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La première rencontre du corps malade en contexte de soins infirmiers : la relation de soin : une expérience ultime, du sensible au social / The first encounter with a sick body in a nursing care context : the care relationship : the utmost experience ranging from the sensitive to the social dimensionsLagarde-Piron, Laurence 07 December 2016 (has links)
Notre étude porte sur les soins infirmiers avec une entrée par le corps et les émotions dans le contexte de formation et dans l’espace sensible de l’hôpital. L’étudiant est placé au centre de notre recherche, il vit à travers son corps une expérience sensorielle et relationnelle inédite et singulière dans un cadre social chargé de symboles. Il perçoit le monde des soins à travers ses sens qui l’informent, l’orientent et le déstabilisent. L’inscription de notre recherche en SIC se fait par la problématisation sensible, sensorielle et symbolique ; par la conceptualisation à travers plusieurs disciplines et différentes approches théoriques, l’interactionnisme symbolique et la phénoménologie. L’enquête a permis de recueillir un corpus de données qui, croisées avec nos archives personnelles, ont permis d’explorer l’expérience de l’étudiant dans ses dimensions perceptive et émotionnelle, cognitive et imaginaire, sans la désincarner. Dans une démarche compréhensive, nous cherchons à saisir les processus à l’œuvre dans l’émergence de l’émotion, ses manifestations et sa gestion lorsque l’étudiant se donne pour la première fois en représentation en réalisant ses premiers soins au corps. Les soins d’hygiène se déroulent dans une mise en scène où chacun, soignant et soigné, protège son image et son espace. Ils se prêtent à des mises en scène très variées et des jeux de rôle d’une grande richesse, se révélant sans nul doute comme les plus riches en significations. Ils mobilisent tous les sens et entraînent de nombreuses sensations intimes et secrètes faisant émerger de multiples ressentis qui s'exposent, se partagent et se montrent ou bien s'imposent et indisposent. Ils font résonner l’histoire des soins, les codes et les normes sociales, l’identité du rôle propre de l’infirmière. / Our study focuses on nursing care with a first approach based on human body and emotions through the teaching context in the sensitive hospital environment. The nursing student is a central point of our research as he lives a unique sensitive and interpersonal experience within his own body in a social setting imbued with symbolism. He perceives health care community through his five senses which inform and direct him, but also may destabilize him. We decided to base our study on the information and communication sciences thanks to a sensitive, sensorial and symbolic problematisation and through a multidisciplinary conceptualization based on different theoretical approaches, symbolic interactionism and phenomenology. The survey enabled us to collect a data set which was crossed with the researcher’s personal archives. This has enabled us to explore the student’s experience in its perceptual and emotional as well cognitive and imaginary dimensions, without disembodying it. Within a comprehensive approach, we tried to understand the process involved in the emergence of emotions, its expressions and management when the student performs and handles for the first time body cares. Personal hygiene tasks unfold in a staging where each of the characters, caregiver and care-receiver, protect both his own image and living space. They show various performances and a high degree of role playing which are doubtlessly the most meaningful. Every sense is mustered, drawing numerous intimate and secretive feelings which lead to the emergence of many perceptions. These perceptions are exhibited and shared, or are imposed on and therefore indispose. They are a true part of nurse care History, social codes and standards, and the identity of the nurse’s role.
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Il costo del diniego. Diritto, religione e sistema sanitario nell'esperienza americana tra giurisprudenza e dottrinaGRECO, MARCO 03 March 2010 (has links)
La tesi approfondisce il complesso rapporto tra diritto, religione e sanità nella realtà americana, concentrandosi in particolare sulle problematiche scaturenti dall’orientamento religioso del paziente, del care provider e della struttura sanitaria.
La prima sezione si propone di studiare, sempre in chiave giuridica, l’evoluzione del rapporto tra fede e medicina, presentando altresì due casi di studio: i nativi americani e christian science.
Nella seconda sezione, invece, si ricostruiscono le linee interpretative essenziali del primo emendamento con specifico approfondimento tanto della Free exercise clause che dalla establishment clause. Parimenti, viene tracciato un disegno di sintesi del sistema sanitario americano, soffermandosi tanto sugli aspetti pubblicistici che su quelli privatistici dello stesso. La ricerca, poi, si sofferma sull’analisi dettagliata delle problematiche evidenziate dalla giurisprudenza americana con riferimento al care receiver, al care provider e, soprattutto, al contenzioso in materia pediatrica.
L’ultima parte è dedicata allo sviluppo di due distinti filoni, ovvero: il rapporto tra scienza e diritto ed il ruolo dell’economia. Questo ultimo aspetto viene approfondito sotto due diversi punti di vista. In primo luogo si ricostruisce l’impatto economico delle policy che garantiscono la libertà religiosa sul “sistema sanità”. In secondo luogo, si approfondisce il tema dell’influenza del dato economico sullo sviluppo della libertà religiosa in ambito sanitario. / This work deals with the complex relationship between law, religion and the sanitary system in the U.S. setting, by focusing on the problems emerging from the religious view of the patient, of the care provider and the religious orientation of the hospital or HMO.
