title: Quality care provision for older people: an interview study with patients and primary healthcare professionals.
abstract: BACKGROUND
  In recent years, primary health care for the ageing population has become increasingly complex.
  
  
  OBJECTIVE
  This study sought to explore the views and needs of healthcare professionals and older patients relating to primary care in order to identify focal areas for improving primary health care for older people.
  
  
  METHODS
  This research was structured as a mixed interview study with focus groups and individual interviews. Participants were made up of primary healthcare professionals and older patients. Patients were recruited from five elderly care homes in a small city in the southern part of the Netherlands.
  
  
  METHODS
  All interviews were transcribed verbatim and analysed by two individual researchers applying constant comparative analysis. Data collection proceeded until saturation was reached.
  
  
  RESULTS
  Participants in the study agreed about the need for primary care for older patients, and showed sympathy with one another's perspectives. They did note, however, a number of obstacles hindering good healthcare provision. The major themes that arose were: 'autonomy and independence', 'organisational barriers', and 'professional expertise'. Participants generally noted that it is important to clarify differences in perspectives about good care between patients and healthcare professionals.
  
  
  CONCLUSIONS
  Effective primary care intervention for older patients requires mutual understanding of the expectations and goals of all parties involved. There are a number of important requirements, especially accessible patient information in the form of care plans; specialist training for nurses and GPs on complex care and multimorbidity; and training on discussing autonomy, goal setting, and shared care. Further improvement in health care for older people and its evaluation research should focus on these requirements.
authors.affiliation: Department of Primary and Community Care;
authors.forename: Marjolein Helena Johanna
authors.initials: MH
authors.lastname: van de Pol
authors.affiliation: Head of the Academic Educational Institute, Academic Educational Institute;
authors.forename: Cornelia Rita Maria Gertruda
authors.initials: CR
authors.lastname: Fluit
authors.affiliation: Department of Internal Medicine, Haga Teaching Hospital, The Hague, the Netherlands.
authors.forename: Joep
authors.initials: J
authors.lastname: Lagro
authors.affiliation: Elderly Care, Elderly care organization 'De Zorggroep', Venlo, the Netherlands.
authors.forename: Danielle
authors.initials: D
authors.lastname: Niessen
authors.affiliation: Department of Geriatrics, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Marcellinus Gerardus Maria Olde
authors.initials: MG
authors.lastname: Rikkert
authors.affiliation: Department of Primary and Community Care;
authors.forename: Antoinette Leonarda Maria
authors.initials: AL
authors.lastname: Lagro-Janssen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D006233:Persons with Disabilities; D005260:Female; D017144:Focus Groups; D016330:Frail Elderly; D015577:Geriatric Assessment; D006282:Health Personnel; D006299:Health Services for the Aged / Q000592:standards* / Q000639:trends; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D020380:Needs Assessment; D009426:Netherlands / Q000453:epidemiology; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards; D026684:Personal Autonomy; D057184:Practice Patterns, Nurses'; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration*; D011787:Quality of Health Care / Q000592:standards*
keywords: care homes; focus groups; health services for older people; patient-centred care; primary care