Older Australians' Expectations of their Interactions with their GPs

2005 ◽  
Vol 11 (3) ◽  
pp. 38 ◽  
Author(s):  
Simone Pettigrew ◽  
Katherine Mizerski ◽  
Robert Donovan
Keyword(s):  
Older People ◽  
Focus Groups ◽  
Medical History ◽  
General Practitioners ◽  
Information Flow ◽  
Older Patients ◽  
Telephone Survey ◽  
General Medicine ◽  
Personal Relevance ◽  
New Developments

This article reports the findings of a study into older Australians' expectations when interacting with their general practitioners (GPs). Six focus groups and a national telephone survey (n=505) were conducted to identify those aspects of interactions with GPs considered to be the most important and relevant to older people. The results indicate that the three most important issues relate to ability of GPs to: (1) provide prompt referrals to specialists and ensure an ongoing information flow between GPs and specialists (2) remain abreast of new developments in geriatric and general medicine, and (3) demonstrate a familiarity with the patient's medical history. These issues were considered important to older patients in general and to be of personal relevance to the large majority of those sampled.

scholarly journals Experiences with approaches to advance care planning with older people: a qualitative study among Dutch general practitioners

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e024762 ◽  
Author(s):  
Jolien Jeltje Glaudemans ◽  
Eric Moll van Charante ◽  
Jan Wind ◽  
John Jacob Oosterink ◽  
Dick Ludolf Willems
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
General Practitioners ◽  
Advance Care Planning ◽  
Older Patients ◽  
Ad Hoc ◽  
Daily Practice ◽  
Community Dwelling ◽  
Care Planning ◽  
Advance Care

ObjectivesAdvance care planning (ACP) with older people needs to be approached differently than ACP with patients with a terminal illness. ACP is still used with only a minority of older patients due to a lack of knowledge regarding appropriate approaches to ACP with older people. General practitioners (GPs) may play a key role in ACP with older people. Therefore, we explored their experiences with and views on approaches to ACP with older patients in daily practice.Design, setting and participantsA qualitative study among a purposive sample of 19 Dutch GPs based on semistructured interviews.ResultsApproaches to ACP with older patients can be divided into two categories: systematic and ad hoc. Systematic approaches consisted of discussing a fixed combination of topics with community-dwelling older patients who are frail, cognitively impaired or are aged >75 years, and with older patients living in residential care homes during group information meetings, intakes, comprehensive geriatric assessments and periodic assessments. Meetings were aimed at making agreements in anticipation of future care, at providing information and encouraging older people to take further steps in ACP. With ad hoc approaches, respondents discussed only one or two topics related to the near future. Ad hoc ACP was mainly done with deteriorating patients or when patients or family initiated ACP. Systematic and ad hoc approaches were used simultaneously or sequentially and were both used for initiating and following up on ACP. Due to a lack of time and knowledge of other occasions and topics than the ones respondents used, respondents seemed to underuse many occasions and topics.ConclusionsAwareness of appropriate systematic and ad hoc approaches for ACP, and the focus on providing information and encouraging older people to take further steps in ACP reported in this study can support GPs and improve older patients’ access to ACP.

Interaction Between Participants in Focus Groups With Older Patients and General Practitioners

2009 ◽  
Vol 20 (5) ◽  
pp. 607-616 ◽  
Author(s):  
Janne Moen ◽  
Karolina Antonov ◽  
J. Lars G. Nilsson ◽  
Lena Ring
Keyword(s):  
Focus Groups ◽  
General Practitioners ◽  
Older Patients

59. General medicine residents' perception of the mini-CEXs

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
General Medicine ◽  
Clinical History ◽  
Phenomenological Approach ◽  
Medical Teacher ◽  
The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

A new medical Internet system in healthcare: innovation of Telegeriatrics and healthcare demands of older patients of different age groups (Preprint)

2020 ◽  
Author(s):  
Yu Gong ◽  
Jianyuan Zhou
Keyword(s):  
Cardiovascular Diseases ◽  
General Practitioners ◽  
Older Patients ◽  
Metabolic Diseases ◽  
Treatment Plan ◽  
Age Groups ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
World Health ◽  
New Model

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.

Polypharmazie – Lösungswege für eine verbesserte Arzneimitteltherapiesicherheit

2017 ◽  
Vol 142 (14) ◽  
pp. 1046-1053
Author(s):  
Olaf Krause ◽  
Gesine Picksak ◽  
Ulrike Junius-Walker
Keyword(s):  
Older People ◽  
General Practitioners ◽  
Nursing Care ◽  
Drug Safety ◽  
Medication Management ◽  
Team Work ◽  
Communication Tool ◽  
Old People ◽  
Medication Plan ◽  
Drug Problems

AbstractPolypharmacy (≥ 5 drugs) is common among older people and may lead to falls, ADEs and delirium. Adherence is an important part in the medication management. Simple questions (i. e. for OTC, handling and omission of drugs) are effective. As most old people are treated by general practitioners (GP), they play a key role for drug safety and reducing polypharmacy. The involvement of pharmacists in analyzing one patient‘s drugs can enhance solutions for drug problems (“two-man rule”). An IT-based medication plan acts as an important communication tool for an enhanced team work between doctors, pharmacists and nursing care.

scholarly journals The concept of health in older age: views of older people and health professionals

