PMID- 29720083
OWN - NLM
STAT- MEDLINE
DCOM- 20190531
LR  - 20190531
IS  - 1471-2296 (Electronic)
IS  - 1471-2296 (Linking)
VI  - 19
IP  - 1
DP  - 2018 May 2
TI  - General practitioners' attitudes towards patients with poorly controlled type 2 
      diabetes: a qualitative study.
PG  - 49
LID - 10.1186/s12875-018-0751-4 [doi]
LID - 49
AB  - BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) with poor glycaemic 
      control can represent a challenge from the perspective of the general 
      practitioner (GP). Apart from patient-sided factors, the understanding of GPs' 
      attitudes may provide ideas for improved management in these patients. The aim of 
      this study is to reveal attitudes of GPs towards T2DM patients with poor 
      metabolic control. METHODS: Qualitative research in German general practice; 20 
      GPs, randomly chosen from participants of a larger study; in-depth narrative 
      interviews, audio-recorded and transcribed; inductive coding and categorisation 
      in a multi-professional team; abstraction of major themes in terms of attitudinal 
      responses. RESULTS: 1) Orientation on laboratory parameters: GPs see it as their 
      medical responsibility to achieve targets, which instil a sense of security. 2) 
      Resignation: GPs believe their efforts are in vain and see their role as being 
      undermined. 3) Devaluation of the patient: GPs blame the "non-compliance" of the 
      patients and experience care as a series of conflicts. 4) Fixed role structure: 
      The expert GP on the one hand, the ignorant patient on the other. 5) Solidarity 
      with the patient: GPs appreciate a doctor-patient relationship in terms of 
      partnership. CONCLUSIONS: The conflict GPs experience between their sense of duty 
      and feelings of futility may lead to perceptions such as personal defeat and 
      insecurity. GPs (and patients) may benefit from adjusting the patient-doctor 
      relationship with regard to shared definitions of realistic and authentic goals.
FAU - Wollny, Anja
AU  - Wollny A
AD  - Institute of General Practice, University Medical Center Rostock, Rostock, 
      Germany.
FAU - Pentzek, Michael
AU  - Pentzek M
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227, Dusseldorf, Germany. 
      pentzek@med.uni-duesseldorf.de.
FAU - Herber, Oliver Rudolf
AU  - Herber OR
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227, Dusseldorf, Germany.
FAU - Abholz, Heinz-Harald
AU  - Abholz HH
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227, Dusseldorf, Germany.
FAU - In der Schmitten, Jurgen
AU  - In der Schmitten J
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227, Dusseldorf, Germany.
FAU - Icks, Andrea
AU  - Icks A
AD  - Institute for Health Services Research and Health Economics, Medical Faculty, 
      Heinrich-Heine University Dusseldorf, Dusseldorf, Germany.
FAU - Wilm, Stefan
AU  - Wilm S
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227, Dusseldorf, Germany.
FAU - Gummersbach, Elisabeth
AU  - Gummersbach E
AD  - Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University 
      Dusseldorf, Werdener Str. 4, 40227, Dusseldorf, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180502
PL  - England
TA  - BMC Fam Pract
JT  - BMC family practice
JID - 100967792
SB  - IM
MH  - *Attitude of Health Personnel
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Female
MH  - *General Practitioners
MH  - Germany
MH  - Humans
MH  - Interviews as Topic
MH  - Male
MH  - Middle Aged
MH  - *Patient Compliance
MH  - *Physician-Patient Relations
MH  - Qualitative Research
PMC - PMC5932823
OTO - NOTNLM
OT  - Attitude of health personnel
OT  - Diabetes mellitus
OT  - General practice
OT  - Physician-patient relations
OT  - Qualitative research
OT  - Type 2
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by the ethics 
      committee of the Medical Faculty of the Heinrich-Heine University Dusseldorf. All 
      participants provided written informed consent. COMPETING INTERESTS: The authors 
      declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature 
      remains neutral with regard to jurisdictional claims in published maps and 
      institutional affiliations.
EDAT- 2018/05/04 06:00
MHDA- 2019/06/01 06:00
PMCR- 2018/05/02
CRDT- 2018/05/04 06:00
PHST- 2017/10/26 00:00 [received]
PHST- 2018/04/23 00:00 [accepted]
PHST- 2018/05/04 06:00 [entrez]
PHST- 2018/05/04 06:00 [pubmed]
PHST- 2019/06/01 06:00 [medline]
PHST- 2018/05/02 00:00 [pmc-release]
AID - 10.1186/s12875-018-0751-4 [pii]
AID - 751 [pii]
AID - 10.1186/s12875-018-0751-4 [doi]
PST - epublish
SO  - BMC Fam Pract. 2018 May 2;19(1):49. doi: 10.1186/s12875-018-0751-4.