans moins de 25% des cas, le patient avait apporté leur CRU au MT. Ces données suggèrent que des progrès restent à faire concernant la continuité des soins en ville.
Book Synopsis What Nazism Did to Psychoanalysis by : Laurence Kahn
Download or read book What Nazism Did to Psychoanalysis written by Laurence Kahn and published by Taylor & Francis. This book was released on 2022-09-09 with total page 157 pages. Available in PDF, EPUB and Kindle. Book excerpt: What Nazism Did to Psychoanalysis explores the impact Nazism had on the evolution of psychoanalysis and tackles the enigma of the transformation of individual hate into mass psychosis and of the autocratic creation of a neo-reality. Addressing the effects of the Holocaust on the psychoanalytic world, this book does not focus on the suffering of the survivors but the analysis of the concrete mechanisms of destruction that affected language and thought, their impact on the practice of psychoanalysis and the defences that psychoanalysts tried to find against the linguistic, legal and symbolic chaos that struck the foundations of reality. Laurence Kahn discusses the struggle against the appropriation, by the Nazi language, of key terms such as demonic nature, drives, ideals and, above all, the Selbsterhaltungstrieb (the self-preservation drive), which became, with Hitler, the axis of the living space policy, the "Lebensraum". Covering key topics such as trauma, transgenerational issues, silence and secrecy and the depredation of culture, this is an essential work for psychoanalysts and anyone wishing to understand how strongly the development of psychoanalysis was affected by Nazism.
Book Synopsis Transformational Processes in Clinical Psychoanalysis by : Lawrence J. Brown
Download or read book Transformational Processes in Clinical Psychoanalysis written by Lawrence J. Brown and published by Routledge. This book was released on 2018-10-09 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, Lawrence J. Brown offers a contemporary perspective on how the mind transforms, and gives meaning to, emotional experience that arises unconsciously in the here-and-now of the clinical hour. Brown surveys the developments in theory and practice that follow from Freud’s original observations and traces this evolution from its conception to contemporary analytic field theory. Brown emphasizes that these unconscious transformational processes occur spontaneously, in the blink of an eye, through the "unconscious work" in which the analyst and patient are engaged. Though unconscious, these processes are accessible and the analyst must train himself to become aware of the subtle ways he is affected by the patient in the clinical moment. By paying attention to one’s reveries, countertransference manifestations and even supposed "wild" or extraneous thoughts, the analyst is able to obtain a glimpse of how his unconscious is transforming the ambient emotions of the session in order to formulate an interpretation. Brown casts a wide theoretical net in his exploration of these transformational processes and builds on the contributions of Freud, Theodor Reik, Bion, Ogden, the Barangers, Cassorla, Civitarese and Ferro. Bion’s theories of alpha function, transformations, dreaming and his clinical emphasis on the present moment are foundational to this book. Brown’s writing is clear and aims to describe the various theoretical ideas as plainly as possible. Detailed clinical material is given in most chapters to illustrate the theoretical perspectives. Brown applies this theory of transformational processes to a variety of topics, including the analyst’s receptivity, countertransference as transformation, the analytic setting, the paintings of J.M.W. Turner, "autistic transformations" and other clinical situations in the analysis of children and adults. Transformational Processes in Clinical Psychoanalysis will be of great interest to all psychoanalysts and psychoanalytic psychotherapists.