2007 ◽  
Vol 31 (4) ◽  
pp. 642 ◽  
Author(s):  
Melita J Giummarra ◽  
Betty Haralambous ◽  
Kirsten Moore ◽  
Joan Nankervis
Keyword(s):  
Older People ◽  
Focus Groups ◽  
Health Professionals ◽  
Social Connectedness ◽  
Older Age ◽  
Concept Of Health ◽  
Concepts Of Health ◽  
Health Promoting ◽  
Barriers And Motivators ◽  
Holistic Manner

This study aimed to explore how older people and health professionals conceptualise health in older age. Thirty-six older people and 41 health professionals participated in 10 focus groups (five with older people and five with health professionals) and discussed concepts of health, the modifiable aspects of health, and barriers and motivators to undertaking health-promoting behaviour change. Both older people and health professionals were found to conceptualise health in a holistic manner. While health professionals tended to place the source of poor health on failures of social connectedness and poor service delivery, older people stressed the importance of taking ownership of one?s own health and actively seeking out health promoting activities and services.

scholarly journals Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
Later Life ◽  
Focus Group Study ◽  
Age Related ◽  
Health Related ◽  
Age Related Changes

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).

Medicine use of elderly Chinese and Vietnamese immigrants and attitudes to home medicines review

2012 ◽  
Vol 18 (1) ◽  
pp. 50 ◽  
Author(s):  
Lesley White ◽  
Christiane Klinner
Keyword(s):  
Focus Groups ◽  
General Practitioners ◽  
Health Care Providers ◽  
Service Use ◽  
Unmet Need ◽  
Care Providers ◽  
Public Health Services ◽  
Elderly Chinese ◽  
Chinese Group ◽  
Home Medicines Review

There is a paucity of research into the perceptions of elderly Australian ethnic minorities towards public health services related to quality use of medicines. Among the six fastest growing ethnic groups in Australia, the Mandarin-speaking Chinese and Vietnamese constitute the largest elderly populations with poor English skills. This paper investigates the relationships of elderly Chinese and Vietnamese migrants with medicines, general practitioners and pharmacists, and how these relationships influence their awareness and attitudes of the home medicines review (HMR) program. Two semi-structured focus groups were held with a total of 17 HMR-eligible patients who have never received a HMR, one with Chinese and one with Vietnamese respondents, each in the respective community language. Confusion about medications and an intention to have a HMR were pronounced among all participants although none of them had heard of the program before participating in the focus groups. Respondents reported difficulties locating a pharmacist who spoke their native language, which contributed to an increased unmet need for medicine information. The Chinese group additionally complained about a lack of support from their general practitioners in relation to their medicine concerns and was adamant that they would prefer to have a HMR without the involvement of their general practitioner. Our results indicate a distinct HMR need but not use among elderly Chinese and Vietnamese eligible patients with poor English skills. Home medicines review service use and perceived medication problems are likely to improve with an increasing availability of bilingual and culturally sensitive health care providers.

Older people's satisfaction with intermediate care: a systematic review

2007 ◽  
Vol 17 (3) ◽  
pp. 199-218 ◽  
Author(s):  
Andrew Wilson ◽  
Suzanne Richards ◽  
Janette Camosso-Stefinovic
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Older Patients ◽  
Hospital Care ◽  
Patient Choice ◽  
Intermediate Care ◽  
Care Services ◽  
The Relationship

Although intermediate care takes a variety of different forms and has developed somewhat differently in different countries, we believe that intermediate-care schemes have enough in common to make it meaningful to examine the relationship between this method of care and the views of older patients receiving either it or its alternatives. This is particularly important as one of the underlying principles of intermediate care is to extend patient choice; furthermore, most intermediate-care services target older people. In this review we examine evidence about whether older people prefer intermediate or hospital care, and what they like and dislike about intermediate care.

Digital Medical Interview Assistant AnCha for Obtaining the Medical History in General Medicine: Case study (Preprint)

2021 ◽  
Author(s):  
Selina Florence Regli ◽  
Floriana Gashi ◽  
Kerstin Denecke
Keyword(s):  
Medical History ◽  
User Interfaces ◽  
Pilot Trial ◽  
Age Groups ◽  
General Medicine ◽  
Time Frame ◽  
Practical Implementation ◽  
Medical Interview ◽  
Digital Tool ◽  
Dialog System

BACKGROUND Collecting information on the medical history of a patient is an important step during the diagnosing process. Besides the interrogation by the physician, computerized questionnaires are used to collect the data. To facilitate interaction, implementation of digital medical interview assistants (DMIA) using conversational user interfaces (CUI) gain in interest. OBJECTIVE The aim of this research is to assess patient’s and physician’s perceptions towards a DMIA with CUI. Beyond, we want to understand how such DMIA can be used in real-world context, what issues and barriers exist in their usage. METHODS We developed a web-based DMIA with CUI (referred to as AnCha for anamnesis chatbot) as a research prototype in a participative and iterative development process. We conducted a pilot trial in a practice for general medicine. Patient perceptions were collected and physicians were interrogated regarding usefulness of collected information. RESULTS 31 patients were approached, and 9 participants were included in the pilot trial; 3 conversation protocols were used by the physicians to prepare for the encounter. Participants spanned all age groups from digital natives (n=5), and digital workers (n=3) to digital seniors (n=1). Patients can easily interact with AnCha and are willing to provide information to the digital tool. They recognize benefits while using the dialog system compared to the existing process. Important insights into practical implementation and integration into practice workflows could be gained. CONCLUSIONS Providing information on complaints and medical history before the actual encounter is considered useful. In order to be supportive for physicians, information has to be made available in a sufficient time frame before the encounter. Future work has to assess in particular whether AnCha is also well accessible for digital seniors.

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