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Master Thesis

Spécificités des comportements personnels de santé et d’accès aux soins des médecins généralistes en Gironde

Abstract : Introduction: the general practitioner (GP) is often alone in his pathology and generally regulates his health problems himself. This study aims to clarify in the population of GP of Gironde, their conditions of access to care but also the perception of their state of health and felt for better care. Objective: to describe the specificities of personal health behaviors and access to care for GPs in Gironde. Secondarily, determine the barriers to seeking care. Method: cross-sectional observational study carried out among GPs enrolled at the CDOM of the Gironde (excluded replacements), using computerized anonymous self-questionnaires. Results: the dissemination of the questionnaires was carried out on April 18, 2018 by e-mailing via the CDOM of the Gironde. 2237 mails have been sent, 1834 have been opened. 236 usable questionnaires were collected and analyzed. Only 24% of the GPs reported a referring doctor different from themselves. 86% of the sample had never consulted a GP about the past year. On the other hand, recourse to the specialist doctor in direct access was much more frequent, and concerned 70% of them. 55% of respondents had already given up consulting a colleague for lack of time, while 27% were embarrassed to "consult for nothing" and 23% had difficulty in taking the patient's place. 52% of physicians with health problems in the past year had given up work stoppage when their state of health justified it. If we found a self-assessment of their general health favorable with a median score of 8/10, their psychological state was worse noted with a median to 7/10 of which 17% of the scores wereless than 5/10. 86% of physicians considered that overwork and psychological difficulties particularly affected the medical profession. 63% of the sample had at least one sign of psychological difficulties over the past year. 40% of respondents felt the need to be helped to cope with an episode of psychological difficulties and 27% had not consulted. Women were significantly more affected than men. The use of psychotropic drugs concerned 32% of the population, and in 90% of cases, doctors used self-prescription. In the solutions for better access to care, the training of doctors specifically dedicated to the care of other caregivers seemed appropriate for more than 50% of respondents. The creation of care structures specifically dedicated to physicians, and annual preventive medicine consultations were of interest for 38% and 28% respectively of doctors, while 33% had an intermediate position in both cases. Conclusion: at the heart of the care system as an actor, GP's position as a patient remains to be improved. The consultation of a colleague remains the domain of the specialty, and the relationship between doctor-patient and doctor-carer seems to constitute a real problematic to solve to improve the access to the care, whereas the professional overwork and the psychological distress seriously affect the profession. Prospects for favorable developments are emerging thanks to the caregivers support associations and the intervention of the CNOM.
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Master Thesis
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Anna Kervern. Spécificités des comportements personnels de santé et d’accès aux soins des médecins généralistes en Gironde. Médecine humaine et pathologie. 2019. ⟨dumas-02494759⟩

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