[Illness concepts and illness experience of patients and their family physicians in varicose ulcer].
Venous ulcers are common in ambulatory care, but there is not much known about the epidemiology or diagnostics and therapeutic strategies in the care for patients by German general practitioners (GPs). In a broader research context we study patients' and their GPs' concepts of disease and their influence on health outcomes. In a pilot study in 1999 a representative sample of all GPs in the State of Hesse (n = 319) are sent a questionnaire. Open problem-centred oral interviews are effected with an asystematic sample of 3 GPs and 2 ulcer patients (n = 6) of each GP to generate hypotheses. In the main study a representative sample of all GPs in the State of North-Rhine are included. They name all of their patients with a fresh venous ulcer during the following 18 months. Especially patients' pain is underestimated by the GPs. From their point of view difficulties in the therapeutic process are often due to 'non-compliant' behaviour of patients. Patients' perceptions of illness and their handling differ individually and are only partially known to the GPs. Concepts of disease and ideas of what is to blame for the development of disease vary considerably.
Wilm
S
S
Abteilung für Allgemeinmedizin, Heinrich-Heine-Universität, Düsseldorf. wilm@med.uni-duesseldorf.de
Kriebel
S
S
D000368:Aged; D001291:Attitude of Health Personnel; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010353:Patient Education as Topic; D011788:Quality of Life; D012803:Sick Role; D016312:Treatment Refusal / Q000523:psychology; D014647:Varicose Ulcer / Q000523:psychology*