Department of General Practice and Health Services Research, Heidelberg University Hospital, Marsilius Arcades, West Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
BMC Fam Pract. 2021 Nov 26;22(1):238. doi: 10.1186/s12875-021-01584-9.
Patients with multimorbidity (here defined as three or more chronic conditions) require constant treatment and care. Furthermore, they have to manage their health and diseases in daily life. Offering support to patients' medical self-management is an important task of primary care. The aim of this study was to explore, what further support is needed from the perspective of patients' and primary care practitioners.
A qualitative study using individual semi-structed interviews with 17 patients with multimorbidity and 7 practitioners (4 primary care physicians and 3 practice assistants) was conducted in Germany. Data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.
The three broad themes: current status, challenges and further support emerged. Patients reported on unfulfilled needs regarding role or emotional management, like coping with loneliness, loss of independence and, changing habits. The importance of social contact was highlighted by patients and practitioners. Patients articulated further support from their primary care practitioners on coping with the disease. Practitioners' wished for further support in aspects of social participation, public transport, and community resources.
Challenges regarding self-management of elderly patients with multimorbidity may be addressed by harnessing social support and community initiatives.
患有多种慢性疾病（此处定义为三种或更多种慢性疾病）的患者需要持续治疗和护理。此外，他们还必须在日常生活中管理自己的健康和疾病。为患者的医疗自我管理提供支持是初级保健的一项重要任务。本研究旨在从患者和初级保健医生的角度探讨还需要哪些进一步的支持。
在德国进行了一项定性研究，采用个体半结构化访谈，共纳入 17 名患有多种慢性疾病的患者和 7 名从业者（4 名初级保健医生和 3 名实习助理）。数据以音频形式记录、匿名并逐字转录。使用定性内容分析对数据进行分析，将数据结构化为主题和子主题。所有数据均在 MAXQDA 中进行管理和组织。
出现了三个广泛的主题：现状、挑战和进一步的支持。患者报告了在角色或情绪管理方面未得到满足的需求，例如应对孤独、丧失独立性和改变习惯。患者和从业者强调了社会联系的重要性。患者表示希望从初级保健医生那里获得应对疾病的进一步支持。从业者希望在社会参与、公共交通和社区资源方面得到进一步的支持。
可以通过利用社会支持和社区举措来解决老年多病患者自我管理方面的挑战。
