Abstract:
BACKGROUND:Multimorbidity poses a challenge for decision-making processes and requires that more attention is paid to patient goals, preferences and needs; however, goal setting is not yet widely recognised as a core aspect of the shared decision-making (SDM) approach. This study aims to analyse clinician perceptions of the concept of goal setting within the context of SDM with older patients with multimorbidity. METHODS:Semi-structured interviews with general practitioners (GPs) and clinical geriatricians (CGs) were analysed using a framework analysis. The integrative model of SDM was used to develop a categorisation matrix, including goal setting as an additional component. RESULTS:Sixteen of the 33 clinicians mentioned explicit Goal setting as an integrated component of their definition of SDM, which was comparable to the number of clinicians who listed Patient values and preferences (n = 16), Doctor knowledge and recommendations (n = 19) and Make or explicitly defer a decision (n = 19), elements which are commonly considered to be important aspects of SDM. The other 17 clinicians (6 CGs and 11 GPs) did not mention Goal setting as an explicit component of SDM. Our analysis revealed two potential reasons for this observation. Besides the use of other terminology, part of clinicians viewed collaborative goal setting and SDM as separate but related processes. CONCLUSIONS:Our study on clinician perspectives highlighted goal setting as component of a SDM approach and could therefore be considered supportive of recent theoretical insights that SDM models that lack an explicit goal-setting component appear to be deficient and overlook an important aspect of engaging patients in decision-making, particularly for patients with complex multimorbidities. We therefore call for the further development of a comprehensive SDM approach for older patients with multimorbidity to include explicit and unequivocal goal setting elements to sufficiently meet the expectations and needs of clinicians and their patients.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Vermunt N,Elwyn G,Westert G,Harmsen M,Olde Rikkert M,Meinders Mdoi
10.1186/s12875-019-0966-zsubject
Has Abstractpub_date
2019-06-06 00:00:00pages
76issue
1issn
1471-2296pii
10.1186/s12875-019-0966-zjournal_volume
20pub_type
杂志文章abstract:BACKGROUND:Cluster randomized controlled trials are often used in research in primary care but creates challenges regarding biases and confounders. We recently presented a study on low back pain from primary care in Norway with equal effects in the intervention and the control group. In order to understand the specific...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-018-0759-9
更新日期:2018-05-22 00:00:00
abstract:BACKGROUND:Since Huntington's Disease (HD) is a familial disease with an average onset in the mid-thirties, one might expect that spousal carers are concerned with providing care for off-spring who may turn out to be affected. METHODS:This study involved ten face-to-face interviews with carers of spouses affected by H...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-38
更新日期:2005-09-14 00:00:00
abstract:BACKGROUND:Comorbid chronic pain and depression is a challenging dyad of conditions to manage in primary care and reporting has shown to vary by ethnic group. Whether the relationship between depression and chronic pain varies by ethnicity is unclear. This study aims to explore chronic pain and depression reporting acr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0343-5
更新日期:2015-10-06 00:00:00
abstract:BACKGROUND:Smoking rates among the general population in Bosnia and Herzegovina are extremely high, and national campaigns to lower smoking rates have not yet begun. As part of future activities of the Queen's University Family Medicine Development Program in the Balkans Region, technical assistance may be provided to ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-5-12
更新日期:2004-06-11 00:00:00
abstract:BACKGROUND:After hours general practice clinics provide medical attention for clients with non-emergency situations but are seeking immediate treatment and unable to wait for a general practitioner during routine opening hours. Evidence on the impact that after hours clinics have on emergency department presentations i...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0657-6
更新日期:2017-09-11 00:00:00
abstract:BACKGROUND:Self-management support is widely accepted for the management of chronic conditions. Self-management often requires behaviour change in patients, in which primary care nurses play a pivotal role. To support patients in changing their behaviour, the structured behaviour change Activate intervention was develo...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-018-0888-1
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Organisational problems contribute to many errors in healthcare delivery. Our objective was to identify the most important organisational items in primary care which could be targeted by programs to improve patient safety. METHODS:A web-based survey was undertaken in an international panel of 65 experts on ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-145
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:General practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse). However, little is known about the ways in which they proceed. The aim of this study is to analyze GPs' management and patterns of referral to other health pr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01203-z
更新日期:2020-07-02 00:00:00
abstract:BACKGROUND:Acceptance to a family practice is key to access and continuity of care. While Canadian patients increasingly report not being able to acquire acceptance to a family practice, little is known about the association between requiring opioids and acceptance. We aim to determine the proportion of family physicia...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-1027-3
更新日期:2019-10-23 00:00:00
abstract:BACKGROUND:The prevalence of childhood obesity is rising and the UK Government have stated a commitment to addressing obesity in general. One method has been to include indicators relating to obesity within the GP pay-for-performance Quality and Outcomes Framework (QOF) contract. This study aimed to explore general pra...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-50
更新日期:2007-09-03 00:00:00
abstract:BACKGROUND:The general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about wei...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-9-58
更新日期:2008-10-14 00:00:00
abstract:BACKGROUND:Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in the UK and the assessment and diagnosis pathway often involves a general practitioner (GP) referral to secondary care services. GPs' levels of knowledge and understanding about ADHD is often a significant barrier in patients accessing care....
