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BMC Primary Care
Published in: BMC Primary Care 1/2018

Open Access 01-12-2018 | Research article

Identifying frailty in primary care: a qualitative description of family physicians’ gestalt impressions of their older adult patients

Authors: Clara Korenvain, Ida-Maisie Famiyeh, Sheila Dunn, Cynthia R. Whitehead, Paula A. Rochon, Lisa M. McCarthy

Published in: BMC Primary Care | Issue 1/2018

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Abstract

Background

Many tools exist to guide family physicians’ impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians’ subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients’ frailty statuses.

Methods

Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one “think-aloud” interviews about the frailty status of their patients aged 80 years and over. Of 23 eligible family physicians, 18 shared their impressions about the frailty status of their older adult patients and the factors influencing their decisions. Interviews were audio-recorded, transcribed, and thematically analyzed.

Results

Four themes were identified, the first of which described how physicians conceptualized frailty as a spectrum and dynamic in nature, but also struggled to conceptualize it without a formal definition in place. The remaining three themes described factors considered before determining patients’ frailty statuses: physical characteristics (age, weight, medical conditions), functional characteristics (physical, cognitive, social) and living conditions (level of independence, availability of supports, physical environment).

Conclusions

Family physicians viewed frailty as multifactorial, dynamic, and inclusive of functional and environmental factors. This conceptualization can be useful to make comprehensive and flexible evaluations of frailty status in conjunction with more objective frailty tools.
Appendix
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Metadata
Title
Identifying frailty in primary care: a qualitative description of family physicians’ gestalt impressions of their older adult patients
Authors
Clara Korenvain
Ida-Maisie Famiyeh
Sheila Dunn
Cynthia R. Whitehead
Paula A. Rochon
Lisa M. McCarthy
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2018
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-018-0743-4

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