Advanced

"It is meaningful; I feel that I can make a difference" -A qualitative study about GPs' experiences of work at nursing homes in Sweden

Borgström-Bolmsjö, Beata LU ; Strandberg, Eva-Lena LU ; Midlöv, Patrik LU and Brorsson, Annika LU (2015) In BMC Family Practice 16(1).
Abstract
Background: Swedish nursing homes (NH) have limited capacity. As a result elderly people living in NH represent the part of the elderly population in most need of care. In Sweden a General Practitioner (GP) is usually responsible for the medical care of all subjects living in a NH. The residents in NH seldom have adequate pharmacological treatment according to diagnosis and often have polypharmacy and/or inappropriate medical treatment regarding concerns of declining renal function. What prevents optimal care for the elderly is multifaceted, but there is limited research on how GPs experience their work with the elderly in NH in Sweden. This study aims to illuminate the GPs' work with the elderly in NH to provide input on how the care can... (More)
Background: Swedish nursing homes (NH) have limited capacity. As a result elderly people living in NH represent the part of the elderly population in most need of care. In Sweden a General Practitioner (GP) is usually responsible for the medical care of all subjects living in a NH. The residents in NH seldom have adequate pharmacological treatment according to diagnosis and often have polypharmacy and/or inappropriate medical treatment regarding concerns of declining renal function. What prevents optimal care for the elderly is multifaceted, but there is limited research on how GPs experience their work with the elderly in NH in Sweden. This study aims to illuminate the GPs' work with the elderly in NH to provide input on how the care can be improved, as well as to identify potential obstacles for good quality of care. Methods: This qualitative study is based on individual semi-structured interviews with 12 GPs and a follow-up focus group discussion with six of the interviewed GPs. The interviews were analysed with systematic text condensation, with the process leading to identify categories and themes. Thereafter, the themes were discussed among six of the participating GPs in a focus group interview. Results: Two main themes were identified: concern for the patient and sustainable working conditions. The principal focus for the GPs was to contribute to the best possible quality of life for the patients. The GPs described discordance between the demand from staff for medications and the patients' actual need of care. GPs found their work with NH enjoyable. Even though the patients at the NH often suffered from multiple illnesses, which could lead to difficult decisions being made, the doctors felt confident in their role by having a holistic view of the patient in tandem with reliable support from the nurse at the NH. Conclusion: Working with NH patients was considered important and meaningful, with the GPs striving for the patient's well-being with special consideration to the continuum of ageing. A continuous and well-functioning relationship between the GP and the nurse was crucial for the patients' well-being. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Family Practice
volume
16
issue
1
publisher
BioMed Central
external identifiers
  • wos:000360194700001
  • scopus:84940387401
  • pmid:26316028
ISSN
1471-2296
DOI
10.1186/s12875-015-0326-6
language
English
LU publication?
yes
id
e825fe5d-272f-4b6e-90e2-e726c0fce160 (old id 7964909)
date added to LUP
2015-10-01 07:40:07
date last changed
2017-06-11 03:57:37
@article{e825fe5d-272f-4b6e-90e2-e726c0fce160,
  abstract     = {Background: Swedish nursing homes (NH) have limited capacity. As a result elderly people living in NH represent the part of the elderly population in most need of care. In Sweden a General Practitioner (GP) is usually responsible for the medical care of all subjects living in a NH. The residents in NH seldom have adequate pharmacological treatment according to diagnosis and often have polypharmacy and/or inappropriate medical treatment regarding concerns of declining renal function. What prevents optimal care for the elderly is multifaceted, but there is limited research on how GPs experience their work with the elderly in NH in Sweden. This study aims to illuminate the GPs' work with the elderly in NH to provide input on how the care can be improved, as well as to identify potential obstacles for good quality of care. Methods: This qualitative study is based on individual semi-structured interviews with 12 GPs and a follow-up focus group discussion with six of the interviewed GPs. The interviews were analysed with systematic text condensation, with the process leading to identify categories and themes. Thereafter, the themes were discussed among six of the participating GPs in a focus group interview. Results: Two main themes were identified: concern for the patient and sustainable working conditions. The principal focus for the GPs was to contribute to the best possible quality of life for the patients. The GPs described discordance between the demand from staff for medications and the patients' actual need of care. GPs found their work with NH enjoyable. Even though the patients at the NH often suffered from multiple illnesses, which could lead to difficult decisions being made, the doctors felt confident in their role by having a holistic view of the patient in tandem with reliable support from the nurse at the NH. Conclusion: Working with NH patients was considered important and meaningful, with the GPs striving for the patient's well-being with special consideration to the continuum of ageing. A continuous and well-functioning relationship between the GP and the nurse was crucial for the patients' well-being.},
  articleno    = {111},
  author       = {Borgström-Bolmsjö, Beata and Strandberg, Eva-Lena and Midlöv, Patrik and Brorsson, Annika},
  issn         = {1471-2296},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Family Practice},
  title        = {"It is meaningful; I feel that I can make a difference" -A qualitative study about GPs' experiences of work at nursing homes in Sweden},
  url          = {http://dx.doi.org/10.1186/s12875-015-0326-6},
  volume       = {16},
  year         = {2015},
}