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Master Thesis

La participation des usager·ère·s, un enjeu pour l’amélioration des soins primaires ? Réflexions sur la place des usager·ère·s au sein des Communautés Professionnelles Territoriales de Santé

Abstract : The notion of participatory democracy is currently present in all public policies. Gradually instituted in the health sector, from the 1980s, this notion allowed the recognition of users rights and users expertise, and the end of the doctor-patient bond. This evolution led to the promulgation of successive laws which legislate the term “health democracy”. However, users are still struggling to find a place in primary care organizations, even though local care appears to be a determining factor in improving the health system. The Territorial Professional Health Communities, territorial organizations aiming to improve the organization and coordination of primary health care, are the major points of the latest national health strategies. However, the absence of legislation on the place given to users in these new organizations leads to some interrogations about the integration of health democracy in primary care. This exploratory study aimed to identify the levers and obstacles to users participation in these new organizations and to define the modalities of action in favor of a real participation process. Semi-structured interviews were conducted with users, representatives and patient-experts and with professionals involved in CPTS projects, in Gironde. The results showed that the persistence of a medico-centered vision and the culture of isolated professional exercise, the lack of knowledge about the health associations present in the territory and the lack of training and support for professionals in participatory methods were the major obstacles to the establishment of this participation. These results have led to several recommendations such as the establishment of a recognized consultation mechanism, closer ties with local elected officials, legislation, better training and the improvement of methodological support. These results are also an opening to further studies on the issue.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03451392
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Submitted on : Friday, November 26, 2021 - 2:18:05 PM
Last modification on : Thursday, December 2, 2021 - 3:50:04 AM
Long-term archiving on: : Sunday, February 27, 2022 - 7:18:34 PM

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Clémence Laroche. La participation des usager·ère·s, un enjeu pour l’amélioration des soins primaires ? Réflexions sur la place des usager·ère·s au sein des Communautés Professionnelles Territoriales de Santé. Santé publique et épidémiologie. 2021. ⟨dumas-03451392⟩

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