ArticleBMC family practice2009
Family physicians' effort to stay in charge of the medical treatment when patients have home care by district nurses. A grounded theory study.
Article in BMC family practice, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The voice of the self: a typology of general practitioners' emotional responses to situational and contextual stressors.Scandinavian journal of primary health care · 2022Article
- GPs' decisions about prescribing end-of-life anticipatory medications: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- The use of model constructs to design collaborative health information technologies: A case study to support child development.Journal of biomedical informatics · 2018Article
- Physical and mental health of homebound older adults: an overlooked population.Journal of the American Geriatrics Society · 2010Review
- Family physicians' experiences when collaborating with district nurses in home care-based medical treatment. A grounded theory study.BMC family practice · 2010Article
- Watchfully checking rapport with the Primary Child Health Care nurses - a theoretical model from the perspective of parents of foreign origin.BMC nursing · 2010Article
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Authors and funding
4 authors.
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Abstract
backgroundDistrict nurses (DNs) provide home care for old persons with a mixture of chronic diseases, symptoms and reduced functional ability. Family physicians (FPs) have been criticised for their lack of involvement in this care. The aim of this study was to obtain increased knowledge concerning the FP's experience of providing medical treatment for patients with home care provided by DNs by developing a theoretical model that elucidates how FPs handle the problems they encounter regarding the individual patients and their conditions.
methodsSemi-structured interviews were conducted with 13 Swedish FPs concerning one of their registered patients with home care by a DN, and the treatment of this patient. Grounded theory methodology (GTM) was used in the analyses.
resultsThe core category was the effort to stay in charge of the medical treatment. This involved three types of problems: gaining sufficient insight, making adequate decisions, and maintaining appropriate medical treatment. For three categories of patients, the FPs had problems staying in charge. Patients with reduced functional ability had problems providing information and maintaining treatment. Patients who were "fixed in their ways" did not provide information and did not comply with recommendations, and for patients with complex conditions, making adequate decisions could be problematic. To overcome the problems, four different strategies were used: relying on information from others, supporting close observation and follow-up by others, being constantly ready to change the goal of the treatment, and relying on others to provide treatment.
conclusionThe patients in this study differed from most other patients seen at the healthcare centre as the consultation with the patient could not provide the usual foundation for decisions concerning medical treatment. Information from and collaboration with the DN and other home care providers was essential for the FP's effort to stay in charge of the medical treatment. The complexity of the situation made it problematic for the FP to make adequate decisions about the goal of the medical treatment. The goal of the treatment had to be constantly evaluated based on information from the DN and other care providers, and thus this information was absolutely crucial.
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