Bilan après 6 mois de l’expérience IDECC II : évaluation de la perception par les médecins généralistes du rôle de l’IDECC, état des lieux et axes d’améliorations

Abstract : Introduction: the cancer population is increasing versus health care facilities with a limited number of beds. There is an increase in ambulatory management of these patients in general practice and a decrease in the average duration of hospital stays. Optimal city / hospital co-ordination is needed, but there are many pitfalls. It appears that the general practitioner can be put in difficulty when managing patients with outpatient cancer. One of the solutions chosen is the creation of a new healthcare profession: the Oncology Coordinating Nurse (ONC) as part of a national experimental pilot project ONC II under the aegis of the cancer plan III. Objectives: the main objective of this work is to know "what are the expectations of general practitioners in the coordination of the city / hospital in oncology, particularly through the ONC ?", and the secondary objectives discussed are the general practitioners assessment of the role of ONC and the identification of difficulties in the management of these patients. Methods: our survey is a descriptive cross-sectional study by self-administered questionnaire sent by email and conducted at 185 general practitioners drawn consecutively from the active rows of patients of the 3 ONC of the CHU of Bordeaux in 2016. Results: 26 responders representing 14% of the total workforce. General practitioners prioritize the missions of the ONC that are most compatible with their activities, with, first and foremost, the role of informing the patient, secondly psychological support, then coordinating the participants, and lastly, assessing the needs of the patient. Expectations of ONC doctors relate to the role of transmission of information 44% somewhat agree and 44% strongly agree; 64% strongly agree for the role of patient education, 72% strongly agree for the role of psychological support and 41.67% disagree on the role of administrative referral. Physicians estimate the role of ONC rather large at 64%. The main difficulty with the management reveled by doctors is the lack of knowledge of new therapies and side effects. Doctors do not know what an ONC is in 80.77% of cases and this lacks visibility in 87.5% of the cases. Conclusion: doctors expect ONC to fulfil missions of patient education and psychological support. Doctors point to a difficulty in taking care of the lack of knowledge and are in demand for training. It is necessary to make more visible the new professions of the health, the general practitioners using only the services of which they are acquainted. Tools to appreciate the opinion of the general practitioner on coordination are to be developed especially since he is the coordinator of care by default.
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Master Thesis
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Darios de La Cruz. Bilan après 6 mois de l’expérience IDECC II : évaluation de la perception par les médecins généralistes du rôle de l’IDECC, état des lieux et axes d’améliorations. Médecine humaine et pathologie. 2017. ⟨dumas-01490025⟩

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