Déterminants et caractéristiques du parcours de soin en hypnose des patientes atteintes d'endométriose : une étude qualitative exploratoire

Context: Endometriosis is a chronic pathology frequently encountered in primary care, affecting 5 to 10% women. Without curative treatment, its management is multidisciplinary, with a central role of the general practitioner, coordinator of the care pathway. According to a 2019 survey, 80% of patients used at least once an alternative and complementary therapy in this context, including hypnotherapy. The latter has demonstrated its benefit in this indication, and is recommended by the HAS. The patient care pathway through this therapy is however little known, and there are concerns linked to certain practices considered deviant, even sectarian. Objective: Explore the subjective characteristics and determinants of the hypnotherapy treatment process for patients who used it for endometriosis. Method: Qualitative study with an inspired approach grounded theory through semi-structured interviews with patients suffering from endometriosis who have used hypnotherapy, until data saturation. Purposive sampling carried out with patient associations, hypnotherapists and display in waiting rooms, with snowball expansion. Analysis of verbatims by double coding with development of an explanatory model. Results: Patients use this therapy at different stages of their care journey and for different purposes: preparation for a surgical procedure, treatment pain, improvement of quality of life, search for listening and a need for self-health. This route seems varied depending on factors linked to the health system, caregivers and their practice (orientation, profession of the hypnotherapist, cost of therapy). Discussion: This original study allows us to better understand the journey of patients using hypnotherapy for endometriosis, and thus provides useful information for the organization of this treatment. Other studies are necessary, paving the way for a more efficient structuring of the use and practice of this therapy.