Eléments décisionnels de la réalisation de visites à domicile non programmées par les médecins généralistes de l’agglomération grenobloise : étude qualitative par entretiens semi-dirigés

Abstract : Context : Despite the population aging, the number of house calls has decreased in France. Patients might need an unprogrammed house call for acute events besides their usual follow-up. This house call is done in a ponctual way, in a semi-urgent or urgent way. Objective : To determine the elements that influence on the Grenoble aera general practitioners (GP) decision to make an unprogrammed house call. Methods : Qualitative study with semi-structured interviews carried out with 20 GPs from Grenoble aera between November 2016 and June 2017. The sample was in maximal variation research. A thematic axial analysis of the verbatims was done in parallel by the 2 searchers with data triangulation to resolve conflicts. Results : The main elements exposed by the GPs were elements linked to the unprogrammed house call (usefull, time consuming, lack of efficiency), to the patients (patients types and reasons that justify an unprogrammed house call, relation between GPs and patients, patients’education), to the GPs (practice organisation, feeling about the unprogrammed house call, burn-out risk) and to medecine practice (deontology). Other elements are listed like time (lack of time, important workload), environment (installation places, journey time) and financial aspect (lack of viability). The way to organize the unprogrammed house calls and the implications of a refusal also play a part in the GPs decision. Conclusion : The decision to realise an unprogrammed house call in urban aera is multifactorial and can not be resumed to simple rules. It can not be generalized to rural aera that need specific studies.
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Master Thesis
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Aurélie Guillot, Cyrielle Ritter. Eléments décisionnels de la réalisation de visites à domicile non programmées par les médecins généralistes de l’agglomération grenobloise : étude qualitative par entretiens semi-dirigés. Médecine humaine et pathologie. 2017. ⟨dumas-01617125⟩

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