Dizziness in older people: at risk of shared therapeutic nihilism between patient and physician. A qualitative study
| Autor: | Marjanne Wisse, Hanneke Stam, Henriëtte E. van der Horst, Bram Mulder, Otto R. Maarsingh, Johannes C. van der Wouden |
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| Přispěvatelé: | General practice, EMGO - Quality of care |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Activities of daily living General Practice Dizziness Interviews as Topic 03 medical and health sciences 0302 clinical medicine Patient satisfaction Qualitative research Health care Activities of Daily Living Complaint Medicine Humans 030212 general & internal medicine Functional ability Mobility Limitation Aged Aged 80 and over Therapeutic nihilism business.industry 030503 health policy & services Impairment Patient Satisfaction Family medicine Female 0305 other medical science Older people business Family Practice Research Article |
| Zdroj: | BMC Family Practice, 17:74. BioMed Central Stam, H, Wisse, M, Mulder, B, van der Wouden, J C, Maarsingh, O R & van der Horst, H E 2016, ' Dizziness in older people: at risk of shared therapeutic nihilism between patient and physician. A qualitative study ', BMC Family Practice, vol. 17, 74 . https://doi.org/10.1186/s12875-016-0474-3 BMC Family Practice |
| ISSN: | 1471-2296 |
| DOI: | 10.1186/s12875-016-0474-3 |
| Popis: | Background Dizziness-related impairment is a strong predictor for an unfavourable course of dizziness in older people. In this study we explored the experiences of older patients with significant dizziness-related impairment and their wishes and expectations regarding general practitioner (GP) care. Knowing the expectations and priorities of people with dizziness may enable the GP to provide tailor-made care, which in turn may substantially increase the quality of life and decrease the use and costs of health care. Methods We conducted a qualitative study with semi-structured interviews. We selected patients from ten Dutch general practices. Patients were invited to participate in the study if they were ≥ 65 years, visited their GP because of dizziness and were significantly impaired due to dizziness (Dizziness Handicap Inventory ≥ 30). We applied content analysis to the semi-structured interviews. Results Thirteen participants participated, seven were female. Analysis of the interviews resulted in the overall theme “Dizziness in older people: at risk of shared therapeutic nihilism by the patient and the GP”. Firstly, this can explained by the fact that participants frequently presented dizziness as a secondary complaint when they visited the GP for another complaint. Secondly, participants reported that the GP often could not help them with any treatment. Despite a poor therapeutic outcome, the vast majority of participants was satisfied how the GP handled their dizziness. Yet, understanding the cause of dizziness seems important for dizzy older patients. Conclusions Despite significant dizziness-related impairment, older dizzy patients may not present dizziness as main reason for encounter. Presenting dizziness as a secondary complaint may give GPs the - wrong - impression that the dizziness-related impairment is only mild. GPs need to be aware of this potential underreporting. Knowing the cause of dizziness seems important for older patients. Yet, GPs regularly did not succeed in identifying the underlying cause of dizziness. Therefore, GPs should manage the expectations of older dizzy patients regarding diagnosis and successful treatment, by informing them about the uncertainty and unpredictability of dizziness. We also recommend GPs to focus on improving functional ability; this is the key to escape from therapeutic nihilism by the GP. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0474-3) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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