چکیده (انگلیسی):

Background:Swedish nursing homes (NH) have limited capacity. As a result elderly people living in NH represent
the part of the elderly population in most need of care. In Sweden a General Practitioner (GP) is usually responsible
for the medical care of all subjects living in a NH. The residents in NH seldom have adequate pharmacological
treatment according to diagnosis and often have polypharmacy and/or inappropriate medical treatment regarding
concerns of declining renal function. What prevents optimal care for the elderly is multifaceted, but there is limited
research on how GPs experience their work with the elderly in NH in Sweden.
This study aims to illuminate the GPs’ work with the elderly in NH to provide input on how the care can be
improved, as well as to identify potential obstacles for good quality of care.
Methods:This qualitative study is based on individual semi-structured interviews with 12 GPs and a follow-up focus
group discussion with six of the interviewed GPs.
The interviews were analysed with systematic text condensation, with the process leading to identify categories and
themes. Thereafter, the themes were discussed among six of the participating GPs in a focus group interview.
Results:Two main themes were identified: concern for the patient and sustainable working conditions. The
principal focus for the GPs was to contribute to the best possible quality of life for the patients. The GPs described
discordance between the demand from staff for medications and the patients’ actual need of care. GPs found their
work with NH enjoyable. Even though the patients at the NH often suffered from multiple illnesses, which could lead
to difficult decisions being made, the doctors felt confident in their role by having a holistic view of the patient in
tandem with reliable support from the nurse at the NH.
Conclusion:Working with NH patients was considered important and meaningful, with the GPs striving for the
patient’s well-being with special consideration to the continuum of ageing. A continuous and well-functioning
relationship between the GP and the nurse was crucial for the patients´ well-being