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Master Thesis

Les représentations de la prescription de morphiniques chez les internes de médecine générale en fin de cursus à l’Université de Bordeaux

Abstract : Background: pain management is a priority in palliative care because it has a huge impact on quality of life. However, many medical residents have difficulties with the prescription of strong opioids though they are highly indicated in intense pain. Aim : The aim of our study was to explore the medical residents’ representations expressed toward opioids’ prescription and their links to professional practices in order to improve them. Methods: a descriptive qualitative monocentric method was chosen. Semi-structured interviews were conducted with oldest medical residents from the University of Bordeaux. These interviews were leading by interviews’ frame. This frame was built from a brainstorm grid of representations’ patterns about opioids’ prescriptions ; theoretical knowledges, experiences and beliefs. The transcription of the interviews named as verbatim were analyzed. Results: 12 semi-directed interviews were conducted before data saturation was achieved. Pain measurements were subjective, prescribing modalities were poorly knew. Mentorship and palliative care team’s help were factors that positively influenced the opioids ‘prescription. Fears and reluctance were broadly based on the addictive risk and side effects of opioids. Discussion: the resident’s difficulties about opioids’ prescriptions were similar to those of the medical literature. The prescription context is influenced by historical opiophobia and confusing American news (opioid crisis) that confronts to misuse and drift. Pain management skills are acquired through relevant academic training and quality mentorship. Conclusion: mentalities about opioid’s prescriptions evolves in a positive way with a more suitable and adapted prescription. Continuing dissemination of the palliative culture, companionship and developing innovative teaching methods could improve the representations of opioids’ prescription in the general practice.
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Master Thesis
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Submitted on : Thursday, April 23, 2020 - 10:51:43 PM
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Marie-Hélène Ducoin-Pannunzio. Les représentations de la prescription de morphiniques chez les internes de médecine générale en fin de cursus à l’Université de Bordeaux. Médecine humaine et pathologie. 2018. ⟨dumas-02552934⟩



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