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Master Thesis

Prise en charge des patients en EHPAD par le médecin généraliste : freins et leviers : une étude qualitative réalisée auprès des médecins généralistes de Drôme-Isère-Savoie

Abstract : Background: France has an aging population, and loss of autonomy among the elderly has been described. According to nursing home indicators, level of care and dependency of residents are increasing. Some studies mention difficulties for general practitioners (GP) in their follow-up. Objectives: The main objective of this study was to describe facilitating or limiting factors faced by GPs in their nursing home patients’ follow-up, in Drôme, Isère and Savoy. The secondary objective was to collect suggestions for improvement. Method: We performed a qualitative study with phenomenological analysis, conducted with general practitioners, using semi-structured interviews, nursing home visit observations and a final focus group. Targeted sampling was conducted to achieve maximum variation. Data encoding and analyses were performed by two investigators independently until data saturation. Results: Fourteen semi-structured interviews, two observations and a final focus group were conducted. Factors linked to patients, to physicians and to nursing homes were identified. Examining elderly patients was complex. Their care and needs often presented challenging ethical considerations. Doctor-patient relationship was affected by cognitive disorders. Families, both « carers » and « cared for », had specific needs. The physician had to conjugate his office activity with planned visits and emergencies at the nursing home. The GP, caregivers and coordinator physician collaborated to follow-up the resident, requiring information sharing. Nursing home representations impacted physician activity. The COVID pandemic revived questions about the meaning of residents’ care, but also revealed adaptive abilities. Conclusion: This work reveals some of the challenges general practitioners face at nursing homes, as well as prospects for improvement, including more communication, more concertation and more anticipation. Other follow-up models and alternatives to the current nursing home are also potential options.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03220251
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Friday, May 7, 2021 - 10:18:09 AM
Last modification on : Wednesday, May 12, 2021 - 3:23:48 AM
Long-term archiving on: : Sunday, August 8, 2021 - 6:20:47 PM

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  • HAL Id : dumas-03220251, version 1

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Béatrice Michalak Collerais, Tommy Studer. Prise en charge des patients en EHPAD par le médecin généraliste : freins et leviers : une étude qualitative réalisée auprès des médecins généralistes de Drôme-Isère-Savoie. Médecine humaine et pathologie. 2021. ⟨dumas-03220251⟩

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