TY - JOUR
T1 - Responsibility of follow-up regarding medical recommendations in primary care and challenging patients
T2 - The perspective of doctors, nurses, pharmacists, and administrative staff
AU - Khazen, M.
AU - Shalev, L.
AU - Golan-Cohen, A.
AU - Rose, A. J.
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2025/1
Y1 - 2025/1
N2 - Objective: This study examines the way healthcare staff describe challenging patients and perceive responsibility for follow-up of patients with chronic conditions. Methods: Interviews were conducted with 46 healthcare staff (15 primary care physicians/12 nurses/15 administrative staff/4 pharmacists) at 12 clinics in Israel. They were audiotaped, transcribed, and thematically analyzed using Atlas qualitative data analysis software. Results: Participants defined patients as “challenging” either because they are less likely to follow medical recommendations or are felt to overconsume care. Staff believed that patients did not follow medical recommendations because they were indifferent, unaware, in denial about deteriorating medical condition, or fear of the unknown. Participants generally perceived a shared responsibility for follow-up between the staff and the patient. Staff who endorsed closer relationships with staff members expressed empathy toward challenging patients and felt responsible for follow-up. Conclusions: Healthcare staff perceive themselves as partially responsible for helping patients follow up with medical recommendations. Cohesive staff relationships may promote higher levels of empathy toward challenging patients and may contribute to helping patients follow up with recommended care. Practice implications To improve follow-up with medical recommendations, there is a need to develop and test interventions to promote more cohesive ties among clinic staff.
AB - Objective: This study examines the way healthcare staff describe challenging patients and perceive responsibility for follow-up of patients with chronic conditions. Methods: Interviews were conducted with 46 healthcare staff (15 primary care physicians/12 nurses/15 administrative staff/4 pharmacists) at 12 clinics in Israel. They were audiotaped, transcribed, and thematically analyzed using Atlas qualitative data analysis software. Results: Participants defined patients as “challenging” either because they are less likely to follow medical recommendations or are felt to overconsume care. Staff believed that patients did not follow medical recommendations because they were indifferent, unaware, in denial about deteriorating medical condition, or fear of the unknown. Participants generally perceived a shared responsibility for follow-up between the staff and the patient. Staff who endorsed closer relationships with staff members expressed empathy toward challenging patients and felt responsible for follow-up. Conclusions: Healthcare staff perceive themselves as partially responsible for helping patients follow up with medical recommendations. Cohesive staff relationships may promote higher levels of empathy toward challenging patients and may contribute to helping patients follow up with recommended care. Practice implications To improve follow-up with medical recommendations, there is a need to develop and test interventions to promote more cohesive ties among clinic staff.
KW - Challenging patients
KW - Difficult patients
KW - Empathy toward patients
KW - Healthcare staff collaboration
KW - Patients with chronic conditions
KW - Primary care settings
KW - Responsibility of follow-up
UR - http://www.scopus.com/inward/record.url?scp=85205805256&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2024.108456
DO - 10.1016/j.pec.2024.108456
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C2 - 39393327
AN - SCOPUS:85205805256
SN - 0738-3991
VL - 130
JO - Patient Education and Counseling
JF - Patient Education and Counseling
M1 - 108456
ER -