L’hôpital comme espace de circulation d’une norme globalisée

Bureau, Eve

doi:10.7202/1024081ar

2014

DOI: 10.7202/1024081ar

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L’hôpital comme espace de circulation d’une norme globalisée

Eve Bureau

Abstract: Ce document est protégé par la loi sur le droit d'auteur. L'utilisation des services d'Érudit (y compris la reproduction) est assujettie à sa politique d'utilisation que vous pouvez consulter en ligne.https://apropos.erudit.org/fr/usagers/politique-dutilisation/ Cet article est diffusé et préservé par Érudit.Érudit est un consortium interuniversitaire sans but lucratif composé de

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Cited by 3 publications

References 17 publications

(8 reference statements)

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The ANRS-Ipergay trial, an opportunity to use qualitative research to understand the perception of the “participant”-physician relationship

et al. 2018

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The ANRS-IPERGAY trial consisted in providing sexual activity-based antiretroviral prophylaxis for HIV prevention (PrEP) with a package of prevention tools (counselling, condoms, HIV and sexually transmitted infections' screening) to highly exposed HIV-negative men who have sex with men (MSM). Few data exist concerning the patient-physician relationship in the particular context of PrEP, where physicians discuss sexual behaviours with MSM who are not classic patients, in that consultation is for prevention purposes, not for illness. This study took place during the open-label extension of ANRS-IPERGAY trial when all participants received PrEP. In this qualitative study, we examined how physicians perceived their relationship with participants in the ANRS-IPERGAY trial. Of all 30 physicians involved in the trial who were contacted by email to participate in an interview about their opinions and perceptions of ANRS-IPERGAY 18 volunteered to participate in the current sub-study. We performed a vertical analysis for each interview to identify the extract in each physician's discourse concerning their relationship with MSM participants, and conducted a horizontal analysis to construct the thematic tree and subsequently investigate differences and similitudes between themes. An analysis of all physicians' discourses showed that the participant-physician relationship during the trial could be described through 4 themes: (i) personal experience of the relationship, (ii) trust and non-judgement, (iii) positive relational climate and (iv) influence of physician's characteristics (age, gender, etc.) on relationship. We found that the particular context of PrEP led some physicians to adopt a patient-as-partner approach during consultations rather than a paternalist or hierarchical approach. Indeed, the close follow-up provided by the trial and the active role of patients in their own prevention care trajectory, are more compatible with the patient-as-partner approach. The prescription of PrEP may lead to an evolution in patient-physician relationships and may even modify the professional identity of physicians.

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The ANRS-Ipergay trial, an opportunity to use qualitative research to understand the perception of the “participant”-physician relationship

et al. 2018

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The Structural Violence of Patient Participation in Cambodian HIV Services

Bureau-Point

Phan

2015

Qual Health Res

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Participation of people living with HIV/AIDS (PLHA) has become a new standard of good governance in HIV services worldwide, and most HIV organizations make reference to it. This standard has had a considerable impact in Cambodia, where hundreds of PLHA have been recruited by organizations to participate in the development of HIV services. However, participation is a vague concept with various interpretations and applications. Drawing on ethnographic research conducted between 2006 and 2008, this article first clarifies what promoters expect from patient participation in Cambodia and then examines its meanings and uses for one category of PLHA working in hospitals (hereafter "volunteers"). It shows that volunteers have played a valuable role in the scaling-up of access to care and treatment policy, and that although international organizations in Cambodia see patient participation as empowering PLHA, these volunteers face structural violence caused by inherent conflicts within Cambodia's strict health care hierarchy.

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Les patients contemporains face à la démocratie sanitaire

Bureau-Point¹,

Hermann-Mesfen²

2014

anthropologiesante

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L’hôpital comme espace de circulation d’une norme globalisée

Cited by 3 publications

References 17 publications

The ANRS-Ipergay trial, an opportunity to use qualitative research to understand the perception of the “participant”-physician relationship

The ANRS-Ipergay trial, an opportunity to use qualitative research to understand the perception of the “participant”-physician relationship

The Structural Violence of Patient Participation in Cambodian HIV Services

Les patients contemporains face à la démocratie sanitaire

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