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Master Thesis

Se soigner chez soi, un pas vers le rétablissement? Modèles et pratiques de soins psychiatriques de particulière intensité à domicile

Abstract : Background: Intensive home psychiatric care is an effective alternative to hospitalisation and is widely available in international models. However, it remains on the fringes of French practices, and is implanted in a heterogeneous way on the French territory. As such, home hospitalization services, mobile teams and a range of community care devices exist, but a comprehensive model cannot guide their implementation. Hypothesis: It seems that a transversal description of these programs, through benchmarking work focused on their implementation challenges, could enable the identification of common criteria that are consistent with their development. These experiences with diverse influences could therefore lead to the emergence of a common and innovative framework, at odds with conventional practices. Methods: We conducted a qualitative survey of physicians practicing acute home care in adult psychiatry. The thematic analysis of the speeches, using grounded theory, made it possible to collect a set of criteria determining the implementation of these teams in France. Results: The analysis of 16 interviews with the professionals involved, revealed a set of criteria that determine the development of these teams. While this dynamic appears to reflect a promising shift from care to community health, it is not based solely on the organizational choices of these teams. In addition to networking facilitated by the mobility and creativity issues specific to crisis intervention, their development is also based on a global evolution of representations and a break with usual practices. The challenges of social inclusion, resource mobilization in the individual's environment, and recovery-oriented practices, seem to provide a comprehensive and more appropriate response to acute psychiatric episodes. Discussion: The determining factors in the evolution of home care are frequently external to psychiatric practice, and allow us to question the conditions for a global community shift in this discipline. They are based on greater flexibility for all mental health stakeholders, with the aim of achieving a shared understanding. Care professionals and health policies alike are therefore expected to commit themselves to greater transdisciplinarity, in support of a clinical practice that respects the rights and specific needs of each individual.
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https://dumas.ccsd.cnrs.fr/dumas-02384899
Contributor : Faculté de Médecine Amu <>
Submitted on : Thursday, November 28, 2019 - 3:35:59 PM
Last modification on : Friday, October 23, 2020 - 4:58:58 PM
Long-term archiving on: : Saturday, February 29, 2020 - 5:02:57 PM

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Martin Fritsch. Se soigner chez soi, un pas vers le rétablissement? Modèles et pratiques de soins psychiatriques de particulière intensité à domicile. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02384899⟩

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