Why do people with long-term health needs see more than one GP?: a qualitative study

2020 ◽  
Vol 26 (6) ◽  
pp. 514
Author(s):  
David Cosgriff ◽  
Jenny Reath ◽  
Penelope Abbott
Keyword(s):  
Continuity Of Care ◽  
Waiting Times ◽  
Health Issues ◽  
Structured Interviews ◽  
Regular Care ◽  
Practice Models ◽  
Qualitative Interview Study ◽  
Gp Care ◽  
Supportive Practice

This study aimed to understand what barriers exist or choices are made by patients who access regular care for long-term health issues from multiple GPs. This was a qualitative interview study in Western Sydney community settings consisting of semi-structured interviews and inductive thematic analysis. Twenty participants who accessed GP care were interviewed. Sixteen had seen multiple GPs over the previous twelve months and all had seen multiple GPs over preceding years. Participants valued interpersonal continuity of care. Nevertheless, they made decisions to meet their needs by seeing multiple GPs. They considered waiting times, preference for an individual GP based on their consultation style or perception of their particular area of expertise, experiences with reception staff and the practice model of care. Participants were aware that interpersonal continuity of care was considered important by GPs and were reticent to be seen as ‘doctor shoppers’. Therefore, they did not usually disclose that they saw multiple doctors and were unlikely to discuss continuity of care with a GP. Participants made considered choices about health care. Despite general practice promoting interpersonal continuity of care, it is not always achievable or desired by patients. GPs can promote care continuity through supportive practice models and dialogue about when continuity is desirable.

A Retrospective Comparison of American Women’s Spontaneous Conceptions and Gestational Surrogate Pregnancies

2021 ◽  
Author(s):  
Jennifer Lahl ◽  
Kallie Fell ◽  
Kate Bassett ◽  
Frances Broghammer ◽  
Maggie Eastman ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Demographic Data ◽  
Health Issues ◽  
Structured Interviews ◽  
Survey Tool ◽  
Level Data ◽  
Retrospective Comparison ◽  
Caucasian Women ◽  
Future Work

Abstract Purpose: To evaluate the retrospective pregnancy experiences of American women by comparing spontaneous pregnancies with gestational surrogate pregnancies. Methods: Data were collected via structured interviews following an approved survey tool utilizing an online video platform. In total, 97 interviews were conducted. Results: Demographic data was collected on age, ethnicity, primary language, country of birth, education, and income level. Data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than a non-surrogate pregnancy, independent of maternal age or gravidity (OR 7.22, p<0.001). A surrogate pregnancy had 4 times higher odds of resulting in a c-section (p<0.001) as well as delivering at an earlier gestational age (p<0.001). Further, women were more likely to experience adverse effects, including postpartum depression, following delivery of a surrogate child than their own biological child (p<0.001). Finally, the rate of new post-surrogacy chronic health issues for non-Caucasian women was significantly higher than for Caucasians (p<0.001). Women reported using the payment they received for their surrogacy for basic needs. Almost half of the women reported using the money to pay bills or get out of debt.Conclusions: These results are among the first of their kind. This study reveals that surrogate health disparities exist and that there may be long-term complications after a surrogate pregnancy. This raises important social, economic, and ethical issues related to surrogacy which must be further explored. Future work will build on this study and help elucidate the circumstances and consequences surrounding this complex issue.

scholarly journals GPs’ insights about discontinuing long-term antidepressant use: a qualitative study

2021 ◽  
pp. BJGP.2020.0913
Author(s):  
Maria Donald ◽  
Riitta Partanen ◽  
Leah Sharman ◽  
Johanna Lynch ◽  
Genevieve A Dingle ◽  
...  
Keyword(s):  
Decision Making ◽  
Prescribing Practices ◽  
Structured Interviews ◽  
Relational Context ◽  
Qualitative Interview Study ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Antidepressant Use ◽  
Set Up

