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Master Thesis

État des lieux du recours personnel et professionnel aux médecines alternatives et complémentaires, chez les professionnels de santé : étude quantitative transversale auprès de médecins généralistes

Abstract : Introduction. Interest in alternative and complementary medicine is growing in France and in industrialized countries. However, few studies focus on the attitude of health professionals themselves towards these complementary therapies, and even fewer on their personal and professional practice. The main objective is to establish an inventory of the use of CAM (alternative and complementary medicine) among general practitioners in both their personal and professional practice: for what type of CAM, reason for use, perceived effectiveness, cost, frequency of use, degree of satisfaction. Thus, we will assess the general characteristics of the respondents, attempting to examine the reasons or barriers to the use of CAM in this population. Method. This descriptive quantitative study took place from February to May 2020, sending an online questionnaire to general practitioners via the internet. The questionnaire was anonymous, with participation on a voluntary basis. Our study was cross-tabulated between general practitioners and physiotherapists, as the initial research and construction of the questionnaire was done in collaboration with a physiotherapy student. To elaborate our questionnaire we studied the bibliography of Albin Guillaud, a physiotherapist, who has realized a research paper, concerning the question of the integration of alternative and complementary medicine in our health system. Also, we relied on existing questionnaires on the evaluation of the use of CAM and whose method of construction and validation were evaluated: I-CAM-FR and QuERTA. The questionnaire was completed by attempting to assess perceptions and attitudes towards CAM by the CHQB (10-item form translated from English), and by analyzing training contexts and demographic information. It was then tested using the cognitive interview technique. Results. The 74 respondents were female (70%), with an average age of 37 years. They worked mainly in the departments of Isère, Savoie and Haute-Savoie. The practitioners are mainly self-employed in a general practice, with no other health professionals practicing MAC. As far as their professional practice is concerned, 85% of the general practitioners questioned replied that they had already recommended at least one MAC to their patients in the last twelve months. On the other hand, only 20% were practicing CAM in their professional practice, of which more than half (53%) practiced homeopathy and 31% had already consulted a TA (alternative therapist) personally. The motivations for use were: to have more therapeutic tools, to reduce stress in practice. Most physicians thought that the effect of CAM was related to a placebo; also, that the personal and professional environment could influence the practice of CAM. Only 43% felt that the initial training was sufficient to meet the needs of patients. There was a near absence of CAM training (in contrast to the apparent frequency of consultations and referrals), and little training in "critical thinking". This raises the question of epistemological tools to address CAM. The reasons for recourse to CAM among physicians were mainly related to chronic pain associated with musculoskeletal pathologies. Osteopathy is predominant, far ahead of acupuncture, homeopathy or naturopathy. Finally, on the question of the integration of CAM into the health care system, more than 2/3 of the doctors were in favour of it. On the other hand, only 46% wanted certain MACs to be reimbursed by health insurance. Conclusion and outlook. Our study found that physicians can significantly recommend CAM to their patients, and that some of them do so both personally and professionally. The physicians surveyed seem to lack therapeutic tools for the management of certain pathologies. This observation leads us to open up research to create practice support tools for general practitioners, concerning the management of chronic pain and anxiety and depression syndromes. Also, to reflect on the status of MACs in our healthcare system.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03085499
Contributor : Jean-Hugues Morneau <>
Submitted on : Monday, December 21, 2020 - 6:45:09 PM
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Anne Lebeugle. État des lieux du recours personnel et professionnel aux médecines alternatives et complémentaires, chez les professionnels de santé : étude quantitative transversale auprès de médecins généralistes. Médecine humaine et pathologie. 2020. ⟨dumas-03085499⟩

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