État de santé des patients sans domicile fixe du centre d’accueil d’urgence Leydet à Bordeaux : quels éléments peuvent rendre compte de leur particulière vulnérabilité ?

Abstract : Introduction: homeless patients form a very heterogeneous group which needs to be taken into account localy. Our main objective was to study the health status of homeless people, who take shelter in a particular center, in order to suggest appropriate and specific health actions. Those patients especially suffer from social health inequalities that are still misunderstood. A patient’s fragilities and abilities to deal with difficulties are highlighted by his vulnerability. This universal and innovative concept could be an interesting tool to tackle those issues. Our secondary objective was to understand which social elements could reflect homeless people’s special vulnerability compared with main population. Methods: observational study, decriptive and transversal, led between January the 29th, and Februray, the 11th 2018, at the Leydet emergency reception center of Bordeaux. Patients answered a survey developed from tools, which were validated during semi-directed interviews. Results : 47 patients were concerned. Among others, results revealed a specific proportion of elderly patients, suffering from psychotic troubles, oral pathologies or addiction problems. Those patients’ vulnerability seems to come from their overexposure to the violence they experience, to their lack of social support, as well as their communication troubles. Discussion: real actions seem to be necessary, such as the increase of the residence time of the specialists in psychiatric care, or the training of various stakeholders on geriatric troubles. The decision making process concerning the further hosting of a patient could be highlighted by his abilities to communicate, to benefit from a quality social support or by his vulnerability to violences he suffers from.
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Master Thesis
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Stanislas Verwaerde. État de santé des patients sans domicile fixe du centre d’accueil d’urgence Leydet à Bordeaux : quels éléments peuvent rendre compte de leur particulière vulnérabilité ?. Médecine humaine et pathologie. 2018. ⟨dumas-01970264⟩

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