Background: There is considerable concern about increasing antidepressant use, with Australians among the highest users in the world. Evidence suggests this is driven by patients on long-term rather than new prescriptions. Most antidepressant prescriptions are generated in general practice and it is likely that attempts to discontinue are either not occurring or are proving unsuccessful. Aim: To explore GPs’ insights about long-term antidepressant prescribing. Design and Setting: A qualitative interview study with Australian GPs. Method: Semi-structured interviews explored GPs’ discontinuation experiences, decision-making, perceived risks and benefits, and support for patients. Data were analysed using reflexive thematic analysis. Results: Three overarching themes were identified from interviews with 22 GPs. The first, ‘Not a simple deprescribing decision’, speaks to the complex decision-making GPs undertake in determining whether a patient is ready to discontinue. The second, ‘A journey taken together’ captures a set of steps GPs take together with their patients to initiate and set-up adequate support before, during and after discontinuation. The third: ‘Supporting change in GPs’ prescribing practices’ describes what GPs would like to see change to better support them and their patients to discontinue antidepressants. Conclusions: GPs see discontinuation of long-term antidepressant use as more than a simple deprescribing decision. It begins with considering a patients’ social and relational context and is a journey involving careful preparation, tailored care and regular review. These insights suggest interventions to redress long-term use will need to take these considerations into account and be placed in a wider discussion about the use of antidepressants.

scholarly journals Professional Footballers’ Association Counselors’ Perceptions of the Role Long-Term Injury Plays in Mental Health Issues Presented by Current and Former Players

2019 ◽  
Vol 13 (3) ◽  
pp. 451-468 ◽  
Author(s):  
Misia Gervis ◽  
Helen Pickford ◽  
Thomas Hau
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Football Players ◽  
Psychological Consequences ◽  
Health Issues ◽  
Structured Interviews ◽  
Mental Health Issues ◽  
The Relationship

The purpose of this study was to investigate counselors’ professional understanding of the long-term psychological consequences of injury in UK football players. Semi-structured interviews were conducted with 11 counselors who were registered to work for the Professional Footballers’ Association (PFA). The interviews examined the counselors’ perception of the relationship between long-term injury and presenting mental health issues, the antecedents to those mental health issues, and recommendations for psychological intervention following injury. The critical finding was the mental health problems regularly presented to PFA counselors were often the psychological and behavioral consequences of long-term injury. Counselors recommended that early and sustained psychological intervention with long-term injured players would act as a preventative measure against future mental health issues.

scholarly journals “Being in good hands”: Next of kin’s perceptions of continuity of care in patients with heart failure

2019 ◽  
Author(s):  
Malin Östman ◽  
Siv Bäck-Pettersson ◽  
Ann-Helén Sandvik ◽  
Annelie J Sundler
Keyword(s):  
Heart Failure ◽  
Continuity Of Care ◽  
Healthcare Providers ◽  
Analysis Method ◽  
Structured Interviews ◽  
Next Of Kin ◽  
Patients With Heart Failure ◽  
Qualitative Descriptive ◽  
Care Situation

Abstract Background Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin's perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF. Methods This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n=15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants' perceptions of the phenomenon. Results The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin's perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities. Conclusions Next of kin perceive continuity of care to entail well-functioning, long-term and reliable contact with healthcare providers that support them in reducing unnecessary medical and nursing hindrances. They have a variety of needs for continuity and support in connection with their caregiving activities so they can continue to live a meaningful life under the prevailing circumstances. In order to strengthen the next of kin's contact with healthcare providers, it is important to consider the need for continuity of care in relation to patients with HF. Keywords Continuity of care, Heart failure, Next of kin, Phenomenography, Qualitative research

scholarly journals “Being in good hands”: next of kin’s perceptions of continuity of care in patients with heart failure

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Malin Östman ◽  
Siv Bäck-Pettersson ◽  
Ann-Helén Sandvik ◽  
Annelie J. Sundler
Keyword(s):  
Heart Failure ◽  
Continuity Of Care ◽  
Structured Interviews ◽  
Next Of Kin ◽  
Collaborative Models ◽  
Patients With Heart Failure ◽  
Qualitative Descriptive ◽  
Care Situation ◽  
Care And Treatment

Abstract Background Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin’s perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF. Methods This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n = 15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants’ perceptions of the phenomenon. Results The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin’s perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities. Conclusions Next of kin perceive continuity of care, when they have access to care and treatment and when caregivers collaborate, regardless of healthcare is given by primary care, municipalities or specialist clinics. A sense of “being in good hands” sums up the need for continuous support, shared decision-making and seamless transitions between caregivers. It seems important that healthcare organisations safeguard effective and collaborative models. Moreover, professionals need to plan and perform healthcare in collaboration with patients and next of kin.

