How do older patients and their GPs evaluate shared decision-making in healthcare?
BACKGROUND
Older persons represent a growing share of the population, yet very little is known about their specific healthcare needs, problems, and expectations. IMPROVE is an international research project that seeks to improve elderly persons' involvement in their healthcare. This paper analyzes perceptions of patient involvement by elderly patients and their GPs in family medicine in Slovenia.


METHODS
Semi-structured interviews with patients over 70 and their GPs were audio-taped and transcribed. The interviews were analyzed using qualitative content analysis.


RESULTS
Specific characteristics of old age must be taken into account in the involvement of older patients. It is important to know the patient's expectations and to communicate clearly with the patient. A trusting relationship between the GP and the patient is a prerequisite for involvement. GPs center involvement on the GP's side. Involvement of the elderly is linked to ethical dilemmas.


CONCLUSIONS
Understanding the involvement of the elderly focuses more on building a relationship than on making decisions. It is reasonable to educate GPs and GPs' coworkers about caring relationships. Ethical aspects have often been treated in a theoretical manner, whereas empirical practice may be entirely different from theoretical premises. GPs and older patients must learn more about how to address their ethical dilemmas.
Rotar-Pavlic
Danica
D
University of Ljubljana, Medical Faculty, Department of Family Medicine, Poljanski nasip 58, 1000 Ljubljana, Slovenia. danica.rotar@guest.arnes.si
Svab
Igor
I
Wetzels
Raymond
R
D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making / Q000941:ethics*; D003695:Delivery of Health Care / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations / Q000941:ethics*; D012189:Retrospective Studies; D017524:Slovenia; D011795:Surveys and Questionnaires