Reasons for disagreement regarding illnesses between older patients with multimorbidity and their GPs – a qualitative study

BMC Family Practice

Research Article

Heike Hansen¹  Martin Scherer¹  Hendrik van den Bussche¹  Nadine Pohontsch¹  Ingmar Schäfer¹ 

[1] Department of Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany;

关键词: Disagreement;    Chronic diseases;    Focus groups;    Illnesses;    Multimorbidity;    Physician report;    Primary care;    Qualitative study;    Self-report;   

DOI  :  10.1186/s12875-015-0286-x

 received in 2015-01-30, accepted in 2015-05-22,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundChronic conditions are the most common themes in doctor-patient communication, especially for older patients with multimorbidity and their GPs. Former quantitative studies identified a variety of socio-demographic and health-related factors which were associated with the (dis-)agreement between medical records and patient self-reported diseases. The aim of this qualitative study was to identify reasons for disagreement regarding illnesses between patients and their GPs.MethodsWe conducted three focus groups with GPs (n = 15) and three focus groups with multimorbid patients aged 65 to 85 (n = 21). The participants were recruited from the MultiCare Cohort Study. Focus groups were audiotaped and transcribed verbatim. The transcripts of the focus groups were analysed using the qualitative content analysis according to Mayring. Categories were determined deductively and inductively.ResultsThe analysis revealed seven themes concerning reasons for disagreement regarding illnesses between patients and their GPs: problems with communication and cooperation between health care professionals, disease management by the GP and the patient, the documentation behaviour of the GP, communication challenges between GP and patient, differences in the understanding of a disease between GP and patient, the prioritization and rating of diseases by GP and patient and obliviousness, repression and avoidance by the patient.ConclusionsFor older patients with multimorbidity, our study demonstrated that there is a need to enhance the cooperation between GPs, specialists and outpatient care, a demand to improve doctor-patient communication and a need for interventions to increase patients’ knowledge of diseases.

【 授权许可】

CC BY   
© Hansen et al.; licensee BioMed Central. 2015