L' éducation thérapeutique en Guyane : pratiques et besoins des médecins généralistes libéraux et des médecins exerçant dans les centres de santé isolés

Abstract : Background: The socio-economic characteristics of French Guyana in South America make difficult for general practitioners to manage patients with chronic disease. A number of patients also live in isolated parts of the country. The so called “Centres Délocalisés de Prévention et de Soins” (CDPS) are community health centers located in isolated areas that provide free consultations. This survey describes the patient education practices and needs for general practitioners. Methods: A quantitative survey focusing on patient education was sent to all private general practitioners and to practitioners in CDPS. Results: 85% of practitioners declared performing patient education. 78% did not make any distinction between common consultation activities and education activities. They declared preferring communication methods and they did not commonly use educational methods. Barriers to expanding patient education are mainly cultural and language barriers, as well as socio-economic difficulties. However, the principal need for 73.8% of the GP’s is time. Health center GP’s declared practicing patient education more often (p=0.001), spending more time with patients (p=0.001) and they also declared sending patients more often to structured education programs (p=0.02). Conclusion: GP familiarity with patient education is limited and doctor-patient relationships are paternalistic in the manner in which they educate. French primary health care organization is not appropriate for patient education and especially in private practice. GPs in CDPS are in a better position to practice patient education but cultural barriers are a major difficulty in a multicultural isolated area.
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Master Thesis
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Frédéric Choupeaux. L' éducation thérapeutique en Guyane : pratiques et besoins des médecins généralistes libéraux et des médecins exerçant dans les centres de santé isolés. Médecine humaine et pathologie. 2016. ⟨dumas-01539088⟩

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