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Negotiating Vulnerabilities: How Older Adults with Multiple Chronic Conditions Interact with Physicians*

  • Laura Hurd Clarke (a1), Erica V. Bennett (a1) and Alexandra Korotchenko (a1)
Abstract
ABSTRACT

The literature on patient-physician interactions has largely ignored the perspectives of older adults with multiple morbidities. Featuring in-depth interview data from 16 men and 19 women with an average of six chronic conditions, this study focused on how participants perceived and experienced the care provided by their primary care physicians. Participants suggested that physicians caring for patients with multiple chronic conditions should be thorough, amenable to gate keeping, trustworthy, and open to different decision-making styles. However, many study participants perceived that they received inadequate care due to the personal failings of their physicians, constraints of medical consultations, and societal ageism. Consequently, many of the participants, especially the women, employed various strategies to maximize the care they received and manage their physicians’ impressions of them as worthy patients. Our findings suggest that elderly patients with multiple morbidities perceive that their health needs are not being adequately met.

RÉSUMÉ

La littérature concernant les interactions entre les patients et les médecins a largement ignoré les points de vue des personnes âgées souffrant de comorbidités multiples. Cette étude, avec des données recueillies à partir d’entretiens approfondis avec 16 hommes et 19 femmes qui ont eu une moyenne de six affections chroniques, a porté sur la façon dont les participants ont perçus et vécus les soins fournis par leurs médecins de soins primaires. Les participants ont suggéré que les médecins qui soignent les patients atteints de maladies chroniques multiples devraient être minutieux, prête à “gate-keeping,” fiables et ouvert à différents styles de prise de décision. Cependant, nombreux participants à l’étude ont perçu qu’ils recevaient des soins inadéquats en raison de faiblesses personnelles de leurs médecins, les contraintes de consultations médicales, et l’âgisme sociétal. Par conséquent, beaucoup de participants, surtout les femmes, ont utilisé des diverses stratégies pour maximiser les soins reçus et pour gérer les impressions des médecins à leur egard comme dignes patients. Nos résultats suggèrent que les patients âgés atteints de morbidités multiples perçoivent que leur besoins de santé ne sont pas suffisamment satisfaits.

Copyright
Corresponding author
Correspondence and requests for reprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Laura Hurd Clarke, Ph.D. School of Kinesiology The University of British Columbia 156-1924 West Mall Vancouver, BC V6T 1Z2 (laura.hurd.clarke@ubc.ca)
Footnotes
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We thank all of the individuals who took part in the study and shared with us their time, personal stories, and important insights. We also thank Lauren Courtice and Chris Liu for their invaluable assistance with data management. This research was supported by a SSHRC Standard Research Grant titled “Body Image and Identity: The Experience of Multiple Chronic Conditions” (Council Grant no. 410-2008-0081), which was awarded to Laura Hurd Clarke.

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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

W. L. Adams , N. L. Mcllvain , N. L. Lacy , H. Magsi , B. F. Crabtree , S. K. Yenny , et al. (2002). Primary care for elderly people: Why do doctors find it so hard? The Gerontologist, 42(6), 835–482.

R. Adelman , M. G. Greene , & R Charon . (1987). The physician-elderly patient-companion triad in the medical encounter: The development of a conceptual framework and research agenda. The Gerontologist, 27(6), 729734.

D. Album , & S Westin . (2008). Do diseases have a prestige hierarchy? A survey among physicians and medical students. Social Science & Medicine, 66(1), 182188.

N. K. Arora , & C. A McHorney . (2000). Patient preferences for medical decision making: Who really wants to participate? Medical Care, 38(3), 335341.

P. Asbring , & A. L Narvanen . (2002). Women’s experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia. Qualitative Health Research, 12(2), 148160.

H. Bastiaens , P. Royen , D. R. Pavlic , V. Raposo , & R Baker . (2007). Older people’s preferences for involvement in their own care: A qualitative study in primary health care in 11 European countries. Patient Education and Counseling, 68(1), 3342.

A. E Beisecker . (1988). Aging and the desire for information and input in medical decisions: Patient consumerism in medical encounters. The Gerontologist, 28(3), 330335.

H. Burroughs , K. Lovell , M. Morley , R. Baldwin , A. Burns , & C Chew-Graham . (2006). ‘Justifiable depression’: How primary care professionals and patients view late-life depression? A qualitative study. Family Practice, 23(3), 369377.

P. Damiano , E. Momany , K. Willard , & G Jogerst . (1997). Factors affecting primary care physician participation in Medicare. Medical Care, 35(10), 10081019.

C. Edwards , S. Staniszweska , & N Crichton . (2004). Investigation of the ways in which patients’ reports of their satisfaction with healthcare are constructed. Sociology of Health and Illness, 26(2), 159183.

E. B. Elkin , S. H. M. Kim , E. S. Casper , D. W. Kissane , & D Schrag . (2007). Desire for information and involvement in treatment decisions: Elderly cancer patients’ preferences and their physicians’ perceptions. Journal of Clinical Oncology, 25(33), 52755280.

M. Gott , S. Hinchliff , & E Galena . (2004). General practitioner attitudes to discussing sexual health issues with older people. Social Science and Medicine, 58(11), 20932103.

M. G. Greene , R. D. Adelman , E. Friedmann , & R Charon . (1994). Older patient satisfaction with communication during an initial medical encounter. Social Science and Medicine, 38(9), 12791288.

J. W Henderson . (1997). Issues in the medical treatment of elderly women. Journal of Women and Aging, 9(1–2), 107115.

S. H. Kaplan , B. Gandek , S. Greenfield , W. Rogers , & J. E Ware . (1995). Patient and visit characteristics related to physicians’ participatory decision-making style: Results from the Medical Outcomes Study. Medical Care, 33(2), 11761187.

R. C. Maly , B. Leake , & R. A Silliman . (2004). Breast cancer treatment in older women: Impact of the patient-physician interaction. Journal of the American Geriatrics Society, 52(7), 11381145.

E. Mutran , & K. F Ferraro . (1988). Medical need and use of services among older men and women. Journal of Gerontology, 43(5), S162S171.

J. F. Nussbaum , M. J. Pitts , F. N. Huber , Raup Krieger , J. L. , & J. E Ohs . (2005). Ageism and ageist language across the life span: Intimate relationships and non-intimate interaction. Journal of Social Issues, 61(2), 287305.

J. Ogden , K. Bavalia , M. Bull , S. Frankum , C. Goldie , M. Gosslau , et al. (2004). “I want more time with my doctor:” A quantitative study of time and the consultation. Family Practice, 21(5), 479483.

K. Rost , & R Frankel . (1993). The introduction of the older patient’s problems in the medical visit. Journal of Aging and Health, 5(3), 387401.

H. Skuladottir , & S Halldorsdottir . (2008). Women in chronic pain: Sense of control and encounters with health professionals. Qualitative Health Research, 18(7), 891901.

C. B. Tannenbaum , L. Nasmith , & N Mayo . (2003). Understanding older women’s health care concerns: A qualitative study. Journal of Women and Aging, 15(1), 315.

C. F. Teh , J. F. Karp , A. Kleinman , C. F. Reynolds , D. Weiner , & P. D Cleary . (2009). Older people’s experiences of patient-centered treatment for chronic pain: A qualitative study. Pain Medicine, 10(3), 521530.

P. F. Weitzman , K. Ballah , & S. E Levkoff . (2008). Native-born Chinese women’s experiences in medical encounters in the U.S. Ageing International, 32(2), 128139.

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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
  • URL: /core/journals/canadian-journal-on-aging-la-revue-canadienne-du-vieillissement
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