Psychologie de la santé en chirurgie : facteurs psychologiques, subjectivité et émotions dans les soins chirurgicaux

Abstract : In surgery, psychological and social factors are not widely studied, and the only variables considered important in surgical care are those related to operating technique and biology. Additionally, surgeons’ experience of their practice is neglected, despite the fact that (i) epidemiological studies showed a 40% burnout rate among surgeons, (ii) the difference between individual surgeons is a key variable in the performed care (like psychotherapists in psychotherapy), and (iii) surgeons work in a high salient social and cultural environment. The aim of this PhD thesis is to explore the psychosocial factors influencing surgical practice and surgeons’ wellbeing. Our findings are based on three studies. First, we performed a systematic review of international qualitative studies (metasynthesis) in order to describe how surgeons experience their practice from their perspective. Then, a second qualitative study extended the findings of the previous one exploring in-depth the everyday emotional experience of liver surgeons (high risk surgery, mainly cancer-related). Finally, a prospective cohort study investigated the influence of preoperative patient-related psychological factors (depression and anxiety) on the outcome of liver surgery, and how surgeons take these data into account in their practice. Several implications of our findings have been discussed, concerning surgeons’ mental wellbeing and burnout, as well as the implementation of the bio-psycho-social model in the care of surgical patients.
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Massimiliano Orri. Psychologie de la santé en chirurgie : facteurs psychologiques, subjectivité et émotions dans les soins chirurgicaux. Psychologie. Université Sorbonne Paris Cité, 2015. Français. ⟨NNT : 2015USPCB161⟩. ⟨tel-01578495⟩

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