Patient-centeredness in the multimorbid elderly: a focus group study.

Aged Chronic Disease Delivery of Health Care Focus Groups Humans Multimorbidity Patient-Centered Care
Chronic disease Focus group Multimorbidity Older patients Patient-centeredness

Journal

BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548

Informations de publication

Date de publication:
18 10 2021
Historique:
received: 23 04 2021
accepted: 01 09 2021
entrez: 19 10 2021
pubmed: 20 10 2021
medline: 28 10 2021
Statut: epublish

Résumé

Patient-centeredness (PC) aims to adapt health care to the individual needs and preferences of patients. An existing integrative model of PC comprises several dimensions of PC which have not yet been investigated from the patients' perspective. Older patients with multimorbidity represent a target group for patient-centered care, as their care needs are particularly complex and should be addressed individually. We aimed to assess the perspective that older patients with multimorbidity have of patient-centered care and to examine the transferability of the integrative model of PC to this specific population. We performed 4 guided focus group interviews with a total of 20 older individuals with multimorbidity. The focus group interviews were audio-recorded and transcribed verbatim. Patients' statements were content-analyzed applying an a priori designed system of categories that included the dimensions of PC from the integrative model and the additional category 'prognosis and life expectancy', which had emerged from an initial literature search on aspects of PC specific to the multimorbid elderly. The new category 'prognosis and life expectancy' was confirmed and expanded to 'individual care needs related to aging and chronic disesase'. All dimensions of our integrative PC model were confirmed for older patients with multimorbidity. Among these, we found that eight dimensions (individual care needs related to aging and chronic disease, biopsychosocial perspective, clinician-patient communication, essential characteristics of the clinician, clinician-patient-relationship, involvement of family and friends, coordination and continuity of care, access to care) were complemented by aspects specific to this target population. The integrative PC model is applicable to the population of older patients with multimorbidity. For a population-specific adaptation, it might be complemented by the dimension 'individual care needs in aging and chronic disease', in conjunction with age-specific aspects within existing dimensions. Together with corresponding results from a Delphi survey, our adapted PC model will serve as the basis for a subsequent systematic review of instruments measuring PC in older patients with multimorbidity. PROSPERO ( https://www.crd.york.ac.uk/prospero; CRD42018084057; 2018/02/01), German Clinical Trials Register ( www.drks.de ; DRKS00013309; 2018/01/23).

Sections du résumé

BACKGROUND
Patient-centeredness (PC) aims to adapt health care to the individual needs and preferences of patients. An existing integrative model of PC comprises several dimensions of PC which have not yet been investigated from the patients' perspective. Older patients with multimorbidity represent a target group for patient-centered care, as their care needs are particularly complex and should be addressed individually. We aimed to assess the perspective that older patients with multimorbidity have of patient-centered care and to examine the transferability of the integrative model of PC to this specific population.
METHOD
We performed 4 guided focus group interviews with a total of 20 older individuals with multimorbidity. The focus group interviews were audio-recorded and transcribed verbatim. Patients' statements were content-analyzed applying an a priori designed system of categories that included the dimensions of PC from the integrative model and the additional category 'prognosis and life expectancy', which had emerged from an initial literature search on aspects of PC specific to the multimorbid elderly.
RESULTS
The new category 'prognosis and life expectancy' was confirmed and expanded to 'individual care needs related to aging and chronic disesase'. All dimensions of our integrative PC model were confirmed for older patients with multimorbidity. Among these, we found that eight dimensions (individual care needs related to aging and chronic disease, biopsychosocial perspective, clinician-patient communication, essential characteristics of the clinician, clinician-patient-relationship, involvement of family and friends, coordination and continuity of care, access to care) were complemented by aspects specific to this target population.
CONCLUSIONS
The integrative PC model is applicable to the population of older patients with multimorbidity. For a population-specific adaptation, it might be complemented by the dimension 'individual care needs in aging and chronic disease', in conjunction with age-specific aspects within existing dimensions. Together with corresponding results from a Delphi survey, our adapted PC model will serve as the basis for a subsequent systematic review of instruments measuring PC in older patients with multimorbidity.
TRIAL REGISTRATION
PROSPERO ( https://www.crd.york.ac.uk/prospero; CRD42018084057; 2018/02/01), German Clinical Trials Register ( www.drks.de ; DRKS00013309; 2018/01/23).

Identifiants

DOI: 10.1186/s12877-021-02448-8 PMID: 34663223 PMC: PMC8522160
pubmed: 34663223
doi: 10.1186/s12877-021-02448-8
pii: 10.1186/s12877-021-02448-8
pmc: PMC8522160
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

567

Informations de copyright

© 2021. The Author(s).

