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Master Thesis

Les déterminants de la pratique de l’échographie par les médecins généralistes équipés d’un échographe devant une suspicion de thrombose veineuse du membre inférieur : une étude qualitative auprès de médecins généralistes en France

Abstract : The suspicion of venous thrombosis is a situation which is often clinically aspecific, encountered on average one to three times a month by a general practitioner. Doppler ultrasound, necessary for the affirmation of the diagnosis, must often be deferred. The « general practitioner ultrasound » is being developed to immediately meet the physician’s needs. The reasons for the practice of ultrasound by general practitioners have not been studied before a suspicion of venous thrombosis of the lower limb.
Objective: to interview general practitioners equipped with an outpatient ultrasound system, in order to obtain the determinants of their ultrasound practice in the case of suspicion of venous thrombosis of the lower limb.
Methods: we conducted a qualitative study, through semi-structured interviews, until data saturation, with fifteen French doctors, from February to June 2020. The thematic analysis of the verbatim helped to highlight the determinants sought.
Results: our work highlights a diversity of practices from several determinants represented in our study by four main themes: ultrasound as a « primary care practice », the ways in which it fosters « a better working environment for the general practitioner » and « more efficient patient management », but also generating a « mixed experience of the imperatives of a developing practice ».
Discussion: the determinants highlighted in our study are similar to the broader determinants of POCUS ultrasound, the development of which raises discussion about this « disruptive innovation ».
Conclusions: the practice of ultrasound by the general practitioner, in case of suspicion of venous thrombosis of the lower limb, is experienced as very beneficial for the patient and for use in the healthcare system. It is also experienced as rewarding and enriching for the physician. However, these benefits, coupled with barriers linked to issues of « legitimacy », « medico-legal risk », or « recognition », leads to a wide variety of practices in this primary care practice. Our study showed a number of benefits in the indication of venous thrombosis of the lower limb. Some physicians provide solutions to give more prominence to this emerging practice that « serves them well ».
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03227818
Contributor : Bibliothèque Universitaire de Médecine Nice Connect in order to contact the contributor
Submitted on : Monday, May 17, 2021 - 4:08:16 PM
Last modification on : Wednesday, November 3, 2021 - 3:59:46 AM

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  • HAL Id : dumas-03227818, version 1

Citation

Mélina Seguret. Les déterminants de la pratique de l’échographie par les médecins généralistes équipés d’un échographe devant une suspicion de thrombose veineuse du membre inférieur : une étude qualitative auprès de médecins généralistes en France. Médecine humaine et pathologie. 2020. ⟨dumas-03227818⟩

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