Table 3.
Reasons to visit and possible ideas, concerns, and expectations (ICEs) during out-of-hours (OOH) care.
| Reasons to visit the OOH | Example | Other reasons or ICEs prompted in the consultation by the patient |
|---|---|---|
| Leaving for vacation/holiday /work next day | P: the reason I come now instead of waiting until Monday is because I have to fly on Monday so I want to know if I should or not… (GP6, male, 50y- P21, male, 31y, URTI) | P: I'm really flu-like and I have a serious bronchitis. … I think it's because of the air conditioning in the airplane. … I don't often take medication. It has to be really bad then. … Last time I had this kind of cough, I let it go on too long and then I came to the doctor and he said I had a bad pneumonia. So I didn't want that this time. GP: ok, and it was cured with? P: yes, just with some antibiotics, and then it was better … I just came back from the States, yes busy life … and then I'm getting married … GP: And a jet lag? P: a jet lag, yes, but I can handle that pretty well … If I can work? I work with clients, one on one, because I don't want to make anyone else sick |
| Sent by family member/partner | P: well I think I've got one of these typical airway infections but my wife said if you can't swallow properly you have to have it checked out, to see it's not an angina (GP16, female, 28y - P61, male, 38y, sore throat) | P: I have taken paracetamol, it helps against the muscle strain, headache, but not against the pain when I swallow, … It started on Friday, and now it's Sunday, I still suffer from it … paracetamol makes it bearable, but if I don't take it I almost can't swallow. … During clinical examination: -I recently took antibiotics for a tick bite. So I think my body is just too weak in general |
| Double consultation as two people in the household are ill | P: so I thought I will go anyway (0.4) I will let him get checked and then me because I feel even more ill (GP11, female, 39y - P36 male, 3y, URTI) | P: I can't swallow well, even my own saliva hurts, and also when I'm eating and drinking … and I'm pregnant too |
| Regular GP not available/ Need of a sick note | P: I have been in bed with the flu for a few days, but I have to work tomorrow, I'm not up for it, and in the Netherlands they are very accommodating but in Belgium… …. P: My GP couldn't see me anymore today (0.2) so I thought … (GP8, female, 28y - P26, male, 21y, URTI) |
During clinical examination: P: yes, I've also had mononucleosis GP: yes? P: actually a year now … P: and I also have the idea that it is a bit more difficult in terms of immunity |
| Worsening of symptoms | Mother: It has been a few days now that he's got an airway infection and now this morning he said this night he really was in pain (GP16, female, 28y - P60, male, 6y, otitis) | - M: when he complains, something is really going on - euh and we will soon leave for Legoland so that's why I eum - yes I just wanted to check |
| Asking for medication | P: I went to the pharmacy (.) three days ago GP: oh yes (looks at the medication) P: and I picked up this but it's not really working GP: no? P: it's more like candy (GP13, female, 29y - P46, male, 74y, tracheitis/laryngitis) | P: I think I have a throat infection - but I also have a strong cough, less during the day now, but at night and in the morning I really have to cough a lot |
| Worried about a symptom | Mother: what should we do? because I see a lot of white spots in her throat (GP17, female, 51y - P64, female, 26y, sore throat) | P: It's an awful lot of pain when I swallow and talk - I went to work yesterday, it was ok, but around noon I took some pain-killers because I was so in so much pain - But I am not someone who takes painkillers quickly, I will say thatM: now our grandson normally comes tomorrow,what would we do? P: And then I also had antibiotics and since then I have been terrified about these. The following week I had sores all over my mouth. |
| To have a thorough clinical examination | Mother: yes, she had a heavy cold just recently so the question is to examine her again thoroughly (GP13, female, 29y - P44, female, <1y, URTI) | M: 3 days ago she got her vaccinations as well - She has been going to day care for a while and she has had such a strong cold several times, with a cough. And then, um, for her nose, yeah, what was that actually called |
| but for the day care they only wanted to give it, if you have a prescription. - and I had already been to the doctor twice, and the doctor said by phone: yes, give her the drops - especially whiny, but it is not too bad. She's a really super happy baby, so During clinical examination: She is ok on the curve they said. But she is, she only weighs 5.2 kilos or so |
AB, antibiotics; RTI, respiratory tract infection; OOH, out-of-hours; P, patient; M, mother; GP, general practitioner; y, years; URTI, upper respiratory tract infection; RSV, respiratory syncytial virus.