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Multimorbidität aus Hausarzt- und Patientensicht

Qualitative Studie

Approaches of general practitioners and patients to multimorbidity

Qualitative study

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Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Für Hausärzte ist die Betreuung von Patienten mit Multimorbidität eine alltägliche Herausforderung. Leitlinien, die jeweils nur einzelne Erkrankungen im Fokus haben, können hier nicht umfassend und „gleichberechtigt“ Anwendung finden. Stattdessen müssen Prioritäten gesetzt werden.

Fragestellung

Vor diesem Hintergrund wird herausgearbeitet, wie Hausärzte und ihre Patienten diesen Herausforderungen begegnen und welche Prioritäten sie jeweils setzen.

Material und Methoden

Neun Hausärzte und 19 ihrer Patienten mit Multimorbidität wurden narrativ interviewt. Die Analyse erfolgte inhaltsanalytisch.

Ergebnisse

Die Mehrzahl der interviewten Patienten fühlte sich durch ihren Hausarzt gut oder sehr gut betreut. Dennoch stellten sich die Prioritäten der Hausärzte und die ihrer Patienten häufig unterschiedlich dar. Während die Ärzte die meiste Energie auf das Management von Erkrankungen verwendeten, die zu potenziell lebensbedrohlichen Situationen führen können, stand bei den Patienten der unmittelbare Erhalt von Autonomie und sozialem Miteinander im Vordergrund.

Diskussion

Die Ergebnisse der Studie legen den Schluss nahe, dass die Kommunikation zwischen Hausärzten und ihren Patienten gerade in Bezug auf einen gemeinsamen Prozess der Prioritätensetzung bei Multimorbidität weiterentwickelt werden kann.

Abstract

Background

For general practioners (GP) the treatment of patients suffering from multimorbidity is an everyday challenge. For these patients guidelines which each focus on a specific chronic disease cannot be applied comprehensively and equally; therefore, it is necessary to prioritize.

Objective

Given this situation the study aimed at analyzing how GPs and patients deal with this challenge and what their priorities are.

Material and methods

Narrative interviews were conducted with 9 GPs and 19 of their multimorbid patients. The data were analyzed by means of content analysis.

Results

The majority of interviewed patients felt well or very well cared for by their GPs; however, GPs and multimorbid patients often had relatively different priorities. Whereas GPs mostly focused on the management of diseases that could lead to life-threatening situations, patients put an emphasis on maintaining autonomy and a social life.

Conclusion

The results of this study suggest that there is room for development in the way GPs and multimorbid patients communicate with each other, particularly as far as shared priority setting is concerned.

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Notes

  1. Städtenamen wurden pseudonymisiert.

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Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Löffler, A. Altiner, W. Streich, C.-O. Stolzenbach, A. Fuchs, E. Drewelow, A. Hornung, G. Feldmeier, H. van den Bussche und H. Kaduszkiewicz geben an, dass keine Interessenskonflikte bestehen.

Dieses Projekt wurde vom Bundesministerium für Bildung und Forschung gefördert (Förderkennzeichen 01ET0725 und 01ET0727; Votum der Ethikkommission Nr. PV3091). Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Institut für Allgemeinmedizin, Universitätsmedizin Rostock, Postfach 100888, 18055, Rostock, Deutschland

    Christin Löffler Ph.D.,  Attila Altiner, Eva Drewelow MSc, Anne Hornung MSc &  Gregor Feldmeier

  2. Institut für Allgemeinmedizin, Heinrich-Heine-Universität, Düsseldorf, Deutschland

    Waldemar Streich &  Angela Fuchs

  3. Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Carl-Otto Stolzenbach &  Hendrik van den Bussche

  4. Institut für Allgemeinmedizin, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland

    Hanna Kaduszkiewicz

Authors
  1. Christin Löffler Ph.D.
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  2. Attila Altiner
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  3. Waldemar Streich
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  4. Carl-Otto Stolzenbach
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  5. Angela Fuchs
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  6. Eva Drewelow MSc
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  7. Anne Hornung MSc
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  8. Gregor Feldmeier
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  9. Hendrik van den Bussche
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  10. Hanna Kaduszkiewicz
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Corresponding author

Correspondence to Christin Löffler Ph.D..

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Löffler, C., Altiner, A., Streich, W. et al. Multimorbidität aus Hausarzt- und Patientensicht. Z Gerontol Geriat 48, 452–456 (2015). https://doi.org/10.1007/s00391-014-0820-9

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  • DOI: https://doi.org/10.1007/s00391-014-0820-9

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