Thanks for hearing me: key elements of primary care according to older patients

Abstract

Objective: When organising healthcare and planning for research to improve healthcare, it is important to include the patients’ own perceptions. Therefore, the aim was to explore older patients’ views on what is important concerning their current care and possible future interventions in a primary care setting.Design: A qualitative design with individual interviews was used. Analysis through latent content analysis.Setting: Seven Swedish primary care centres.Subjects: Patients (n 30) aged >75 years, connected to elder care teams in primary healthcare.Results: Three categories, consisting of 14 sub-categories in total, were found, namely: Care characterised by easy access, continuity and engaged staff builds security; Everyday life and Plans in late life. The overarching latent theme Person-centred care with easy access, continuity and engaged staff gave a deeper meaning to the content of the categories and sub-categories.Conclusion: It is important to organise primary care for older people through conditions which meet up with their specific needs. Our study highlights the importance of elder care teams facilitating the contact with healthcare, ensuring continuity and creating conditions for a person-centred care. There were variations regarding preferences about training and different views on conversations about end-of-life, which strengthens the need for individualisation and personal knowledge. This study also exemplifies qualitative individual interviews as an approach to reach older people to be part of a study design and give input to an upcoming research intervention, as the interviews contribute with important information of value in the planning of the Swedish intervention trial Secure and Focused Primary Care for Older pEople (SAFE).

KEY POINTS

• In this qualitative interview study, the three categories Care characterised by easy access, continuity and engaged staff builds security; Everyday life and Plans in late life with underlying sub-categories describe the older patients’ views on what is important in their current care and possible future interventions in a Swedish primary care setting.

• The latent theme ‘Person-centred care with easy access, continuity and engaged staff’ was formed to give a deeper meaning to the content of the categories and sub-categories.

• Having a permanent care contact with a responsible nurse in an elder care team and a personal doctor (most often a general practitioner) over time seems important for vulnerable older patients with high risk of hospitalisation.

• The study suggests qualitative individual interviews as an approach to increase older peoples’ participation in future clinical complex study designs.

Keywords:

• Older adults
• patient-centered care
• patient participation
• primary health care
• qualitative research

Acknowledgements

The authors thank the patients who participated in this study and Gun Lindgren for recruiting the participants. We also thank Linköping University, ALF grants, Region Östergötland, Primary Health Care Centre in Region Östergötland, and the Medical Research Council of Southeast Sweden.

Disclosure statement

The authors report there are no competing interests to declare.

Ethical standards

The study was approved by the Swedish Ethical Review Authority (Dnr 2021-04387). Verbal informed consent was obtained from all patients and was witnessed and formally recorded.