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Master Thesis

Identification de facteurs psycho-sociaux associés au délai diagnostique dans les carcinomes basocellulaires avancés

Abstract : Introduction. Local malignant potential of BCC can lead in advanced stages to the destruction of underlying tissues and significant morbidity. The primary risk factor for progression of aBCC is the long duration of the tumour, which results from delay in seeking medical care. Objectives. To assess implication of psychosocial factors in the delay before the first medical consultation among patients with aBCC, in order to identified factors potentially targetable for an earlier diagnosis. Methods. We crossed the information from two independent sources: (1) a qualitative meta-analysis of the literature; (2) semi-structured interviews with patients with advanced BCC and oncodermatology caregivers. The qualitative analysis of the data collected allowed the development of synthetic logical models. Results. The most relevant barriers identified, also found in literature, were the “fear of the diagnosis”, “the lack of knowledges concerning skin related problems”, “denial/avoidance”. The qualitative prospective study included 14 patients and 12 caregivers. In literature, “negligence” presumed to be the main cause for the delay in most studies. Patients emphasized on their weariness in the medical community, preferred to maintain their quality of life and to avoid to congest the medical environment for minor health problems. Levers more reported in the decision making to seeking medical help were the “pressure from relatives to seek medical help”, “evolution of side effects” and to be “dispose to talk about disease”. Conclusion. We propose a logical model of change to explain how psychosocial factors are involved in the delay before the first medical consultation among patients with aBCC, and how help an earlier presentation.
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Submitted on : Wednesday, September 16, 2020 - 6:18:46 PM
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  • HAL Id : dumas-02941078, version 1

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Adeline Legrand. Identification de facteurs psycho-sociaux associés au délai diagnostique dans les carcinomes basocellulaires avancés. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02941078⟩

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