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Master Thesis

Attentes vis-a-vis du médecin généraliste et expériences de soins premiers des personnes en situation de prostitution dans l’agglomération bordelaise

Abstract : Introduction: if the health needs of sex-workers and their difficulties in accessing healthcare are well documented, there are no studies exploring their representations and feelings about primary healthcare. The main objective of our study was to identify the specific expectations of sex workers in a general practice consultation. Method: a qualitative study was carried out in Bordeaux from september 2018 to may 2019 among sex workers recruited through field associations. The semi-structured interviews were recorded, transcribed, then two researchers coded and analysed the verbatims by grounded theory. Results: 17 women were interviewed aged 19 to 60 of six different nationalities. The general practitioner (GP) was recognized as a privileged health interlocutor because of his accessibility, the follow-up provided and the plurality of his skills. The care pathway was conditioned by people’s social situation, explaining the use of multiple health facilities. Patients expected from the practitioner a global approach (with medical, psychological and social dimension) as well as relational and communication skills : kindness, non-judgement, empathy, active and accurate listening. Talking about prostitution in a medical consultation was difficult, due to fear of being stigmatized and to practising an activity considered shameful by women. However it was found necessary in order to provide care adapted to the health situations encountered. The GP had a role in initiating a dialogue and in allowing the patient to speak openly. Conclusion: promoting a « patient-centred approach » favors satisfactory healthcare and access to care for sex workers. The GP’s reflection and questioning about his practice should be constant allowing to deconstruct social representations and fight against stigma. Promoting the opening of a dialogue in a medical consultation is beneficial in order to obtain adapted support for patients and to deliver prevention messages improving their overall health.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02933460
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Submitted on : Tuesday, September 8, 2020 - 2:30:49 PM
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Anouk Chastand. Attentes vis-a-vis du médecin généraliste et expériences de soins premiers des personnes en situation de prostitution dans l’agglomération bordelaise. Médecine humaine et pathologie. 2020. ⟨dumas-02933460⟩

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