Critères de jugement du « mieux vivre » en réanimation

Well-being is multidimensional; it comprises both known dimensions (comfort, pain control) and unknown dimensions, just as it comprises measurable dimensions (discomforts) and non-measurable dimensions (those that are directly related to the deep psychological experience). It is thus impossible to clearly state what are the criteria of judgment of patients' well-being in the intensive care unit. However, there is one fundamental condition for well-being that is to be recognized as a person. In the intensive care setting, this means treating the patient as a person capable of giving meaning to his experience and not as a pure object of care: individual subjectivity is at the heart of the concept of well-being and the quality of communication between professionals and the lay person can be a criterion of judgement of the patient's well-being. Well-being is part of a system: the well-being of the people surrounding the patient plays an important role as family and caregivers can influence patients' well-being. Lastly, encouraging patients' well-being will depend on the culture of the unit. The existence of clear and shared objectives within an intensive care unit is also a criterion of judgment of patients' well-being. Thus, there is no one scale that permits to measure patients' general well-being in the ICU as it is impossible to quantify such a complex qualitative concept.