Références

J Am Board Fam Med. 2011 May-Jun;24(3):229-39
pubmed: 21551394
J Psychosom Res. 2013 Jan;74(1):82-5
pubmed: 23272993
J Am Geriatr Soc. 2012 Oct;60(10):E1-E25
pubmed: 22994865
Gerontologist. 2021 Sep 13;61(7):1008-1018
pubmed: 33388770
J Intern Med. 2019 Mar;285(3):272-288
pubmed: 30357955
J Am Geriatr Soc. 2016 Jan;64(1):15-8
pubmed: 26626262
J Holist Nurs. 2012 Mar;30(1):6-15
pubmed: 21772048
Health Policy. 2018 Jan;122(1):36-43
pubmed: 29129270
Int J Health Plann Manage. 2018 Apr 27;:
pubmed: 29701255
PLoS One. 2014 Sep 17;9(9):e107828
pubmed: 25229640
Med Care Res Rev. 2013 Aug;70(4):351-79
pubmed: 23169897
Risk Manag Healthc Policy. 2016 Jul 05;9:143-56
pubmed: 27462182
BMJ Open. 2020 Feb 5;10(2):e033273
pubmed: 32029488
Lancet. 2012 Jul 7;380(9836):37-43
pubmed: 22579043
J Am Geriatr Soc. 2012 Oct;60(10):1957-68
pubmed: 22994844
Z Evid Fortbild Qual Gesundhwes. 2017 Jun;123-124:46-51
pubmed: 28546055
Patient Educ Couns. 2013 Jan;90(1):54-60
pubmed: 22884411
Patient Educ Couns. 2019 Jan;102(1):3-11
pubmed: 30201221
PLoS One. 2015 Nov 05;10(11):e0141978
pubmed: 26539990
Age Ageing. 2019 May 1;48(3):401-406
pubmed: 30892604
Ochsner J. 2013 Summer;13(2):190-3
pubmed: 23789003
Health Aff (Millwood). 2001 Nov-Dec;20(6):64-78
pubmed: 11816692
Z Gerontol Geriatr. 2010 Oct;43(5):303-9
pubmed: 20821333
BMC Health Serv Res. 2018 Jun 14;18(1):446
pubmed: 29898713
Patient Prefer Adherence. 2013 Oct 23;7:1117-27
pubmed: 24187489
Patient Educ Couns. 2006 May;61(2):200-11
pubmed: 16154311
J Am Geriatr Soc. 2016 Jan;64(1):e8-14
pubmed: 26626544
Soc Sci Med. 2000 Oct;51(7):1087-110
pubmed: 11005395
Qual Health Care. 2001 Sep;10 Suppl 1:i34-8
pubmed: 11533436
Arch Gerontol Geriatr. 2016 Nov-Dec;67:130-8
pubmed: 27500661
Fam Pract. 2008 Aug;25(4):287-93
pubmed: 18628243
Ageing Res Rev. 2011 Sep;10(4):430-9
pubmed: 21402176
J Pain Symptom Manage. 2016 Jan;51(1):33-40
pubmed: 26342727
J Gen Intern Med. 2004 Nov;19(11):1069-79
pubmed: 15566435
Lancet. 2019 Oct 12;394(10206):1365-1375
pubmed: 31609228
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Ann Fam Med. 2017 Nov;15(6):546-551
pubmed: 29133494
Med Care Res Rev. 2011 Aug;68(4):387-420
pubmed: 21813576
Epidemiol Rev. 2013;35:75-83
pubmed: 23372025
BMJ Open. 2019 Dec 23;9(12):e031741
pubmed: 31874875
BMC Health Serv Res. 2019 Jan 8;19(1):13
pubmed: 30621688
Age Ageing. 2017 Nov 1;46(6):882-888
pubmed: 28985248
J Am Acad Nurse Pract. 2008 Dec;20(12):600-7
pubmed: 19120591
Patient Educ Couns. 2011 Oct;85(1):46-52
pubmed: 20801601
Lancet. 2018 Jul 7;392(10141):41-50
pubmed: 29961638
Health Policy. 2018 Jan;122(1):4-11
pubmed: 28967492
J Psychosom Res. 2016 Jul;86:28-33
pubmed: 27302543
Cochrane Database Syst Rev. 2012 Dec 12;12:CD003267
pubmed: 23235595

Auteurs

Manuela Kanat (M)

Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany.

Jonas Schaefer (J)

Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany. jonas.schaefer@uniklinik-freiburg.de.

Laura Kivelitz (L)

Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.

Jörg Dirmaier (J)

Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.

Sebastian Voigt-Radloff (S)

Center for Geriatric Medicine and Gerontology Freiburg, Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine and Medical Center - University of Freiburg, Breisacher Str. 86, 79110, Freiburg, Germany.

Bernhard Heimbach (B)

Center for Geriatric Medicine and Gerontology Freiburg, Faculty of Medicine and Medical Center - University of Freiburg, Lehener Str. 88, 79106, Freiburg, Germany.

Manuela Glattacker (M)

Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Patient-centeredness in the multimorbid...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie chronique › Patient-centeredness in the multimorbid...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Patient-centeredness in the multimorbid...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Groupes de discussion › Patient-centeredness in the multimorbid...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Patient-centeredness in the multimorbid...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Comorbidité › Multimorbidité › Patient-centeredness in the multimorbid...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Soins centrés sur le patient › Patient-centeredness in the multimorbid...