Caring relatives in General Practice – subjective perspectives of General Practitioners from Saxony-Anhalt

Yvonne Marx, Thomas Frese, Alexander Bauer

Background:
General practitioners usually are responsible for the early detection of burden due to informal care and the coordination of adequate measures. Their individual approaches for identifying and supporting caregiving relatives as well as subjective perspectives regarding their field of competence have hardly been examined yet.

Research questions:
1. Concerning caring relatives, how do general practitioners estimate their own field of competence?
2. How do they identify caring relatives, which symptoms indicate burden due to family care?
3. Which circumstances complicate the identification and care?

Method:
In preparation of a representative quantitative survey, we, therefore, conducted 12 guideline-based expert interviews with general practitioners from Saxony-Anhalt. To evaluate the interviews we used qualitative content analysis (Mayring).

Results:
With regard to the medical care and support of caring relatives, the examination of subjective attitudes and perspectives affirms the central and directive position of general practitioners. It also shows possibilities to improve or to facilitate: Time-dependent problems, inadequate remuneration for long consultations, and a lack of communication complicate support. The evidence-based guideline “Family Caregivers“, issued by the German Society of General Practice and Family Medicine (DEGAM), is either unknown or not used in German General Practice.

Conclusions:
A short screening instrument (identification, measuring subjective burden) represents a sensible intervention. In advance, a following representative quantitative survey using case vignettes is necessary to evaluate specific requirements of interventions used in general medical practice and capabilities for a better implementation of the guideline.

Points for discussion:
Why is the guideline “Family Caregivers” either unknown or not used in German General Practice?

What should be done for a better implementation of the guideline?

For a successful development and implementation of a short screening instrument for family caregivers (identification, measuring subjective burden): What requirements and characteristics must be met in General Practice?