Analyse des facteurs influençant la prise décisionnelle d'une consultation aux urgences : étude qualitative au Centre hospitalier de Menton

Abstract : Objective : The saturation of the emergency wards causes difficulties. The patient who has not received medical training is considered unable to judge the seriousness of his state of health. Many studies have been done to analyze the reasons for consultations in emergency wards, but the majority have been conducted from health professionals’ point of view. The objective of this study is to analyze the patients’ decision to come to theese services, as well as to see their representations of the notions of emergency and severity.
Methods : This is a monocentric qualitative study, based on forty individual interviews composed of open questions to patients presenting themselves to the emergency ward of the Menton hospital during the working hours of general practicioners.
Results : This study shows a number of reasons for consultation not listed by previous researches such as : the lack of confidence in other liberal doctors, the need for a second medical opinion, the report of an accident at work, the convenience for the hospital staff, the convenience for a foreign patient, the need for medical advice without disturbing their doctor. In the representations of the emergency and severity by the patients, additional notions such as the fear to be misdiagnosed and to be overcome by a poorly controlled situation, the inappropriate self-medication, the psychological distress, the social emergency, and recognition of symptoms known to be severe.
Conclusion : The patient often feels worried and helpless in the face of an unusual situation that is perceived as potentially serious. He does not feel competent and often uses emergency wards to reassure himself, to learn about his situation. The lack of training and reliable sources of information means that he will turn to the nearest doctor. It appears that often this doctor will be the emergency doctor, for geographical convenience and speed. To improve this situation, some solutions have already been applied, such as a sorting doctor or a dispensary. Others could be considered such as health education, mandatory first aid training and better information on the role of the emergency departments in order to limit consultations perceived as abusive.
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Master Thesis
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Jean Ablart. Analyse des facteurs influençant la prise décisionnelle d'une consultation aux urgences : étude qualitative au Centre hospitalier de Menton. Médecine humaine et pathologie. 2019. ⟨dumas-02185666⟩

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