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'Life After Life' --- Near Death Experience --- the brink of death --- the after-life --- NDE

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Introduction : Les « expériences de mort imminente » (EMI) représentent un ensemble de phénomènes mentaux incluant des aspects mystiques et spirituels, apparaissant suite à une situation de danger réel ou perçu. À ce jour, le processus d’apparition d’une EMI n’est pas complètement compris. Or, une EMI peut entraîner un impact sur la vie du patient, ce qui nécessite une meilleure compréhension du phénomène. 
Objectifs : Évaluer la prévalence des rappels d’EMI après un séjour prolongé en « unité de soins intensifs » (USI), ainsi que comparer la spiritualité et la tendance à la dissociation chez les patients ayant rapporté une EMI et chez ceux n’en ayant pas rapportée.
Population étudiée : Les patients adultes ayant survécu à un séjour de plus de 7 jours dans les unités de soins intensifs généraux du CHU de Liège entre le 1er juillet 2019 et le 12 mars 2020.
Méthode : Cette étude prospective et monocentrique est de type quantitatif. Dans les 3 semaines suivant sa sortie des soins intensifs, chaque patient inclus a été vu une fois afin d’être soumis à l’échelle de Greyson pour identifier une EMI, à l’échelle d’expériences dissociatives (DES) pour rechercher des symptômes dissociatifs et à un questionnaire évaluant les croyances spirituelles, religieuses et personnelles (WHOQOL-SRPB). Une première analyse statistique a permis de déterminer un certain nombre de variables significatives qui ont été introduites dans un modèle de régression logistique binaire multivarié.
Résultats : Parmi les 126 patients inclus dans l’étude, 19 patients rapportent une EMI. Aucune différence statistiquement significative en termes de variables sociodémographiques n’est démontrée entre les 2 groupes (« groupe EMI » et « groupe non EMI »). Les variables significativement associées à la probabilité de rapporter une EMI en univarié sont : motif d’admission en USI, système atteint en USI, ventilation mécanique, sédation, analgésie, SpO2, score au DES et score au WHOQHOL-SRPB. Après l’analyse statistique en multivarié, seules les variables score au DES (p=0.04) et au WHOQHOL-SRPB (p=0.0007) restent significativement associées à la probabilité de rapporter une EMI.
Conclusion : La prévalence d'EMI est de 15.1%. Une tendance à la dissociation non pathologique ainsi que les croyances spirituelles, religieuses et personnelles sont des facteurs influençant la probabilité de rapporter une EMI chez les patients avec séjour prolongé en USI. Introduction : « Near death experiences » (NDE) represent a set of mental phenomena including mystical and spiritual aspects, occurring after a situation of real or perceived danger. To date, the process of developing an NDE is not fully understood. However, NDE can have an impact on the patient’s life, which requires a better understanding of the phenomenon.
Objectives : To assess the prevalence of recalls of NDE after a prolonged stay in « intensive care unit » (ICU), and to compare spirituality and the tendency to dissociation for patients who reported an NDE and for those who didn’t.
Studied population : Adult patients who survived a stay of more than 7 days in the general intensive care units of the CHU de Liège between July 1, 2019 and March 12, 2020.
Method : This prospective and monocentric study is quantitative. Within 3 weeks of discharge from intensive care, each patient included was seen one time to be subjected to the Greyson scale to identify NDE, to the dissociative experience scale (DES) to look for dissociative symptoms and to questionnaire assessing spiritual, religious and personal beliefs (WHOQOL-SRPB). A first statistical analysis made it possible to determine a certain number of significant variables which were introduced into a binary multivariate logistic regression model.
Results : From the 126 patients included in the study, 19 patients reported an NDE. No statistically significant difference in terms of socio-demographic variables was demonstrated between the 2 groups (« NDE group » et « no NDE group »). The variables significantly associated with the probability of reporting an NDE in univariate are : reason for admission to the ICU, system reached in the ICU, mechanical ventilation, sedation, analgesia, SpO2, score at DES and score at WHOQHOL-SRPB. After the multivariate statistical analysis, only the variables score at DES (p=0.04) and score at WHOQHOL-SRPB (p=0.0007) remain significantly associated with the probability of reporting an NDE compared to the probability of not reporting one.
Conclusion : The prevalence of NDE is 15.1%. A tendency to non-pathological dissociation as well as spiritual, religious and personal beliefs are factors that can influence the probability of reporting an NDE in patients with prolonged stay in ICU.

Expérience de mort imminente, soins intensifs, spiritualité, dissociation --- Near-death experience, intensive care, spirituality, dissociation --- Sciences de la santé humaine > Santé publique, services médicaux & soins de santé

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Today most people die gradually, from incremental illnesses, rather than from the heart attacks or fast-moving diseases that killed earlier generations. Given this new reality, the essays in Final Acts explore how we can make informed and caring end-of-life choices for ourselves and for those we loveùand what can happen without such planning. Contributors include patients, caretakers, physicians, journalists, lawyers, social workers, educators, hospital administrators, academics, psychologists, and a poet, and among them are ethicists, religious believers, and nonbelievers. Some write moving, personal accounts of "good" or 'bad" deaths; others examine the ethical, social, and political implications of slow dying. Essays consider death from natural causes, suicide, and aid-in-dying (assisted suicide). Writing in a style free of technical jargon, the contributors discuss documents that should be prepared (health proxy, do-not-resuscitate order, living will, power of attorney); decision-making (over medical interventions, life support, hospice and palliative care, aid-in-dying, treatment location, speaking for those who can no longer express their will); and the roles played by religion, custom, family, friends, caretakers, money, the medical establishment, and the government. For those who yearn for some measure of control over death, the essayists in Final Acts, from very different backgrounds and with different personal and professional experiences around death and dying, offer insight and hope.

Thanatology. --- Death. --- Death --- Dying --- End of life --- Life --- Terminal care --- Terminally ill --- Thanatology --- Cardiac Death --- Determination of Death --- End Of Life --- End-Of-Life --- Near-Death Experience --- Death, Cardiac --- Fatal Outcome --- Philosophy

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History of human medicine --- Death. --- Health. --- Disease. --- History of Medicine. --- Medicine, History --- Medicine --- Diseases --- Normalcy --- Normality --- Normalities --- Cardiac Death --- Determination of Death --- Near-Death Experience --- Death, Cardiac --- Thanatology --- Fatal Outcome --- history --- Death --- DISEASE --- Health --- history. --- Disease --- History. --- History Medicines --- Medicine Histories --- Medicines, History --- End Of Life --- End-Of-Life --- History of Medicine

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Euthanasia --- DEATH --- ATTITUDE TO DEATH --- Attitude to Death. --- Death. --- Euthanasia. --- #gsdb5 --- Euthanasia, Involuntary --- Involuntary Euthanasia --- Mercy Killing --- Killing, Mercy --- Killings, Mercy --- Mercy Killings --- Right to Die --- Suicide, Assisted --- Bioethical Issues --- Cardiac Death --- Determination of Death --- Near-Death Experience --- Death, Cardiac --- Thanatology --- Fatal Outcome --- Attitudes to Death --- Death, Attitude to --- Death, Attitudes to --- Death --- End Of Life --- End-Of-Life --- Attitude to Death --- gsdb5.