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Table 4 Themes and categories of reasons for disagreement regarding illnesses between older patients with multimorbidity and their GPs

From: Reasons for disagreement regarding illnesses between older patients with multimorbidity and their GPs – a qualitative study

No Theme Perspective
  Category GP Patient
1 Problems with communication and cooperation between health care professionals   
  The hospital communicates many diagnoses that the general practitioner considered incorrect or exaggerated × ×
  The specialist explains his findings too little and / or responds insufficiently towards the patient × ×
  The GP is not/ or inadequately informed by the specialists, e.g. because no medical report is transferred × ×
  The GP is not involved in the treatment by the specialist × ×
  The patient reluctantly reports being treated by an alternative practitioner ×  
2 Disease management by GP and patient   
  The GP’s and patient’s understanding of a disease agree more in diagnoses requiring regular disease management × ×
  The GP’s diagnostic process is more difficult, if the examination of the patient is uncomfortable for the GP or he/she does not feel responsible × ×
  The complexity of a single or multiple diseases complicates the GP’s diagnostic process and the clinical management, as seen for example in multimorbidity × ×
  In patients who take own initiatives, there is a greater consistency in disease understanding between GP and patient   ×
3 Documentation behaviour of the GP   
  The pressure from health insurances to encode certain diseases, affects the documentation behaviour of the GP ×  
  Whether a disease is diagnosed by the GP or not, depends on the disease stage and measured values × ×
  Not all symptoms are documented by the GP as diseases × ×
  The GP has little knowledge about diseases that are lie far in the patients’ pasts × ×
  Errors in the patient record cannot be corrected subsequently, e.g. in the hospitals’ or GPs’ records × ×
4 Communication challenges between GP and patient   
  There is too little time to discuss complaints and diseases to achieve a mutual understanding × ×
  The GPs’ medical understanding of illnesses must be translated into the patients’ level of understanding and vice versa × ×
  The consultation can be exhausting and this may cause something to be forgotten or missed ×  
  The exchange of information and disease management are dependent on the doctor-patient relationship and the mutual trust × ×
  Agreement on understanding a disease is worse in patients who are difficult to lead and / or functionally impaired ×  
5 Differences in the understanding of a disease between GP and patient   
  Information that is given by specialists and / or elaborate diagnostics are formative for the patient ×  
  The patients’ clinical pictures are influenced by the media and campaigns × ×
  The GPs’ medical understanding of an illness deviates from the patients’ everyday understanding × ×
6 Prioritization and rating of diseases by GP and patient   
  The GP prioritizes diseases that affect the prognosis of the patient ×  
  The patient prioritizes diseases associated with complaints ×  
  Diseases that are not relevant for the patient from a general practitioner's point of view are not communicated to the patient ×  
  Diseases that are not relevant for the GP, from a patient’s perspective, are not communicated to the GP × ×
7 Obliviousness, repression and avoidance by the patient   
  The patient does not remember diseases if they are too far in the past × ×
  Diseases are repressed by the patient, e.g. cancer × ×
  The patient conceals embarrassing diseases × ×
  The patient tries to avoid the utilization of health services × ×
  1. × = Category has been reported by the respective perspective (GP, patient)