Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, South-Holland, Netherlands
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, South-Holland, Netherlands.
BMJ Open. 2024 Sep 25;14(9):e083367. doi: 10.1136/bmjopen-2023-083367.
Given the growing population of older persons, medical students need to develop an appropriate professional identity to comply with older persons' healthcare needs. In this study, we explored the needs and expectations of older persons regarding their doctor to gain more insight into the characteristics of this professional identity.
A qualitative study based on a constructivist research paradigm was conducted, based on individual semistructured, in-depth interviews using a letter as a prompt, and focus groups. Thematic analysis was applied to structure and interpret the data.
Our study population consisted of older persons, aged 65 years and above, living at home in the South-West of the Netherlands, with no apparent cognitive or hearing problems and sufficient understanding of the Dutch language to participate in writing, talking and reflecting. The in-depth interviews took place at the participant's home or the Leiden University Medical Center (LUMC), and the focus groups were held at the LUMC.
The older persons shared and reflected on what they need and expect from the doctor who takes care of them. Four major themes were identified: (1) personal attention, (2) equality, (3) clarity and (4) reasons why.
Increasing complexity, dependency and vulnerability that arise at an older age, make it essential that a doctor is familiar with the older person's social context, interacts respectfully and on the basis of equality, provides continuity of care and gives clarity and perspective. To this end, the doctor has to be caring, involved, patient, honest and self-aware. Participation in a community of practice that provides the context of older persons' healthcare may help medical students develop a professional identity that is appropriate for this care.
鉴于老年人口的不断增长，医学生需要形成适当的职业认同感，以满足老年人的医疗保健需求。本研究旨在探讨老年人对医生的需求和期望，以更深入地了解这种职业认同感的特征。
本研究基于建构主义研究范式，采用个体半结构化深入访谈，以信件作为提示，并进行焦点小组讨论。采用主题分析对数据进行结构和解释。
我们的研究人群包括居住在荷兰西南部、年龄在 65 岁及以上、没有明显认知或听力问题且对荷兰语有足够理解能力以参与写作、交谈和反思的老年人。深入访谈在参与者的家中或莱顿大学医学中心（LUMC）进行，焦点小组在 LUMC 举行。
老年人分享并反思了他们对照顾他们的医生的需求和期望。确定了四个主要主题：（1）个人关注，（2）平等，（3）清晰，（4）原因。
老年人年龄增长带来的复杂性、依赖性和脆弱性增加，使医生熟悉老年人的社会背景、以尊重和平等为基础进行互动、提供连续性护理以及提供清晰度和视角变得至关重要。为此，医生必须有爱心、投入、耐心、诚实和有自我意识。参与提供老年人医疗保健背景的实践共同体可能有助于医学生形成适合这种护理的职业认同感。