scholarly journals General practitioners’ views and experiences in caring for patients after sepsis: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040533
Author(s):  
Sabine Gehrke-Beck ◽  
Jochen Gensichen ◽  
Katrina M Turner ◽  
Christoph Heintze ◽  
Konrad FR Schmidt
Keyword(s):  
Primary Care ◽  
Critical Illness ◽  
General Practitioners ◽  
Continuity Of Care ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Daily Practice ◽  
Training Programme ◽  
Qualitative Interview Study

BackgroundPatients surviving critical illnesses, such as sepsis, often suffer from long-term complications. After discharge from hospital, most patients are treated in primary care. Little is known how general practitioners (GPs) perform critical illness aftercare and how it can be improved. Within a randomised controlled trial, an outreach training programme has been developed and applied.ObjectivesThe aim of this study is to describe GPs’ views and experiences of caring for postsepsis patients and of participating a specific outreach training.DesignSemistructured qualitative interviews.Setting14 primary care practices in the metropolitan area of Berlin, Germany.Participants14 GPs who had participated in a structured sepsis aftercare programme in primary care.ResultsThemes identified in sepsis aftercare were: continuity of care and good relationship with patients, GP’s experiences during their patient’s critical illness and impact of persisting symptoms. An outreach education as part of the intervention was considered by the GPs to be acceptable, helpful to improve knowledge of the management of postintensive care complications and useful for sepsis aftercare in daily practice.ConclusionsGPs provide continuity of care to patients surviving sepsis. Better communication at the intensive care unit–GP interface and training in management of long-term complications of sepsis may be helpful to improve sepsis aftercare.Trial registration numberISRCTN61744782.

scholarly journals “Being in good hands”: Next of kin’s perceptions of continuity of care in patients with heart failure

2019 ◽  
Author(s):  
Malin Östman ◽  
Siv Bäck-Pettersson ◽  
Ann-Helén Sandvik ◽  
Annelie J Sundler
Keyword(s):  
Heart Failure ◽  
Continuity Of Care ◽  
Structured Interviews ◽  
Next Of Kin ◽  
Collaborative Models ◽  
Patients With Heart Failure ◽  
Qualitative Descriptive ◽  
Care Situation ◽  
Care And Treatment

Abstract Background Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin's perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF. Methods This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n=15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants' perceptions of the phenomenon. Results The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin's perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities. Conclusions Next of kin perceive continuity of care, when they have access to care and treatment and when caregivers collaborate, regardless of healthcare is given by primary care, municipalities or specialist clinics. A sense of “being in good hands” sums up the need for continuous support, shared decision-making and seamless transitions between caregivers. It seems important that healthcare organisations safeguard effective and collaborative models. Moreover, professionals need to plan and perform healthcare in collaboration with patients and next of kin. Keywords Continuity of care, Heart failure, Next of kin, Phenomenography, Qualitative research

scholarly journals Experiences of transitioning between settings of care from the perspectives of patients with advanced illness receiving specialist palliative care and their family caregivers: A qualitative interview study

2021 ◽  
pp. 026921632110433
Author(s):  
Ping Guo ◽  
Cathryn Pinto ◽  
Beth Edwards ◽  
Sophie Pask ◽  
Alice Firth ◽  
...  
Keyword(s):  
Palliative Care ◽  
Family Caregivers ◽  
Continuity Of Care ◽  
Future Research ◽  
Specialist Palliative Care ◽  
Structured Interviews ◽  
Advanced Illness ◽  
Biographical Disruption ◽  
Practical Support ◽  
Qualitative Interview Study

