engleski

For an international deffinition of multi-morbidity in general practice what lies behind the term "condition" for French and Polish GP's?

Background: Multi-morbidity is defined by WHO as the cooccurance of two medical conditions. "Conditions" is vague and not usable for GP practice or research as a systematic review of literature found 132 different definitions for that terminology. Research Question: what lies behind "condition" for GPs and what definition of multi-morbidity could be issued from GP practice in France and in Poland? Method: Qualitative by focus groups and semi structured interviews with a purposive sample of in practice GPs. The focus/interview guide was designed and tasted by a group of seven researches and translated into each language. Data collection was audio recorded and transcribed verbatim till saturation. Analysis was undertaken in a phenomenological perspective, using a grounded theory based methodwith four independent researchers and pooling at each coding step. Results: Sample's maximal variation was reached in each country. Saturation on axial (or thematic) coding wa achieved in each country. The conditions describing multi-morbidity were described with the following definition: Multi-morbidity is defined as the association of chronic and/or acute illnesses with somatic risk factors, and/or biopsychosocial factors. It is modulated by demographic factors, social factors, psychological factors, health care consumption, coping strategies of the patient, life habits, social network and managementby the GPs. It could lead to dependence and instability. Conclusion: The conditions defining multi-morbidity for GPs in France and Poland have been explored with this study. The exploration goes on for Bulgaria, Bosnia, Greece, Croatia, Germany and Italy.

multi-morbidity; deffinition; conditions; general practitioners

European Journal of General Practice, 2013 ; 19:162-184