Développement d'une échelle de satisfaction des victimes de violences sur leur prise en charge : étude pilote dans l'unité médico-judiciaire du CHU de Clermont-Ferrand

Abstract : Context: In France, a major reform of Forensic Medicine was set up in 2010. One of its objectives was to harmonize and improve practices, both in the areas of thanatology and victimology. This approach is part of the public policies implemented since the 2000s in favor of better care for victims of infractions. The main change brought by this reform was the structuration of the forensic medical activity by entrusting it to dedicated public structures (Medico Legal Institutes and Forensic Units). This reform was assessed in december 2013 by an inter-ministerial commission. The interdepartmental report submitted in january 2014 showed that the results were insufficient, particularly in the field of victimology. In 2016, Dr. Malou Guerant conducted a qualitative study to highlight the determinant of patient’s satisfaction who be seen by a doctor in the forensic department of the university hospital of Clermont-Ferrand. The determinants identified were: a short time delay between the aggression or accident and the consultation, the quality of the welcome in the department, the doctor’s ability to listen and make them feel confident, his ability to answer questions and his expert quality. The question of psychological care and the way it can be initiated after the medical consultation were also relevant. The results of this study allowed her to propose a version of satisfaction questionnaire dedicated to patients consulting in victimology. It comprises 41 items and is built based on a previously validated questionnaire, the QSH (Hospitalized patient Satisfaction Questionnaire), used by the University Hospital of Clermont-Ferrand. The validation of this questionnaire would make it the first one assessed in this area. It could become a central tool in the evaluation of practices and feed future reflection on a reassessment of the care system in victimology. Objectives: Validation of the metrological properties of the Questionnaire of Satisfaction about Victimology Consultations. Method: The validation of such a questionnaire requires it be completed by test patients in order to evaluate its acceptability, the validity of its internal structure, its validity against external criteria and its reproducibility. This questionnaire was tested via two filling methods: computerized and paper. We needed to include 230 patients in each arm to validate both modalities. The choice of filling mode was left to the patient. They received the questionnaire at least 15 days after their consultation. Reproducibility was studied by submitting 85 patients from each arm to a test-retest. Results: Since its beginning, our study has allowed the inclusion of 129 patients in the computerized arm and 58 patients in the paper arm. We collected respectively 39 and 17 answers. This study has not yet generated enough data to test its primary endpoint, but its continuation in the coming months will help to reach the number of subjects needed. Once this questionnaire is validated, its implementation in the routine service will be discussed. Conclusion: The measurement of patient satisfaction is an essential element of a quality management policy. Providing a tool for this measurement in victimology is an essential step in the implementation of a practice evaluation process that can subsequently pave the way for their improvement and harmonization.
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Anaïs Sahy. Développement d'une échelle de satisfaction des victimes de violences sur leur prise en charge : étude pilote dans l'unité médico-judiciaire du CHU de Clermont-Ferrand. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02079772⟩

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