[Accompanying the end of life and bereavement in oncology: ateam affair. What can we expect from the guidelines?] / Accompagner la fin de vie et le deuil en oncologie : une affaire d'équipe. Qu'attendre des référentiels ?

Supporting a cancer patient up until the end of life and then mourning the loss represents a long, and emotionally marking period that is potentially problematic for health professionals. In addition to individual and environmental characteristics-and related to death or to the relationship prior to death-the communication established between the doctor, patient, family members and other health professionals in the team, seems to determine how an individual experiences the loss and mourning process. Acknowledging the suffering of the bereavement without always being able to respond is neither easy nor trivial, requiring modified/appropriate knowledge and skills. The opportunity to share their experiences within a healthcare team and with external health care professionals guarantees an ethical approach, professional enrichment and limits the risk of burnouts. In order to offer guidance and potential solutions, the references specific to cancerology are regularly updated in France by the AFSOS ("French Association of Supportive Cancer Care"). This multidisciplinary effort, including professionals from different professional societies (AFSOS, SFFPO, SFAP) and coordinated by the cancerology network of Nouvelle Aquitaine (Onco-Nouvelle-Aquitaine), has resulted in the recent publication of two complementary resources that address bereavement. The first report provides theoretical guidelines, while the second proposes a more clinical approach on how to support a mourning individual. Thus, with regards to the clinical situation and contextualization of the aforementioned references, this article considers the dimensions of separation, bereavement, and supportive care and further discusses tools to help health professionals protect themselves when affronting these situations.

[Recommendations for the implementation of multi-professional staffs (MPS) in care services]. / Recommandations pour la mise en place de staffs pluriprofessionnels (SPP) dans les services de soins.

The context and constraints of modern medicine (hospital beds and caregivers' reductions, ambulatory shift, new therapeutic approaches, integration of supportive care…) combined with new societal and Health system changes (ageing population, chronic diseases, new requirements of the patients…) redefine the orientations of care and question professional practices. The participative approach (PA) as a model of team organization proposes solutions involving the skills of the various interacting caregivers and experimental knowledge and consideration of patient needs. The multi-professional staff (MPS) is a collaborative tool of this participative approach that federates a team around a health or care project personalized from the crosschecked eyes of care professionals and from a shared decision-making process. Its objective is to combine the improvement of quality of care with quality of life at work. It requires a transversal mindset of teams, intrinsic values and specific characteristics. Its organization is simple but requires some rules and we will develop the main steps to success. This article, which is the result of a joint reflection and experience of health professionals, shows the principles and wants to demonstrate the weakness of MPS. The interest of the French National Cancer Institute for this collaborative tool is an asset for further work in the perspective of generalization of MPS for all patients with chronic disease and not only for patients at palliative phase.