[Frequent users and difficult patients: how do they feel about their treatment by doctors?]. / Pacientes hiperfrecuentadores y difíciles: cómo se sienten tratados por sus médicos?

BACKGROUND: To determine the opinions and expectations of difficult, frequent user, patients about their relationship with their GP. MATERIAL AND METHODS: Qualitative design. Discussion groups. Invitation to a meeting at the Chantrea Health Centre (Pamplona). The participants were frequent users of the health centre in the year 2003, who had been defined as "difficult"--according to previously defined criteria--by each of the 12 doctors of the health centre. Excluded were patients with mental retardation, severe hearing problems, severe mental illness, difficulties in mobility and travelling, and over 70 years of age. Groups were formed from amongst the 112 preselected patients. Four groups were designed: "older" persons (GMA) of 46 to 70 years (14); "women" (GMU) of 31 to 45 years (14); "men" (GHO) of 31 to 45 years (13) and "youths" (GJO) of 16 to 30 years (12). The patients were invited by letter and by a subsequent telephone confirmation to a meeting, the content of which was not specified. Sessions of 2 hours duration were held with each of the groups formed. Audio recording, with prior authorization, and verbatim transcription of sessions. Discussion and content analysis by the research group resulting in lines of consensus. RESULTS: The three groups of older patients were formed with a total of 16 participants. The group of youths was not formed since the figure for attendance did not reach the number of 3 or more after three appointments. CONCLUSIONS: From the perspective of the patient it is very important that there should be efficient communication with the doctor. Awareness of a state of frequent use was not detected in those attending. They feel themselves to be chronic patients who need frequent attention. Satisfaction at the treatment received was observed as well as an understanding attitude towards the organisational limitations of the health centre. They did not give verbal expression to the existence of conflictive relations with their GPs.

Pacientes hiperfrecuentadores y difíciles: ¿cómo se sienten tratados por sus médicos? / Frequent users and difficult patients: How do they feel about their treatment by doctors?

Fundamento. Conocer las opiniones y expectativas de los pacientes hiperfrecuentadores difíciles sobre la relación con sus médicos de familia.Material y métodos. Diseño cualitativo. Grupos de discusión. Emplazamiento en el Centro de Salud Chantrea (Pamplona). Los participantes fueron pacientes hiperfrecuentadores que acudieron al centro de salud en el año 2003 y que habían sido preseleccionados como “difíciles” –según criterios previamente definidos– por cada uno de los 12 médicos del centro de salud. Se excluyeron los pacientes con: retraso mental, problemas severos de audición, enfermedad mental grave, dificultades de movilidad y desplazamiento y mayores de 70 años.Se formaron grupos de entre los 112 pacientes preseleccionados. Se diseñaron 4 grupos: personas “mayores” (GMA) de 46 a 70 años (14); “mujeres” (GMU) de 31 a 45 años (14); “hombres” (GHO) de 31 a 45 años (13) y “jóvenes” (GJO) de 16 a 30 años (12), citando mediante una carta y posterior confirmación telefónica a los pacientes para una reunión, sin especificar el contenido de la misma.Se desarrollaron sesiones de 2 horas de duración en cada uno de los grupos formados. Grabación de audio, previa autorización y transcripción literal. Discusión y análisis de contenido por parte del grupo investigador provocando líneas de consenso.Resultados. Se realizaron los tres grupos de pacientes de mayor edad con un total de 16 participantes. No se formó el grupo de jóvenes, por no acudir en un número de 3 o más tras 3 citas. Conclusiones. Según la perspectiva del paciente, es muy relevante una comunicación eficaz con el médico. No se detecta estado de conciencia de hiperfrecuentación por parte de los asistentes. Se sienten pacientes crónicos que precisan atención frecuente. Se observa satisfacción ante el trato recibido y actitud comprensiva ante las limitaciones organizativas del centro de salud. No verbalizan la existencia de relaciones conflictivas con sus médicos de familia

Background. To determine the opinions and expectations of difficult, frequent user, patients about their relationship with their GP. ;;Material and methods. Qualitative design. Discussion groups. Invitation to a meeting at the Chantrea Health Centre (Pamplona). ;;The participants were frequent users of the health centre in the year 2003, who had been defined as “difficult” – according to previously defined criteria – by each of the 12 doctors of the health centre. Excluded were patients with mental retardation, severe hearing problems, severe mental illness, difficulties in mobility and travelling, and over 70 years of age. ;;Groups were formed from amongst the 112 preselected patients. Four groups were designed: “older” persons (GMA) of 46 to 70 years (14); “women” (GMU) of 31 to 45 years (14); “men” (GHO) of 31 to 45 years (13) and “youths” (GJO) of 16 to 30 years (12). The patients were invited by letter and by a subsequent telephone confirmation to a meeting, the content of which was not specified. ;;Sessions of 2 hours duration were held with each of the groups formed. Audio recording, with prior authorisation, and verbatim transcription of sessions. Discussion and content analysis by the research group resulting in lines of consensus. ;;Results. The three groups of older patients were formed with a total of 16 participants. The group of youths was not formed since the figure for attendance did not reach the number of 3 or more after three appointments. ;;Conclusions. From the perspective of the patient it is very important that there should be efficient communication with the doctor. Awareness of a state of frequent use was not detected in those attending. They feel themselves to be chronic patients who need frequent attention. Satisfaction at the treatment received was observed as well as an understanding attitude towards the organisational limitations of the health centre. They did not give verbal expression to the existence of conflictive relations with their GPs