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How general practitioners perceive the aging trajectory of oldest-old - A qualitative study

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Název: How general practitioners perceive the aging trajectory of oldest-old - A qualitative study
Autoři: Escourrou, Emile, Joyeux, Thomas, Guilhem, Matthieu, Oustric, Stéphane, Gardette, Virginie
Přispěvatelé: Maison de Santé Pluriprofessionnelle universitaire La Providence (MSPU), Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Toulouse (UT), Equipe AGING (CERPOP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Service Epidémiologie clinique et santé publique CHU Toulouse, Pôle Santé publique et médecine publique CHU Toulouse, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Zdroj: ISSN: 2731-4553 ; BMC Primary Care ; https://ut3-toulouseinp.hal.science/hal-04814708 ; BMC Primary Care, 2023, 24 (1), pp.5. ⟨10.1186/s12875-023-01964-3⟩.
Informace o vydavateli: CCSD
Springer Nature
Rok vydání: 2023
Sbírka: Université Toulouse III - Paul Sabatier: HAL-UPS
Témata: Age 80 and over, Aging, General practice, Independent living, Longevity, Qualitative research, MESH: Humans, MESH: Aged, 80 and over, MESH: General Practitioners, MESH: Qualitative Research, MESH: Aging, MESH: Focus Groups, MESH: Delivery of Health Care, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Popis: International audience ; Background A new population of older people is growing: the oldest-old. The care of the oldest-old (individuals aged 90 and over) is a new challenge in primary care. This study aimed to analyze the perception of General Practitioners (GP) on (1) the aging process of their patients up to a very advanced age, (2) how to adapt their practice to the care of these patients. Methods We conducted a qualitative study using focus group (face to face) and individual (video call) interviews of GPs in southwest France. The sampling was purposive. We analyzed the interviews using an inductive approach based on the phases of thematic analysis. We used researchers’ triangulation during the process. Collection was concluded when saturation was reached. Results Three focus groups and one individual interview were conducted with a total of seventeen general practitioners. GP perception concerning aging and very advanced age were based on their personal experience and their daily clinical practice. Aging was perceived as an individual, unconscious, unpredictable and irreversible phenomenon. The shift towards “very old age” appeared inevitable. It could be a physical or psychological shift, or patients neglecting themselves or lacking a project. The care of the oldest-old became more specific and individual, adapted to the wishes of the patient. Those adaptations involve medical disengagement to focus on the most essential outcomes. The objectives of health care needed to be less strict with limited invasive practices. Prevention needed to focus mainly on prevention of falls and limitation of functional decline. Conclusion GPs identified an inevitable and unpredictable shift from old age to very old age. The adaption of the theory of disengagement allowed us to identify a medical disengagement of the GPs in the care of their oldest patients.
Druh dokumentu: article in journal/newspaper
Jazyk: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36624382; PUBMED: 36624382; PUBMEDCENTRAL: PMC9829226
DOI: 10.1186/s12875-023-01964-3
Dostupnost: https://ut3-toulouseinp.hal.science/hal-04814708
https://ut3-toulouseinp.hal.science/hal-04814708v1/document
https://ut3-toulouseinp.hal.science/hal-04814708v1/file/Escourrou_2023.pdf
https://doi.org/10.1186/s12875-023-01964-3
Rights: http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess
Přístupové číslo: edsbas.FDDDC4A6
Databáze: BASE
Popis
Abstrakt:International audience ; Background A new population of older people is growing: the oldest-old. The care of the oldest-old (individuals aged 90 and over) is a new challenge in primary care. This study aimed to analyze the perception of General Practitioners (GP) on (1) the aging process of their patients up to a very advanced age, (2) how to adapt their practice to the care of these patients. Methods We conducted a qualitative study using focus group (face to face) and individual (video call) interviews of GPs in southwest France. The sampling was purposive. We analyzed the interviews using an inductive approach based on the phases of thematic analysis. We used researchers’ triangulation during the process. Collection was concluded when saturation was reached. Results Three focus groups and one individual interview were conducted with a total of seventeen general practitioners. GP perception concerning aging and very advanced age were based on their personal experience and their daily clinical practice. Aging was perceived as an individual, unconscious, unpredictable and irreversible phenomenon. The shift towards “very old age” appeared inevitable. It could be a physical or psychological shift, or patients neglecting themselves or lacking a project. The care of the oldest-old became more specific and individual, adapted to the wishes of the patient. Those adaptations involve medical disengagement to focus on the most essential outcomes. The objectives of health care needed to be less strict with limited invasive practices. Prevention needed to focus mainly on prevention of falls and limitation of functional decline. Conclusion GPs identified an inevitable and unpredictable shift from old age to very old age. The adaption of the theory of disengagement allowed us to identify a medical disengagement of the GPs in the care of their oldest patients.
DOI:10.1186/s12875-023-01964-3