Abstract:
OBJECTIVE:This paper investigated patients' experiences of disease and self-care as well as perceptions of the general practitioner's role in supporting patients with impaired self-care ability. DESIGN:Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care ability assessed by a general practitioner. We analyzed our data using systematic text condensation. The shifting perspectives model of chronic illness formed the theoretical background for the study. RESULTS:Although most patients experienced challenges in adhering to recommended self-care activities, many had developed additional, personal self-care routines that increased wellbeing. Some patients were conscious of self-care trade-offs, including patients with concurrent mental disorders who were much more attentive to their mental disorder than their somatic diseases. Patients' perspectives on diseases could shift over time and were dominated by emotional considerations such as insisting on leading a normal life or struggling with limitations caused by disease. Most patients found support in the ongoing relationship with the same general practitioner, who was valued as a companion or appreciated as a trustworthy health informant. CONCLUSION:Patient experiences of self-care may collide with what general practitioners find appropriate in a medical regimen. Health professionals should be aware of patients' prominent and shifting considerations about the emotional aspects of disease. Patients valued the general practitioner's role in self-care support, primarily through the long-term doctor-patient relationship. Therefore, relational continuity should be prioritized in chronic care, especially for patients with impaired self-care ability who often have a highly complex disease burden and situational context. Key points Little is known about the perspectives of disease and self-care in patients with a doctor-assessed impaired ability of self-care. • Although patients knew the prescribed regimen they often prioritized self-care routines that increased well-being at the cost of medical recommendations. • Shifting emotional aspects were prominent in patients' considerations of disease and sustained GPs' use of a patient-centred clinical method when discussing self-care. • Relational continuity with general practitioners was a highly valued support and should be prioritized for patients with impaired self-care.
journal_name
Scand J Prim Health Carejournal_title
Scandinavian journal of primary health careauthors
Kristensen MAT,Guassora AD,Arreskov AB,Waldorff FB,Hølge-Hazelton Bdoi
10.1080/02813432.2018.1487436subject
Has Abstractpub_date
2018-09-01 00:00:00pages
342-351issue
3eissn
0281-3432issn
1502-7724journal_volume
36pub_type
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439408997056
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to describe patients' experience of yoga as a treatment for hypertension, as well as their experience of living with hypertension. DESIGN:Qualitative interview study Method and materials: In 2013-2014, in southern Sweden, patients with hypertension from three health care centres were...
journal_title:Scandinavian journal of primary health care
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更新日期:2017-12-01 00:00:00
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journal_title:Scandinavian journal of primary health care
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更新日期:1987-05-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2015.1117283
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To assess the incidence of whiplash associated disorders (WAD) after minor whiplash injuries in car accidents. DESIGN:A cohort defined by means of a health-care-based registration of traffic injuries and followed up by postal questionnaire after 12 months. SETTING:Primary and hospital care in a Swedish midd...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134300453359
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To study changes in Finnish GPs' child-psychiatric networks over a one-year period. DESIGN:Postal questionnaire. SETTING:Health centres in the area of Tampere University Hospital with a catchment population of one million. INTERVENTION:A one-off course in the field of child psychiatry was held 56 times in ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430510018374
更新日期:2005-03-01 00:00:00
abstract::In Iceland a problem oriented medical record system for primary health care has been developed. A contact-form is used to record data on all contacts between the inhabitants in a district and the health center. A minicomputer is used for retrieval and analysis. One rural health center using this system has been succes...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438409017714
更新日期:1984-11-01 00:00:00
abstract::The aim of the study was to describe and evaluate a controlled intervention to achieve more rational and economical drug therapy in general practice. The strategy was based on peer comparison feedback and encouragement of local peer group discussions. Seven districts comprising 53, and 6 districts comprising 55 eligib...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439209014040
更新日期:1992-03-01 00:00:00
abstract::A Regional Health University is planned at the University of Linköping, Sweden. To evaluate new educational principles, a trial project was carried out in which medical and nursing students trained together in a two-week full-time course aimed at patient-oriented clinical social medicine and epidemiological field work...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438509013940
更新日期:1985-09-01 00:00:00
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journal_title:Scandinavian journal of primary health care
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doi:10.3109/02813438509013957
更新日期:1985-11-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/02813430410000941
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to gain a deeper knowledge and understanding of experiences of antihypertensive drug treatment. DESIGN:Interview study. SETTING:A primary health care centre in western Sweden. METHOD:Qualitative interviews and analyses through systematic text condensation described by Malter...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2014.982365
更新日期:2014-12-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2014.915132
更新日期:2014-06-01 00:00:00
abstract::Ninety-three percent of all problems and complaints reported by patients aged 21 and older to their family physician dealt with somatic disorders, and only 7% with psychosocial problems. Psychological complaints were evenly distributed among major age groups, and between male and female patients. "Social problems" pea...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438809009294
更新日期:1988-05-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430310000555
更新日期:2003-03-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438409017717
更新日期:1984-11-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1080/02813430310003543
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:Sputum colour plays an important role in the disease concepts for acute cough, both in the patients' and the doctors' view. However, it is unclear whether the sputum colour can be used for diagnosis of a bacterial infection. DESIGN:Cross-sectional study. SETTING:A total of 42 GP practices in Dusseldorf, Ger...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430902759663
更新日期:2009-01-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
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更新日期:2007-09-01 00:00:00
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doi:10.3109/02813439608997089
更新日期:1996-12-01 00:00:00
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journal_title:Scandinavian journal of primary health care
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更新日期:1999-06-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813432.2018.1487377
更新日期:2018-09-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439008994960
更新日期:1990-12-01 00:00:00
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journal_title:Scandinavian journal of primary health care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.3109/02813439308994908
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:For general practitioners (GPs) dizziness is a challenging condition to deal with. Data on the management of dizziness in older patients are mostly lacking. Furthermore, it is unknown whether GPs attempt to decrease Fall Risk Increasing Drugs (FRIDs) use in the management of dizziness in older patients. The a...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2016.1160634
更新日期:2016-06-01 00:00:00
abstract::Some general ideas of the evaluation of the work of the physician applicable also to primary care physicians are taken up in this article. The presentation is not trying to be a complete review of the topic. It tries, however, to direct attention to the importance of the subject from the point of view of the practisin...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438309038480
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:To investigate daytime sleepiness and napping in relation to nocturnal sleep, health, and medication. DESIGN:An epidemiological survey using a questionnaire. SETTING:The county of Jämtland in northern Sweden. SUBJECTS:3669 randomly selected women aged 40-64 years, with a similar number of women in each 5-y...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134398750003278
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To determine how often patients with musculoskeletal (MSK) complaints prescribed a non-steroidal anti-inflammatory drug (NSAID) subsequently consult their general practitioner (GP) with a non-serious adverse drug reaction (ADR). DESIGN:Cohort study. SETTING:A healthcare database containing the electronic GP...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2015.1067513
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To develop a group-based treatment programme in primary health care for women with chronic muscle pain, and adjust programme development according to experiences obtained by the participating women and health personnel. The aim of the programme was to help the women develop a tool for handling their chronic s...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430152706783
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:To examine the access, workload, duties, commitments and quality standards of primary care physicians (GPs) resulting from out-of-hours service. SETTING:All GPs (n = 96) in rural Iceland. MAIN OUTCOME MEASURES:Answers to a postal survey. RESULTS:The participation rate was 80%. The GPs estimated that in 97...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134300750018945
更新日期:2000-06-01 00:00:00