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<dc:title xml:lang="fr">Vieillesse et fragilité : le parcours et le devenir des personnes âgées de 75 ans ou plus hospitalisées pour fracture du col du fémur à Strasbourg</dc:title>
<dcterms:alternative xml:lang="en">The career and future of persons aged 75 years or more for hip fracture in Strasbourg</dcterms:alternative>
<dc:subject xml:lang="fr">Prise en charge hospitalière</dc:subject>
<dc:subject xml:lang="fr">Fracture du col du fémur</dc:subject>
<dc:subject xml:lang="fr">Personne âgée</dc:subject>
<dc:subject xml:lang="fr">Parcours de soin</dc:subject>
<dc:subject xml:lang="fr">Vieillissement</dc:subject>
<dc:subject xml:lang="en">Hospital care</dc:subject>
<dc:subject xml:lang="en">Fractures of the femoral neck</dc:subject>
<dc:subject xml:lang="en">Eldery people</dc:subject>
<dc:subject xml:lang="en">Healthcare paths</dc:subject>
<dc:subject xml:lang="en">Aging</dc:subject>
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<tef:elementdEntree autoriteExterne="027274934" autoriteSource="Sudoc">Personnes âgées -- Protection, assistance, etc.</tef:elementdEntree>
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<tef:elementdEntree autoriteExterne="029728525" autoriteSource="Sudoc">Personnes âgées -- Soins hospitaliers</tef:elementdEntree>
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<tef:elementdEntree autoriteExterne="178086517" autoriteSource="Sudoc">Parcours de soins coordonnés</tef:elementdEntree>
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<tef:elementdEntree autoriteExterne="027369072" autoriteSource="Sudoc">Relations médecin-patient</tef:elementdEntree>
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<tef:elementdEntree autoriteExterne="033005508" autoriteSource="Sudoc">Personnes âgées dépendantes</tef:elementdEntree>
<tef:subdivision autoriteExterne="027226794" autoriteSource="Sudoc" type="subdivisionGeographique">France</tef:subdivision>
<tef:subdivision autoriteExterne="02788743X" autoriteSource="Sudoc" type="subdivisionGeographique">Alsace (France)</tef:subdivision>
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<dcterms:abstract xml:lang="fr">L’état de santé des personnes âgées se dégrade, les niveaux de dépendance s’accroissent, induisant de profondes conséquences sur l’organisation sanitaire en France. Les fractures du col du fémur illustrent ce défi au regard de leur fort impact sur la qualité de vie et sur la morbi-mortalité des patients. Notre étude quantitative et qualitative, (Jan. 2012 - Jan. 2013) au sein du principal service de chirurgie orthopédique d’Alsace, a permis de retracer le parcours de soin de 107 patients âgés de 75 ans et plus. Notre principale conclusion est que le patient n’a que très peu de place dans le processus décisionnel de son parcours de soin. Cela est d’autant plus dommageable que cette fracture revêt une double signification: physique (besoin d’assistance accrue) et symbolique (dépendance anticipée). Notre étude interactionniste permet de dégager des pistes d’actions opérationnelles dans les domaines sanitaires, politiques et éthiques afin de limiter les effets délétères de cette pathologie.</dcterms:abstract>
<dcterms:abstract xml:lang="en">In a context of depressed health-conditions for elderly people, the levels of dependency are rising. It induces deep consequences for the entire health care organisation. For instance, the fractures of the femoral neck (FFN) represent a healthcare challenge regarding their strong impact on patients’ quality of life and on their morbity-mortality. We conducted a qualitative and quantitative study (Jan. 2012- Jan. 2013) within the main department of orthopedic surgery in Alsace in order to track the healthcare paths of 107 patients of 75 years-old or more. Our main conclusion is that patients are poorly involved in the decisions for their care. This is all the more harmful because the FFN is in fact dual. It is both a physical (higher assistance needed) and a symbolic (earlier dependency) breakage. Our interactionist study identifies areas for pragmatic actions in health-care, public policies and ethic that could contribute to absorb / reduce the pernicious effects of this pathology.</dcterms:abstract>
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