title: [End of life conflicts: perceptions of health professionals in French speaking Valais].
abstract: The aim of the study was to identify the perception health professionals in palliative care had of end of life conflicts. The nature of t he conflicts,their prevalence, intensity, causes andeffects were specially addressed. Furthermore proposals of possible solutions of conflicts were investigated. A cross-sectional study was done through a self-administered questionnaire among 460 health professionals in the French Speaking Valais. The health professionals worked either in acute care hospitals, chronic health institutions, and old people nursing homes or in ambulatory palliative care units. Among the target population 233 persons replied to the questionnaire (50.6%). Among the respondents 82.4% reported to be confronted to end of life conflicts. Conflicts were quite rare (66%) and of medium or high intensity (86%). Conflicts were of medical nature (74%) or related to ethic issues (64%). Conflicts occurred among family members (68%), medical doctors and nurses (49%) or patients et medical staff (16%). Conflicts were due mainly (50-60%) to lack of communication, ambivalence among parties, differences in value systems. Mentioned (50-60%) consequences of conflicts were the waste of resources, the physical and the psychological burnout. Possible identified solutions to conflicts were interdisciplinary seminars, internal supervision procedure and the sharing of experiences. Neither age, nor gender, professional experience, working par place, training were predictive of exposure toconflicts. End of life conflicts are a common reality. They may compromise the quality of care and may contribute to high economic and social costs. They should be put on the public health agenda as a high priority.
authors.affiliation: Département Ages, Santé et Société, Institut Universitaire Kurt-Bosch, Sion.
authors.forename: Emmanuel Kabengele
authors.initials: EK
authors.lastname: Mpinga
authors.forename: Philippe
authors.initials: P
authors.lastname: Chastonay
authors.forename: François
authors.initials: F
authors.lastname: Pellissier
authors.forename: Charles-Henri
authors.initials: CH
authors.lastname: Rapin
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000517:prevention & control / Q000523:psychology; D015984:Causality; D003142:Communication; D003220:Conflict, Psychological; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D034462:Dissent and Disputes; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D010348:Patient Care Team / Q000458:organization & administration; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D012945:Social Values; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013557:Switzerland; D013727:Terminal Care / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*