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Master Thesis

Vécu du gut feeling dans le dépistage de la maltraitance infantile par les médecins généralistes en Isère, Savoie et Haute-Savoie

Abstract : Context: Child abuse is a subject that concerns all social and cultural backgrounds. General practitioners are regularly faced with complex situations and are in the centre of child abuse detection. However, today only 5% of reports come from the medical sector. The gut feeling is a tool that relies on the intuition of clinicians. It is frequently used in complex and/or uncertain situations. Objective: The aim of this study is to analyze the experience of gut feeling by general practitioners towards the detection of child abuse in Isère, Savoie and Haute-Savoie. Methods: A qualitative study was carried out with general practitioners in these three departments to share their experience of these situations of child abuse, focusing on screening. They were recruited via a preliminary questionnaire. Twelve individual semi-directed interviews were conducted from July to September 2021 and then analyzed according to the phenomenological interpretive model by the two investigators. Results: Three men and nine women were interviewed. The results of this study can be presented along two main lines: the relationship with abuse and the experience of gut feeling. Thirty-two themes were grouped into ten superordinate themes. Firstly, it appears that doctors' investment in screening is inhomogeneous. The physicians interviewed rated their screening abilities. They describe how this trust relationship with the patient is central and how it is involved in screening for child maltreatment. The exploration of the physicians' decision-making process assessed their experience of gut feeling, which they have all experienced, from taming to regular handling/use. This process leads to decisions, sometimes opposite, to alert child protection structures. It is influenced by the reflection on the impact of society and the place attributed to the doctor on detection of child abuse. The participants’ assessment of the gut feeling varied greatly, but this did not affect their confidence in it. Some participants even suggested evaluating it as a screening tool. This reflects the ambivalence of doctors towards this tool. This pathway leads to the initiative of alerting child protection measures, which is sometimes opposed among the participants. Finally, the doctors reflect on the impact of society and the place attributed to the doctor on the detection of child abuse. Conclusion: The experiences of the general practitioners interviewed were heterogeneous depending on their training and experience. Most participants were ambivalent about the validity of gut feeling and their confidence in it to screen child maltreatment in general practice, even though they all experience this tool instinctively. It is proposed to evaluate the validity of the gut feeling in screening for child maltreatment in general practice and to consider training students in the gut feeling as a non-analytical decision-making process.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03600704
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Monday, March 7, 2022 - 5:21:45 PM
Last modification on : Wednesday, March 9, 2022 - 3:36:32 AM

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  • HAL Id : dumas-03600704, version 1

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Sanguîta Marane, Shakti Loljeeh. Vécu du gut feeling dans le dépistage de la maltraitance infantile par les médecins généralistes en Isère, Savoie et Haute-Savoie. Médecine humaine et pathologie. 2022. ⟨dumas-03600704⟩

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