Hunter, C, Chew-Graham, C, Langer, S et al. (4 more authors) (2013) A qualitative study of patient choices in using emergency health care for long-term conditions: The importance of candidacy and recursivity. Patient Education and Counseling, 93 (2). pp. 335-341. ISSN 0738-3991
Abstract
Objective We aimed to explore how patients with long-term conditions choose between available healthcare options during a health crisis. Methods Patients in North-West England with one or more of four long-term conditions were invited to take part in a questionnaire cohort study of healthcare use. Semi-structured interviews were conducted with a sub-sample of fifty consenting patients. Data were analysed qualitatively, using a framework approach. Results Patients described using emergency care only in response to perceived urgent need. Their judgements about urgency of need, and their choices about what services to use were guided by previous experiences of care, particularly how accessible services were and the perceived expertise of practitioners. Conclusion Recursivity and candidacy provide a framework for understanding patient decision-making around emergency care use. Patients were knowledgeable and discriminating users of services, drawing on experiential knowledge of healthcare to choose between services. Their sense of ‘candidacy’ for specific emergency care services, was recursively shaped by previous experiences. Practice implications Strategies that emphasise the need to educate patients about healthcare services use alone are unlikely to change care-seeking behaviour. Practitioners need to modify care experiences that recursively shape patients’ judgements of candidacy and their perceptions of accessible expertise in alternative services.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2013 The Authors. Published by Elsevier Ireland Ltd. Open access under CC BY-NC-SA license. |
Keywords: | Healthcare utilisation; Primary health care; Patient experiences; Qualitative research; Longterm conditions; Unscheduled care; Emergency healthcare; Chronic obstructive pulmonary disease; Asthma; Diabetes; Coronary heart disease; Theory; Candidacy; Recursivity; Patient decision-making |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Primary Care (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Sep 2017 15:19 |
Last Modified: | 06 Sep 2017 15:19 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.pec.2013.06.001 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:116142 |