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. 2018 Jul 17;13(7):e0200614. doi: 10.1371/journal.pone.0200614

Table 1. Results and recommendations per theme.

Summary of findings Recommendations
I Patient characteristics: Health complaints and impact
A diverse range of complaints was experienced and often accepted. Social limitations were considered worst. GPs were not expected to solve all problems. Ask pro-actively about (social) limitations.
I Patient characteristics: Self-management of health complaints and limitations
Continuing activities were tried despite limitations. Accepting dependency and asking for help was difficult. Informal and professional care was appreciated. Ask pro-actively whether help is needed to be able to continue their activities.
II Expectations of their GP: Expectations of treatment
Not much was expected of GPs for most complaints (including pain and problems standing/walking) due to acceptance and low expectations of treatment. Focus more on coping with limitations instead of curing diseases.
II Expectations of their GP: Shared decision-making
To live at home as long as possible, some guidance was expected regarding diagnostics, therapy, and to welfare organisations. Guide patients to further diagnostics, therapy and welfare organisations if needed.
II Expectations of their GP: Pro-active care
Some considered contact with their GP to be their own responsibility. Others indicated that they are afraid to lose sight of the ‘big picture’ of their health due to age and limitations and would therefore like the GP to take more initiative. Discuss with patients whether they need a more pro-active attitude from the general practice because they lose sight of the ‘big picture’ of their health situation.
II Expectations of their GP: Attentive care (i.e. support and empathy)
For a good patient-doctor relationship it was considered important to also recognise social and emotional matters. Be attentive: especially around major life events, as well as for previously mentioned complaints, even if these cannot be cured.
II Expectations of their GP: Attainability and accessibility
Some participants felt their complaints do not warrant bothering the GP, and were even more reluctant to contact their GP after a negative experience or for a known but unsolved problem. Establish a yearly moment of contact initiated by the general practice. Offer help to older patients and promote the services of the practice nurse to all older patients
Telephone accessibility during office hours was too limited. The emergency option was not suitable because older persons are reluctant to use this option. Continuous telephone accessibility during office hours.
Some participants did not know why the assistant (instead of the GP) asks about their complaints and gives advice on health complaints. Be clear why the GP’s assistant asks clarifying questions in order to make an appointment with the GP.
II Expectations of their GP: Coordinating health care and medication
Unsure whether their medication was up-to-date and an apparent lack of communication with medical specialists was perceived. Follow-up on information from medical specialists and perform a yearly review of medications and communicate this to the patient, even if no changes are made.
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