Clinique interactionnelle de la consultation d’annonce de diagnostic de cancer en neuro-oncologie : analyse critique des consultations d’annonce et post-annonce des gliomes malins de l’adulte

Abstract : This thesis aims at describing and understanding the processes of interaction that are at stake during the announcement of the diagnosis of glioblastoma to an adult by a team encompassing various fields of action. Glioblastoma is a serious brain tumor that can be life-threatening in a short or mid- term. The announcement of the diagnosis is of paramount importance in the healing process that is going to seal a relationship between two persons, one who knows but who has some troubles telling it and another one who wants to know while fearing to discover and understand a dark reality about himself. This revelation that is said to the patient and his/her relatives is an engaging act for the person announcing the bad news, the latter being unable not to feel concerned with the impact of his words or to deny his own emotions. For this research, an original scheme was put into practice to announce this diagnosis to four patients who were surrounded by their families and friends. Two teams of professionals were composed of doctors, psychologists and nurses. The analyses, resulting from four consultations of announcement, each one constituted of five philological interviews, showcased the sometimes surprising expectations of the patients concerning the doctors as for their way of announcing as well as the psychic effects of this revelation. The discursive strategies used by the persons present, in an unconscious perspective and even protective for most of them, are also unveiled and enable to give thorough landmarks, especially about the training of the doctors but also the other actors involved in the announcement of the diagnosis.
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Rénald Lanfroy de Belly. Clinique interactionnelle de la consultation d’annonce de diagnostic de cancer en neuro-oncologie : analyse critique des consultations d’annonce et post-annonce des gliomes malins de l’adulte. Psychologie. Université de Lorraine, 2015. Français. ⟨NNT : 2015LORR0229⟩. ⟨tel-01754503⟩

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