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01289-5
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Despite evidence supporting the effectiveness of alcohol screening and brief advice to reduce heavy drinking, implementation in primary healthcare remains limited. The challenges that clinicians experience when delivering such interventions are well-known, but we have little understanding of the patient pers...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01142-9
更新日期:2020-04-22 00:00:00
abstract:BACKGROUND:For people with hearing loss, the General Practitioner (GP) can play an instrumental role in early detection of hearing loss as well as guiding appropriate and timely choices for addressing hearing concerns. The aim of this study was to generate a conceptual framework for understanding the role of the GP in ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01157-2
更新日期:2020-05-14 00:00:00
abstract:BACKGROUND:Increasing physical activity is a cornerstone in the treatment of type 2 diabetes and in general practice it is a challenge to achieve long-term adherence to this life style change. The aim of this study was to investigate in a non-randomised design whether the introduction of motivational interviewing combi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-83
更新日期:2010-11-03 00:00:00
abstract:BACKGROUND:Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01330-7
更新日期:2020-12-05 00:00:00
abstract:BACKGROUND:As in other countries, there is concern and some fragmentary evidence that GPs' central role in the Swiss healthcare system as the primary provider of care might be changing or even be in decline. Our study gives a systematic account of GPs' involvement in accident care from 2008 to 2016 and identifies chang...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01170-5
更新日期:2020-06-05 00:00:00
abstract:BACKGROUND:This study evaluated the impact of multifaceted NPS MedicineWise programs that targeted all general practitioners (GPs) in Australia in 2009 and 2015 with the aim of reducing unnecessary prescribing of proton pump inhibitors (PPIs) and encouraged stepping down to a lower strength PPI or to discontinue treatm...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01158-1
更新日期:2020-05-09 00:00:00
abstract:BACKGROUND:Frailty is a condition of increasing importance, given the aging adult population. With an anticipated shortage of geriatricians, primary care physicians will increasingly need to manage care for frail adults with complex functional risks and social-economic circumstances. METHODS:We used cross-sectional da...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0851-1
更新日期:2018-10-19 00:00:00
abstract:BACKGROUND:A well-functioning general practice sector that has a strong research component is recognised as a key foundation of any modern health system. General practitioners (GPs) are more likely to collaborate in research if they are part of an established research network. The primary aims of this study are to desc...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1100-y
更新日期:2020-02-05 00:00:00
abstract:BACKGROUND:People use a variety of means to find health information, including searching the Internet, seeking print sources, and talking to healthcare providers, family members, and friends. Doctors are considered the most trusted source of health information, but people may be underutilizing them in favor of searchin...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0805-7
更新日期:2018-08-29 00:00:00
abstract:BACKGROUND:Survivers of stroke or transient ischaemic attacks (TIA) are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and pat...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-47
更新日期:2010-06-15 00:00:00
abstract:BACKGROUND:Many western countries are facing an existing or imminent shortage of primary care physicians especially in rural areas. In Germany, working in rural areas is often thought to be associated with more working hours, a higher number of patients and a lower income than working in urban areas. These perceptions ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-112
更新日期:2011-10-11 00:00:00
abstract:BACKGROUND:During an influenza epidemic prompt diagnosis of influenza is important. This diagnosis however is still essentially based on the interpretation of symptoms and signs by general practitioners. No single symptom is specific enough to be useful in differentiating influenza from other respiratory infections. Ou...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-4
更新日期:2011-02-09 00:00:00
abstract:BACKGROUND:Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0773-y
更新日期:2018-06-19 00:00:00
abstract:BACKGROUND:A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops. METHODS:Twenty-nine practices were randomly allocated to one of thre...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-9-22
更新日期:2008-04-20 00:00:00
abstract:BACKGROUND:Over three-quarters of all suicides are men (England and Wales), this is despite higher levels of anxiety and depression being reported by women. This disparity may in part be explained by atypical presentations of distress in men, and gendered issues around help-seeking. Consequently, the Atlas Men's Well-b...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0410-6
更新日期:2016-02-02 00:00:00
abstract:BACKGROUND:The way GPs work does not appear to be adapted to the needs of depressive patients. Therefore we wanted to examine Swedish GPs' conceptions of depressive disorders and their treatment and GPs' ideas of factors that may influence their manner of work with depressive patients. METHODS:A postal questionnaire t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-21
更新日期:2005-05-16 00:00:00
abstract:BACKGROUND:There is increasing focus on patient-centred communicative approaches in medical consultations, but few studies have shown the extent to which patients' positive coping strategies and psychological assets are addressed by general practitioners (GPs) on a regular day at the office. This study measures the fre...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-49
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Guidelines for primary prevention of cardiovascular disease provide little guidance on how patients' preferences should be taken into account. We wanted to explore whether general practitioners (GPs) are sensitive to patient preferences regarding survival gains from statin therapy. METHODS:In a cross sectio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0288-8
更新日期:2015-07-03 00:00:00