Experiment of systematic data collection using three personal life events
Type de matériel :
39
Among the skills expected of a general practitioner (GP), the ability to formulate situational diagnosis is crucial. GPs must be able to assess the bio-psycho-social and cultural context specific to the patient. This is known as a holistic approach, or patient-centered approach, to general medicine. In this vein, life events (LEs) of the patient, alongside their patient history and medical conditions, are incontestably valuable. This study follows on from an experiment carried out in a primary care practice, in which patients were systematically asked the following question: “Can you tell me three significant events from your personal life?” A study was carried out by three primary care practitioners from an provincial urban practice to assess the interest, feasibility, and acceptability of this approach. Method: The study was organized around the retrospective collection of 254 files containing three personal events supplied by each patient and the prospective collection involving 100 patients new to the medical practice. Results: Among the 254 files examined, 699 LE themes were identified, including 67 percent from the negative category. The most common LEs related to marital and family life (2/3), followed by bereavement (101 LEs). Psychological, physical, and sexual violence were found in 24.8 percent of cases (63/254). Sexual violence was observed in 8.3 percent of all patients. In the prospective study, doctors did not ask the question in one appointment out of ten, due to a lack of time or because they did not dare to. However, they reported that they never felt uncomfortable with the inquiry. Only one patient refused to take part in the exercise and five were unable to, including four men. In 85 percent of cases, patients were able to share three significant LEs. Conclusion: This study suggests that it is possible to gather Life Events (LEs) through systematic open-ended questioning. This does not seem to pose a problem for patients, who readily disclose significant, sometimes very painful, life events. LEs provide real-life background information and having knowledge of them would prove useful for the patient-centered approach. A complementary, larger-scale study could be conducted once the method for collecting LEs has been shared with other practitioners.
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