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Master Thesis

Perception et recours à l'Hospitalisation à Domicile par les médecins de Guadeloupe

Abstract : Introduction: Patients increasingly want to be treated at home and the government wants to develop Hospital at home (HH). Objective: We aim at determining knowledge of practitioners in Guadeloupe about this new form of hospitalization and the reservations, which could reduce HH use. Methods: A transversal study was conducted in Guadeloupe from the 1st of June 2019 and the 7th of July 2019 on general practitioners, hospital practitioners and medicine students, except physicians who had already worked in a service of HH. Data was collected anonymously. The following were explored: HH use, knowledge on HH, positive and negative reservations of physicians, the benefits of HH. We have looked for a link between the number of negative concerns and the level of knowledge or the lack of HH’s use. We have studied possible differences between the three groups of physicians regarding the knowledge, negative perceptions and the benefits of HH. Results: Out of 843 physicians surveyed, 99 were included. 79.8% of the physicians had already asked for an HH. The level of knowledge was insufficient with an average < 75% of correct answers and no difference between the groups. The main positive reservations were the respect for the patient's wish to stay at home, improvement of their quality of life and the presence of nurses who have been prepared for the management of difficult situations. The main concerns were the risk of family being exhausted, the very different management according to HH services and the fact that the patient was sometimes kept at home, which was sometimes inappropriate. The physicians with less knowledge, had a more reservations (p = 0.041) but there was no link between the number of negative perceptions and the lack of request (p = 0.19). General practitioners had more concerns than other physicians (p = 0.035) and they considered that the benefit of HH was lower (p = 0.011). Conclusion: Our study showed the interest of informing physicians in order to develop the use of HH in Guadeloupe and to decrease the reluctances.
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Master Thesis
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Céline Gledel. Perception et recours à l'Hospitalisation à Domicile par les médecins de Guadeloupe. Médecine humaine et pathologie. 2019. ⟨dumas-02949501⟩

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