Mots-clés
qualitatif
expériences négatives à l'enfance
grossesse
soins primaires
Comment citer
Résumé
Objectifs : Explorer les obstacles et les facilitateurs, du point de vue des médecins de famille, à la mise en œuvre d'une initiative pilote de soins sensibles aux traumas (SST) visant à promouvoir la résilience, en mettant particulièrement l'accent sur les questions relatives aux expériences négatives à l'enfance (ENE), dans une clinique de soins de maternité.
Méthodes : À l'aide d'un modèle qualitatif exploratoire, des entretiens semi-dirigés approfondis ont été menés avec des médecins de famille qui pratiquaient dans une clinique de maternité d'une grande ville canadienne. Les entretiens ont été enregistrés et transcrits mot à mot. Les transcriptions de verbatim ont été examinées par trois codeurs et les thèmes ont été extraits à l'aide d'une analyse thématique.
Résultats : L'analyse de 10 entretiens a permis de dégager six domaines thématiques. Trois domaines concernaient les obstacles perçus à l'obtention d'un historique des ENE, soit : (1) le souci de la gestion du temps, (2) le manque d'aisance initiale du médecin avec les SST et (3) les limites culturelles de l'utilisation du questionnaire sur les ENE. Trois thèmes ont trait aux facilitateurs perçus de l'obtention d'un historique des ENE, notamment : (1) l'importance d'un médecin parrain, (2) un environnement clinique favorable et flexible, et (3) l'amélioration des relations patient-médecin.
Implications: Dans le contexte d'une campagne de SST plus large au sein d'un établissement de soins de maternité, le fait d'interroger les patients sur les ENE a été généralement perçu de manière positive par les médecins. Un environnement clinique favorable et une formation adéquate du personnel peuvent être des facteurs critiques qui contribuent à une implantation réussie. De futures recherches axées sur les diverses expériences des médecins dans différents contextes sont nécessaires.
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