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Canadian Journal on Aging / La Revue canadienne du vieillissement

Articles

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

Laura Hurd Clarkea1 c1, Erica V. Bennetta1 and Alexandra Korotchenkoa1

a1 University of British Columbia

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.

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.

(Received June 25 2012)

(Accepted May 28 2013)

Keywords

  • aging;
  • ageism;
  • medical care;
  • multiple chronic conditions;
  • older adults;
  • physicians

Mots clés

  • vieillissment;
  • âgisme;
  • soins médicaux;
  • affections (maladies) chroniques multiples;
  • adultes (personnes) âgés;
  • médecins

Correspondence

c1 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

*  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.