Edeline Agathe, Tripault Amelie, Lebeau Jean Pierre, Pautrat Maxime
Department of General Practice, Tours Regional University Hospital, Tours, France.
Faculty of Medicine, University of Tours, EA7505 Education Ethique Santé, 37000, Tours, France.
PLoS One. 2025 Jan 24;20(1):e0315926. doi: 10.1371/journal.pone.0315926. eCollection 2025.
Early addiction disorders screening is recommended in primary care. The goal of health system reform is to include allied health professionals in this screening. The appropriation of their new role has not yet been explored. The main aim of this study was to examine the perspective of allied health professionals in primary care on the screening of addictive disorders. This qualitative study inspired by the grounded theory was carried out between August 2018 and July 2019. Semi-structured individual interviews and focus groups were organized to include of primary care health professionals (physiotherapist, nurse, midwife, pharmacist, and dentist). Thirteen semi-structured individual interviews and four focus groups were recorded and coded. The paramedics described the advantages of their professions for the detection of addictions: home visits, prescription history, habit of intimate subjects, close consultations, etc. Despite daily practice-specific observation posts, they sometimes remained silent witnesses, and their helplessness hindered identification. They felt both closer to the patients and less legitimate than the doctors in dealing with addictions. Finally, their desire for a multidisciplinary approach was limited by the fear of disturbing the doctor and the confusion between betrayal and medical secrecy. Paramedical professionals claimed to have a complementary role to play in identifying addictions. Their reluctance echoed the concept of self-censorship, already described in studies with addictologists and patients. These results must be compared with the opinions of general practitioners and patients.
初级保健中建议进行早期成瘾障碍筛查。卫生系统改革的目标是让专职医疗人员参与到这项筛查工作中。他们新角色的职责尚未得到探讨。本研究的主要目的是调查初级保健中专职医疗人员对成瘾障碍筛查的看法。这项受扎根理论启发的定性研究于2018年8月至2019年7月期间开展。组织了半结构化的个人访谈和焦点小组,参与人员包括初级保健卫生专业人员(物理治疗师、护士、助产士、药剂师和牙医)。记录并编码了13次半结构化个人访谈和4次焦点小组访谈的内容。辅助医疗人员描述了他们职业在成瘾检测方面的优势:家访、用药史、处理私密问题的习惯、密切咨询等。尽管有日常特定的观察岗位,但他们有时仍是沉默的见证者,而他们的无助阻碍了识别工作。在处理成瘾问题时,他们觉得自己比医生更贴近患者,但合法性却更低。最后,他们对多学科方法的渴望因担心打扰医生以及在背叛与医疗保密之间的困惑而受到限制。辅助医疗专业人员声称在识别成瘾方面可发挥补充作用。他们的不情愿与成瘾病专家和患者研究中已经描述的自我审查概念相呼应。这些结果必须与全科医生和患者的意见进行比较。