General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study
Abstract Background Patients with type 2 diabetes mellitus (T2DM) with poor glycaemic control can represent a challenge from the perspective of the general practitioner (GP). Apart from patient-sided factors, the understanding of GPs’ attitudes may provide ideas for improved management in these pati...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-05-01
|
| Series: | BMC Family Practice |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12875-018-0751-4 |
| _version_ | 1811228129643986944 |
|---|---|
| author | Anja Wollny Michael Pentzek Oliver Rudolf Herber Heinz-Harald Abholz Jürgen in der Schmitten Andrea Icks Stefan Wilm Elisabeth Gummersbach |
| author_facet | Anja Wollny Michael Pentzek Oliver Rudolf Herber Heinz-Harald Abholz Jürgen in der Schmitten Andrea Icks Stefan Wilm Elisabeth Gummersbach |
| author_sort | Anja Wollny |
| collection | DOAJ |
| description | Abstract Background Patients with type 2 diabetes mellitus (T2DM) with poor glycaemic control can represent a challenge from the perspective of the general practitioner (GP). Apart from patient-sided factors, the understanding of GPs’ attitudes may provide ideas for improved management in these patients. The aim of this study is to reveal attitudes of GPs towards T2DM patients with poor metabolic control. Methods Qualitative research in German general practice; 20 GPs, randomly chosen from participants of a larger study; in-depth narrative interviews, audio-recorded and transcribed; inductive coding and categorisation in a multi-professional team; abstraction of major themes in terms of attitudinal responses. Results 1) Orientation on laboratory parameters: GPs see it as their medical responsibility to achieve targets, which instil a sense of security. 2) Resignation: GPs believe their efforts are in vain and see their role as being undermined. 3) Devaluation of the patient: GPs blame the “non-compliance” of the patients and experience care as a series of conflicts. 4) Fixed role structure: The expert GP on the one hand, the ignorant patient on the other. 5) Solidarity with the patient: GPs appreciate a doctor-patient relationship in terms of partnership. Conclusions The conflict GPs experience between their sense of duty and feelings of futility may lead to perceptions such as personal defeat and insecurity. GPs (and patients) may benefit from adjusting the patient-doctor relationship with regard to shared definitions of realistic and authentic goals. |
| first_indexed | 2024-04-12T09:53:22Z |
| format | Article |
| id | doaj.art-83a03290d7cf49babb61824b0fe20de1 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-12T09:53:22Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-83a03290d7cf49babb61824b0fe20de12022-12-22T03:37:47ZengBMCBMC Family Practice1471-22962018-05-011911710.1186/s12875-018-0751-4General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative studyAnja Wollny0Michael Pentzek1Oliver Rudolf Herber2Heinz-Harald Abholz3Jürgen in der Schmitten4Andrea Icks5Stefan Wilm6Elisabeth Gummersbach7Institute of General Practice, University Medical Center RostockInstitute of General Practice (ifam), Medical Faculty, Heinrich-Heine University DüsseldorfInstitute of General Practice (ifam), Medical Faculty, Heinrich-Heine University DüsseldorfInstitute of General Practice (ifam), Medical Faculty, Heinrich-Heine University DüsseldorfInstitute of General Practice (ifam), Medical Faculty, Heinrich-Heine University DüsseldorfInstitute for Health Services Research and Health Economics, Medical Faculty, Heinrich-Heine University DüsseldorfInstitute of General Practice (ifam), Medical Faculty, Heinrich-Heine University DüsseldorfInstitute of General Practice (ifam), Medical Faculty, Heinrich-Heine University DüsseldorfAbstract Background Patients with type 2 diabetes mellitus (T2DM) with poor glycaemic control can represent a challenge from the perspective of the general practitioner (GP). Apart from patient-sided factors, the understanding of GPs’ attitudes may provide ideas for improved management in these patients. The aim of this study is to reveal attitudes of GPs towards T2DM patients with poor metabolic control. Methods Qualitative research in German general practice; 20 GPs, randomly chosen from participants of a larger study; in-depth narrative interviews, audio-recorded and transcribed; inductive coding and categorisation in a multi-professional team; abstraction of major themes in terms of attitudinal responses. Results 1) Orientation on laboratory parameters: GPs see it as their medical responsibility to achieve targets, which instil a sense of security. 2) Resignation: GPs believe their efforts are in vain and see their role as being undermined. 3) Devaluation of the patient: GPs blame the “non-compliance” of the patients and experience care as a series of conflicts. 4) Fixed role structure: The expert GP on the one hand, the ignorant patient on the other. 5) Solidarity with the patient: GPs appreciate a doctor-patient relationship in terms of partnership. Conclusions The conflict GPs experience between their sense of duty and feelings of futility may lead to perceptions such as personal defeat and insecurity. GPs (and patients) may benefit from adjusting the patient-doctor relationship with regard to shared definitions of realistic and authentic goals.http://link.springer.com/article/10.1186/s12875-018-0751-4Diabetes mellitusType 2Physician-patient relationsGeneral practiceAttitude of health personnelQualitative research |
| spellingShingle | Anja Wollny Michael Pentzek Oliver Rudolf Herber Heinz-Harald Abholz Jürgen in der Schmitten Andrea Icks Stefan Wilm Elisabeth Gummersbach General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study BMC Family Practice Diabetes mellitus Type 2 Physician-patient relations General practice Attitude of health personnel Qualitative research |
| title | General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study |
| title_full | General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study |
| title_fullStr | General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study |
| title_full_unstemmed | General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study |
| title_short | General practitioners’ attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study |
| title_sort | general practitioners attitudes towards patients with poorly controlled type 2 diabetes a qualitative study |
| topic | Diabetes mellitus Type 2 Physician-patient relations General practice Attitude of health personnel Qualitative research |
| url | http://link.springer.com/article/10.1186/s12875-018-0751-4 |
| work_keys_str_mv | AT anjawollny generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy AT michaelpentzek generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy AT oliverrudolfherber generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy AT heinzharaldabholz generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy AT jurgeninderschmitten generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy AT andreaicks generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy AT stefanwilm generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy AT elisabethgummersbach generalpractitionersattitudestowardspatientswithpoorlycontrolledtype2diabetesaqualitativestudy |