Prise en charge des symptômes biomédicalement inexpliqués en médecine générale

Abstract : MUS consultations are common in general practice and generate costs for the health system. General practitioners say they are struggling with these symptoms. This research work aims at studying the management of MUS with these practitioners in order to propose an adapted model of management. Methods: our qualitative study has two sections. We realized the transcription and the analysis by grounded theory of 13 videos of consultations. We developed a summary of the results and then built a survey that we used for semi-structured interviews with 11 of these general practitioners. The analysis of these interviews was done by grounded theory. Results: the management of MUS can be considered as a theatre play. The patient brings the scenario through the lived experience and the hidden meaning of his symptom, the doctor is the director by the scope he proposes. The doctor should consider MUS as positive diagnosis. He must guide the patient to describe his symptom and bring him to express his experience. Gradually, the doctor makes him aware of a link between his symptom and his life context. The patient must use his own resources to understand and accept this link. This shared work often requires a long follow-up. Conclusion: the effective management of MUS must be understood as a duality between the somatic approach and the psychic approach. Doctor and patient will progress together through a specific relationship focused on patient and similar to psychotherapeutic care.
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Master Thesis
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Laetitia Alberto Caille. Prise en charge des symptômes biomédicalement inexpliqués en médecine générale. Médecine humaine et pathologie. 2018. ⟨dumas-02075963⟩

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