Vorilhon Philippe, Picard Valérie, Marty Laurent, Vaillant Roussel Hélène, Llorca Pierre M, Laporte Catherine
Department of General Practice, Faculty of Medicine, University of Auvergne, 28 place Henri Dunant, 63001 Clermont-Ferrand, Faculty of Medicine, EA 4681, Périnatalité, grossesse, Environnement, Pratiques médicales et Developpement, 28 place Henri Dunant, 63001 Clermont-Ferrand,
Adult Psychiatry Department - B, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63000 Clermont-Ferrand.
Fam Pract. 2014 Oct;31(5):585-91. doi: 10.1093/fampra/cmu030. Epub 2014 Jun 17.
GPs are the health professionals most frequently consulted by adolescents. However, discussion between GPs and adolescents regarding cannabis use does not occur spontaneously.
To identify obstacles to the identification and management of cannabis use by adolescents based on GPs' experiences.
We conducted a qualitative study using focus groups of GPs from the Auvergne area (France). The GPs were selected according to descriptive and strategic variables. Three researchers--an anthropologist, a psychiatrist with expertise in addiction and a GP--performed a thematic analysis.
Twenty-four GPs participated in three consecutive focus groups. The GPs were aware of the health risks of cannabis, yet ambivalent about its use by adolescents. The GPs also reported a lack of patient questioning during consultation. The obstacles to the identification and treatment of cannabis use by adolescents identified included lack of GP knowledge about cannabis (e.g. consumption patterns and laws); difficulties in addressing the issue with adolescents, evaluating adolescents' consumption and its impact and proposing support and follow-up and the presence of parents. The GPs were aware that their role lies at the intersection between the medical, personal, familial and social fields.
Despite these barriers, GPs are willing to ask adolescents about their cannabis use. An adolescent's awareness, environment and receptiveness favour a sustainable therapeutic relationship. Brief intervention is a tool that may be of assistance in this relationship and allow GPs to take the initiative.
全科医生是青少年最常咨询的健康专业人员。然而，全科医生与青少年之间关于大麻使用的讨论并不会自发进行。
基于全科医生的经验，确定青少年大麻使用识别与管理的障碍。
我们对来自法国奥弗涅地区的全科医生进行了焦点小组定性研究。根据描述性和策略性变量选择全科医生。三位研究人员——一位人类学家、一位成瘾领域专家精神科医生和一位全科医生——进行了主题分析。
24名全科医生参加了连续三个焦点小组。全科医生意识到大麻对健康的风险，但对青少年使用大麻持矛盾态度。全科医生还报告说在咨询过程中缺乏对患者的询问。确定的青少年大麻使用识别与治疗障碍包括全科医生对大麻缺乏了解（例如消费模式和法律）；难以与青少年讨论该问题、评估青少年的消费情况及其影响以及提供支持和后续跟进，以及家长的在场。全科医生意识到他们的角色处于医疗、个人、家庭和社会领域的交叉点。
尽管存在这些障碍，全科医生仍愿意询问青少年的大麻使用情况。青少年的意识、环境和接受度有利于建立可持续的治疗关系。简短干预是一种可能有助于这种关系并使全科医生能够采取主动的工具。
