title: [Problems and solutions in health care for chronic diseases. A qualitative study with patients and doctors].
abstract: BACKGROUND
  Chronic diseases represent a challenge for health systems and the professionals most involved in chronic care. Despite biomedical advances, the results of care for chronic problems are not as good as they should be.
  
  
  OBJECTIVE
  To find out what doctors and patients think of care for some of the main chronic illnesses; to detect concrete areas of deficit and lack of satisfaction felt by both sides and possible lines of improvement; to raise mutual understanding between patients and doctors.
  
  
  METHODS
  Forty-one patients with fibromyalgia or diabetes mellitus, carers for people with Alzheimer's and breast cancer patients. Forty-three family doctors involved in health care delivery to this kind of patient.
  
  
  METHODS
  Four discussion groups. Transcription and syntactical, semantic and pragmatic contents analysis, with both pre-established and emerging categories of consensus.
  
  
  RESULTS
  Patients thought, with different nuances as a function of the problem put forward, that questions of respectful, human and integrated care, clear and suitable information, and consistent follow-up were important and insufficiently covered by doctors and health services. Doctors thought that many of their efforts in caring for these patients were useless, and thought it important to reconsider their clinical responsibilities and the patient-doctor relationship. Doctors highlighted the limitations in the health care resources available for working with these patients.
  
  
  CONCLUSIONS
  To tackle prevalent chronic problems requires, in the view of doctors and patients, important modifications that are related mainly to the kind of relationship between the two, with new clinical responsibilities and certain organisational care delivery features.
authors.affiliation: Comité Científico y Responsable, Maratón de debates con pacientes, XXIV Congreso semFYC. roger.ruiz.sspa@juntadeandalucia.es
authors.forename: Roger
authors.initials: R
authors.lastname: Ruiz Moral
authors.forename: Juanjo
authors.initials: J
authors.lastname: Rodríguez Salvador
authors.forename: Luis
authors.initials: L
authors.lastname: Pérula
authors.forename: Isabel
authors.initials: I
authors.lastname: Fernández
authors.forename: Jorge
authors.initials: J
authors.lastname: Martínez
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Fernández
authors.forename: Antonio
authors.initials: A
authors.lastname: Yun
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Arboníes
authors.forename: María Auxiliadora
authors.initials: MA
authors.lastname: Cabanás
authors.forename: Luis
authors.initials: L
authors.lastname: Luque
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology / Q000628:therapy; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy; D017028:Caregivers / Q000523:psychology; D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care; D003920:Diabetes Mellitus / Q000523:psychology / Q000628:therapy; D019468:Disease Management; D005180:Faculty, Medical; D005260:Female; D005356:Fibromyalgia / Q000523:psychology / Q000628:therapy; D017144:Focus Groups; D006801:Humans; D008297:Male; D018447:Medical Futility; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*