The first section of the work aims to study, from a legal point of view, the evolution of the relationship “medicine-religion”, and focuses on two case studies: native Americans and Christian science.
In the second section the essential interpretative streamlines about the first amendment are presented, through a deep analysis of the Free Exercise Clause and of the Establishment Clause. At the same time, the American (U.S.) sanitary system is deeply studied both in the private sector and the public one.
The research then focuses on a detailed analysis of the jurisprudence related to the care provider and the care receiver, while a specific section is dedicated to the litigation concerning pediatric patients and the related litigation cases.
The last part develops two different subjects: the relationship between science and law, and the role of economy. This last subject is deeply analyzed under two different points of view: the economic impact of the religious freedom on the “sanitary system” on the one hand; and the influence of the economic data on the development of religious freedom in the health care system setting on the other.
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De l'invention du mourant à la figure de l'agonie. Recherche sur l'ultime épiphanie de la personne incarnée / From the invention of the dying, to the figure of agony : research on the final epiphany of the incarnated personTranchant, Blandine 11 January 2017 (has links)
A l’heure où la prise en charge médicale s’avère de plus en plus nécessaire pour accompagner la fin de vie, il nous apparait que sa place est de plus en plus importante et de moins en moins questionnée. Or, réduire la fin de vie à la question du mourant et de sa prise en charge est pour le moins problématique. L’arrêt d’hydratation et d’alimentation, les différentes formes de sédation, l’euthanasie, le suicide assisté, les soins palliatifs résument-ils à eux seuls ce que l’on peut dire de la fin de vie ? Peut-elle se résumer uniquement à une question d’ordre médical ? N’est-elle pas avant tout une question d’ordre existentiel où, à l’heure de notre déclin, nous sommes confrontés à l’agonie ? Souffrance et finitude se trouvent au cœur de notre interrogation et nous poussent à nous confronter au pâtir de la vie, nous dévoilant ainsi comme être de chair. Grâce à la philosophie henryenne, l’agonie va peu à peu se dévoiler comme une occasion ultime de révélation de soi à soi en tant que soi. Face à l’aporie du mal qui frappe, nous découvrons les hommes capables toujours d’y faire face par un effort de repersonnalisation. C’est cet effort nécessaire qui va se dévoiler tant dans le champ métaphysique, que dans le champ éthique, et que dans le champ politique. C’est ce même effort qui amène l’homme à prendre ses responsabilités et à répondre aux questions existentielles. La subjectivité de chacun se doit alors de devenir le centre de l’institution soignante. L’agonie devient possibilité de repenser la place de la personne au sein du système hospitalier : place de la personne soignante, de la personne soignée, de ceux qui accompagnent, tout en développant une éthique de l’accompagnement qui doit ensuite se décliner dans une politique. Car si, métaphysiquement, vivre son agonie ne peut se justifier que par l’Amour, éthiquement, il nous faut construire une nouvelle poétique de l’action faisant place à la fraternité issue de la chair, à l’imagination de l’homme pour répondre à l’appel d’autrui et de la vie, et à la subsidiarité, afin que chacun soit respecté dans son agir et sa conscience. Politiquement, cela nous ouvre alors à un système hospitalier respectueux de chaque « Je Peux » qui se déploie en son sein. Le respect du consentement du patient reste ainsi la pierre angulaire du système hospitalier ; mais il ne peut se construire que dans une alliance avec les soignants. / In the context of today’s world, medical care is becoming increasingly necessary to assist patients at the end of life. It appears that this care is taking on more and more importance and is subject to fewer and fewer questions. is less and less questioned. However, confining the end of life to the state of dying and its medical support is problematic. Can the end of life be resumed as stopping hydration and artificial feeding, sedation in its different forms, euthanasia, assisted suicide, and palliative care? Can it be summed up as a simple medical question? Isn’t the end of life, first and foremost, linked to an existential question in which, at the time of our decline, we come face to face with agony? Finiteness and suffering are at the heart of our questioning as we confront life’s hardships, revealing the mystery of the flesh. With the help of Michel Henry’s philosophy, agony will gradually reveal itself as an ultimate opportunity for self-revelation. Faced with the paradox of evil, we find Man capable of coping with an effort of re-personification. This necessary effort will unfold in the metaphysical, ethical and political fields. This same effort allows Man to take responsibility for himself and to contemplate existential questions. The subjectivity of each person must become the center of the healthcare institution. Agony becomes the possibility to rethink the place of the individual person within the hospital system: the care giver, the care receiver and those supporting them, all while developing an ethical personal assistance which must then translated into policies. Because even if metaphysically, living out agony cannot be otherwise justified but by Love, ethically we must build a new way of operating. We must leave room for fraternity as a consequence of being of the flesh, to imagination in order to respond to our fellow man and our life’s calling, and to subsidiarity so that everyone is respected in his actions and consciousness. Politically, it opens up the possibility of a hospital system respectful of each "I Can" which is echoed within its walls. Respect for the patient's consent remains the cornerstone of the hospital system but can only be built with an alliance with caregivers.
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