Book Synopsis The Analyst's Reveries by : Fred Busch
Download or read book The Analyst's Reveries written by Fred Busch and published by Routledge. This book was released on 2019-03-04 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: While the use of the analyst’s own reveries in work with patients has increased in recent times, there has been little critical inquiry into its value, and the problems it may lead to. The Analyst's Reveries finds increasing veneration for the analyst’s use of their reveries, while revealing important differences amongst post-Bionians in how reverie is defined and used clinically. Fred Busch ponders if it has been fully recognized that some post-Bionions suggest a new, radical paradigm for what is curative in psychoanalysis. After searching for the roots of the analyst’s use of reverie in Bion’s work and questioning whether in this regard Bion was a Bionian, Busch carefully examines the work of some post-Bionians and finds both convincing ways to think about the usefulness and limitations of the analyst’s use of reverie. He explores questions including: From what part of the mind does a reverie emerge? How does its provenance inform its transformative possibilities? Do we over-generalize in conceptualizing what is unrepresented, with the corresponding problem of false positives? Do dreams equal understanding and what about the generalizability of the co-created reverie? Busch concludes that it is primarily through the analyst’s own associations that the reverie’s potential is revealed, which further helps the analyst distinguish it from many other possibilities, including the analyst’s countertransference. He believes in the importance of converting reveries into verbal interpretations, a controversial point amongst post-Bionians. Busch ends with the difficult task of classifying the analyst’s reveries based on their degree of representation. The Analyst's Reveries will be of great interest to psychoanalysts and psychoanalytic psychotherapists.
Book Synopsis In the Analyst's Consulting Room by : Antonino Ferro
Download or read book In the Analyst's Consulting Room written by Antonino Ferro and published by Psychology Press. This book was released on 2002 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt: Complements and develops Antonino Ferro's new model of the relationship between patient and analyst, by concentrating on adults.
Book Synopsis Psychoanalytic Studies on Dysphoria by : Marion M. Oliner
Download or read book Psychoanalytic Studies on Dysphoria written by Marion M. Oliner and published by Routledge. This book was released on 2018-11-12 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychoanalytic Studies on Dysphoria: The False Accord in the Divine Symphony depicts the profound dysphoria afflicting certain individuals, and includes the author's own personal experience of this as a German Jewish child during the Holocaust. Marion M. Oliner explores the impact of catastrophic events on the lives of individuals and their descendants from a broadly psychoanalytic perspective. The book focuses on the interplay between the experience and the unconscious meaning attributed to the trauma, and the ways in which patients may feel guilt, and blame themselves for the events and effects of their trauma. Drawing on the work of Freud and Winnicott, and with emphasis on the traumas suffered during the Second World War, Oliner offers new ways of understanding how resistant to treatment such traumas can be, and how the analyst can understand the experiences. The chapters span the evolution undergone in the nearly four decades of practice by the author. The book references a range of works including some taken from the German and French psychoanalytic literature, some never published in English. Taken together they aim at keeping the vitality of psychoanalysis without idealization, while discarding concepts whose essence is static, and therefore unhelpful. Psychoanalytic Studies on Dysphoria will appeal to psychoanalysts as well as other mental health professionals working with self-defeating behavior as a result of trauma.
Book Synopsis Love of Beginnings by : J.-B. Pontalis
Download or read book Love of Beginnings written by J.-B. Pontalis and published by . This book was released on 1993 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: Winner of the Prix Femina and considered a masterpiece of autobiography, this is J. B. Pontalis' lyrical meditation on his own life. One of France's pre-eminent psychoanalysts, he is co-author of the classic The Language of Psychoanalysis and he has also been a member of the editorial committee of Les Temps Modernes.
Book Synopsis Unrepresented States and the Construction of Meaning by : Howard B. Levine
Download or read book Unrepresented States and the Construction of Meaning written by Howard B. Levine and published by Routledge. This book was released on 2018-05-01 with total page 244 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the last several decades, the analytic field has widened considerably in scope. The therapeutic task is now seen by an increasing number of analysts to require that patient and analyst work together to strengthen, or to create, psychic structure that was previously weak, missing, or functionally inoperative. This view, which may apply to all patients, but is especially relevant to the treatment of non-neurotic patients and states of mind, stands in stark contrast to the more traditional assumption that the therapeutic task involves the uncovering of the unconscious dimension of a present pathological compromise formation that holds a potentially healthy ego in thrall. The contrast which this book calls attention to is that which exists roughly between formulations of psychic structure and functioning that were once assumed to have been sufficiently well explained by the hypotheses of Freud's topographic theory and those that were not. The former are modeled on neurosis and dream interpretation, where conflicts between relatively well-defined (saturated) and psychically represented desires were assumed to operate under the aegis of the pleasure-unpleasure principle.
