• Open Access

Health professionals, patients and chronic illness policy: a qualitative study

Authors

  • Laurann Yen BSc MPsych,

    1. Associate Director, Menzies Centre for Health Policy, The Australian National University, Acton, ACT
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  • James Gillespie BA PhD,

    1. Deputy Director, Menzies Centre for Health Policy and School of Public Health, University of Sydney, NSW
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  • Yun-Hee Jeon RN BHSc (Nursing) MN PhD,

    1. Research Fellow, Australian Primary Health Care Research Institute, The Australian National University, Acton, ACT
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  • Marjan Kljakovic MB CHB FRNZCGP FRACGP PhD,

    1. Professor of General Practice, the Australian National University Medical School, The Canberra Hospital Campus, Woden, ACT
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  • Jo-anne Brien B Pharm BS PharmD,

    1. Professor of Clinical Pharmacy, Faculty of Pharmacy, University of Sydney and Therapeutics Centre, St Vincent’s Hospital, Darlinghurst, NSW
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  • Stephen Jan B Econ M Econ PhD,

    1. Senior Health Economist, The George Institute for International Health, Camperdown, NSW
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  • Elin Lehnbom BSc MPharm Sc MClinPharm PhD Scholar,

    1. PhD Scholar, Faculty of Pharmacy, University of Sydney and Therapeutics Centre, St Vincent’s Hospital, Darlinghurst, NSW
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  • Carmen Pearce-Brown RN DipHlthSc MCritCareN Research Assistant,

    1. Research Assistant, Australian Primary Health Care Research Institute, The Australian National University, Acton, ACT
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  • Tim Usherwood BSc MD BS FRCGP FRACGP FRCP FAICD DMS

    1. Professor of General Practice, Department of General Practice, The University of Sydney, Westmead, NSW, Austalia
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Laurann Yen BSc(Applied Psychology), M Psych
Associate Director, Menzies Centre for Health Policy
The Australian National University
Building 62, Mills Road
ACTON ACT 0200
Australia
E-mail: laurann.yen@anu.edu.au

Abstract

Background and objective  This study investigates health professionals’ reactions to patients’ perceptions of health issues – a little-researched topic vital to the reform of the care of chronic illness.

Methods  Focus groups were undertaken with doctors, nurses, allied health staff and pharmacists (= 88) in two Australian urban regions. The focus groups explored responses to patient experiences of chronic illness (COPD, Diabetes, CHF) obtained in an earlier qualitative study. Content analysis was undertaken of the transcripts assisted by NVivo7 software.

Results  Health professionals and patients agreed on general themes: that competing demands in self-management, financial pressure and co-morbidity were problems for people with chronic illness. However where patients and carers focused on their personal challenges, health professionals often saw the patient experience as a series of failures relating to compliance or service fragmentation. Some saw this as a result of individual shortcomings. Most identified structural and attitudinal issues. All saw the prime solution as additional resources for their own activities. Fee for service providers (mainly doctors) sought increased remuneration; salaried professionals (mainly nurses and allied health professionals) sought to increase capacity within their professional group.

Conclusions  Professionals focus on their own resources and the behaviour of other professionals to improve management of chronic illness. They did not factor information from patient experience into their views about systems improvement. This inability to identify solutions beyond their professional sphere highlights the limitations of an over-reliance on the perspectives of health professionals. The views of patients and carers must find a stronger voice in health policy.

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