Background: Transitions between care settings (hospice, hospital and community) can be challenging for patients and family caregivers and are often an under-researched area of health care, including palliative care. Aim: To explore the experience of transitions between care settings for those receiving specialist palliative care. Design: Qualitative study using thematic analysis. Setting/participants: Semi-structured interviews were conducted with adult patients ( n = 15) and family caregivers ( n = 11) receiving specialist palliative care, who had undergone at least two transitions. Results: Four themes were identified. (1) Uncertainty about the new care setting. Most participants reported that lack of information about the new setting of care, and difficulties with access and availability of care in the new setting, added to feelings of uncertainty. (2) Biographical disruption. The transition to the new setting often resulted in changes to sense of independence and identity, and maintaining normality was a way to cope with this. (3) Importance of continuity of care. Continuity of care had an impact on feelings of safety in the new setting and influenced decisions about the transition. (4) Need for emotional and practical support. Most participants expressed a greater need for emotional and practical support, when transitioning to a new setting. Conclusions: Findings provide insights into how clinicians might better negotiate transitions for these patients and family caregivers, as well as improve patient outcomes. The complexity and diversity of transition experiences, particularly among patients and families from different ethnicities and cultural backgrounds, need to be further explored in future research.

scholarly journals Patients’ Expectations of Physiotherapeutic Treatment for Long-Term Side Effects After Cancer: A Qualitative Study

2021 ◽  
Vol 28 ◽  
pp. 107327482110470
Author(s):  
Rikke Klitlund Jensen ◽  
Sarah Jakobsen ◽  
Sigrid Velling Gundersen ◽  
Martin Faerch Andersen ◽  
Marianne Kongsgaard ◽  
...  
Keyword(s):  
Side Effects ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Cancer Society ◽  
Current State ◽  
Qualitative Interview Study ◽  
Interview Guide ◽  
After Cancer ◽  
Physiotherapy Clinic

Objective This study aims to explore the expectations of physiotherapeutic treatment of long-term side effects (LTSEs) after cancer among patients treated in physiotherapy clinics. Methods This a qualitative interview study based on a phenomenological approach. Adult patients with LTSEs after cancer were recruited through The Danish Cancer Society and a private physiotherapy clinic in Denmark. Individual semi-structured interviews were carried out using Microsoft Teams based on an interview guide piloted before the interviews. Interviews were audiotaped and transcribed verbatim. Sampling was conducted with a focus on variation in LTSE. The data were analyzed using Malterud’s principles of systematic text condensation and coded in NVivo 12. Results 2 males and 8 females with an average age of 55.8 years were interviewed for between 40 and 60 minutes from October to November 2020. Four main themes emerged from the interviews 1 : The importance of the physiotherapist’s approach, 2 the benefits of meeting patients with similar symptoms, 3 the importance of receiving knowledge, and 4 patients seeking to maintain their current state more often than aiming to improve their condition. Conclusions Patients consulting a physiotherapy clinic with LTSE after cancer prefer the physiotherapist to have knowledge about cancer and to be emphatic. Furthermore, patients prefer to meet like-minded people and expect support to maintain their current condition rather than improve their condition.

scholarly journals Patient experiences of waiting times in standardised cancer patient pathways in Norway – a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marit Solbjør ◽  
Kari Sand ◽  
Bente Ervik ◽  
Line Melby
Keyword(s):  
Cancer Patient ◽  
Waiting Times ◽  
Qualitative Interview ◽  
Patient Experiences ◽  
Rapid Diagnosis ◽  
Patient Needs ◽  
Structured Interviews ◽  
Patient Pathways ◽  
Qualitative Interview Study ◽  
Urgent Action

Abstract Objective Standardised cancer patient pathways (CPP) are implemented within cancer care with an aim to ensure standardised waiting times for diagnosis and treatment. This article investigates how patients in Norway experience waiting times within a CPP. Methods Qualitative semi-structured interviews with 19 patients who had been through CPP for breast cancer, prostate cancer or malignant melanoma in Norway. Results Few patients knew about the term CPP but trusted that waiting times were standardised to decrease mortality. Their experiences of waiting depended on their expectations as much as the period they waited. Patients generally felt safe about the timing of treatment, but not all expectations of a rapid response from health services were met. Short waiting times were interpreted as a sign of urgency, and a change of pace between urgent action and prolonged periods of waiting were disturbing. Conclusions Patients are comforted by knowing they are within a structured CPP that ensures rapid diagnosis and start of treatment. CPPs still need to be improved to avoid delays, allow for adaptions to patient needs, and include more information to avoid stress.

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