Les activités des médecins du travail dans la prévention des TMS : ressources et contraintes

Abstract : MSD represents the primary cause of occupational illness and the occupational health physician would appear to be a determining stakeholder in prevention. The studies of risk factors of MSD are important but the studies of intervention are limited. The objective of our research is double: understand the practices of occupational health physician and give the means of activity development. Theoretical framework is multidisciplinary approach about activity analysis. The problematic is to produce knowledge of activity of occupational health physicians to take into account their activity in the debate of professional evolution and pluridisciplinarity in health of work. The disciplinary skills of each equip of research produce some methods. Fifty physicians participate in our research. We have observed during 60 day with ergonomics methods, notably 200 sequences of medical consultation with protocol to record data, confirmed by institutions of protection of physician profession and protection of data. Some types of interview are realized (65): semi-directive, clarification, simple self-confrontation, cross self-confrontation. Furthermore, our research is based on the objective to develop the activity of occupational health physicians. To do this, we set up four groups of volunteer occupational health physicians. The discussion of groups is based on objective data of activity (14 discussion sessions) and on instruction of double (15 discussions sessions). All equips of our research have building a common reference to facilitate the data exploitation. Each equip has written one or some articles (in annex of report) to keep this specificity of data production based of disciplinary approach. The first result is that there are some skills of occupational health physicians to make prevention. Someone physicians prefer to realize their action in consultation while the others prefer make intervention in company. The professionals styles of physicians according to the gender building with experience and training depend on context of company, legislative prevention system, relationship between stakeholders and operators, which facilitate or slow down to built the room of maneuver to exercise these professional styles. The activity of physician can be to hamper in certain conditions. The occupational health physicians are the only one to follow the operators, the story of company and relationships of stakeholders, the evolution of health and work. They use their knowledge about work in company to help operator to understand the relation between work and health. They mobilize the words using by operators in consultation, with respected the medical secret, to modify the stakeholders representation of the interaction between work and health. In the other words, it is impossible to separate the individual approach and collective approach in prevention activity of occupational health physician. These different approaches organize the actions of physician. The discussion of research led to questioning the legislative evolution and comparing our French system with de others system like Quebec system.
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Sandrine Caroly, Céline Cholez, Aurélie Landry, Philippe Davezies, Nadine Poussin, et al.. Les activités des médecins du travail dans la prévention des TMS : ressources et contraintes. [Rapport de recherche] PACTE. 2012. ⟨halshs-00676973⟩

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