Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain
Objective To explore the experiences of patients suffering from new daily persistent headache (NDPH) regarding the diagnostic process, treatment and medical care.Design A qualitative phenomenological study was conducted.Setting A specialised headache unit at two university hospitals in Spain between...
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| Format: | Article |
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BMJ Publishing Group
2021-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/8/e048552.full |
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| author | Domingo Palacios-Ceña David García-Azorín María Luz Cuadrado Blanca Talavera Víctor Gómez-Mayordomo María Gallego-Gallego Ángel Luis Guerrero-Peral |
| author_facet | Domingo Palacios-Ceña David García-Azorín María Luz Cuadrado Blanca Talavera Víctor Gómez-Mayordomo María Gallego-Gallego Ángel Luis Guerrero-Peral |
| author_sort | Domingo Palacios-Ceña |
| collection | DOAJ |
| description | Objective To explore the experiences of patients suffering from new daily persistent headache (NDPH) regarding the diagnostic process, treatment and medical care.Design A qualitative phenomenological study was conducted.Setting A specialised headache unit at two university hospitals in Spain between February 2017 and December 2018.Participants Patients diagnosed with NDPH according to the International Classification of Headache disorders (third beta edition).Methods Purposeful sampling was performed. Data were collected using unstructured and semistructured interviews, researchers’ field notes and patients’ drawings. An inductive thematic analysis was used to identify significant emerging themes from interviews, field notes and descriptions of patients’ drawings. Also, Guillemin’s proposal was used to analyse the contents of drawings.Results Nineteen patients with a mean age of 45.3 were recruited. Four main themes emerged: (1) Seeking a diagnosis, patients visit many doctors without receiving a clear answer and their diagnosis is delayed; (2) Self-medication—minimising pill intake, medication is ineffective, and therefore, some patients discontinue treatment, or are flexible with how they take medication; (3) Trying other non-pharmacological options, many patients turn to other therapies and complementary and/or alternative therapies as a second option, however these are ineffective and (4) Medical care, with two subthemes, referrals and lacking continuity of care, and building the doctor–patient relationship. Patients describe how the referral breaks the continuity of care, and how they identify the traits of a doctor who is approachable and which behaviours the doctor should avoid when caring for patients.Conclusions An in-depth knowledge of the beliefs and expectations of patients with NDPH will allow the professional to establish a relationship of trust, which will improve the patients’ knowledge of which therapies are the most appropriate, and to establish expectations based on the relationship with the doctor, and not only on patients’ beliefs. |
| format | Article |
| id | doaj-art-5fe807ec4ad54d70a9a894785598c55d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-5fe807ec4ad54d70a9a894785598c55d2024-12-11T07:15:09ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2020-048552Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in SpainDomingo Palacios-Ceña0David García-Azorín1María Luz Cuadrado2Blanca Talavera3Víctor Gómez-Mayordomo4María Gallego-Gallego5Ángel Luis Guerrero-Peral6Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón/Madrid, SpainDepartment of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, SpainDepartment of Neurology, Hospital Clínico San Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainDepartment of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, SpainDepartment of Neurology, Institute of Neurosciences, Vithas Hospital Group, Madrid, SpainDepartment of Anesthesiology, Hospital General de Segovia, Segovia, SpainDepartment of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, SpainObjective To explore the experiences of patients suffering from new daily persistent headache (NDPH) regarding the diagnostic process, treatment and medical care.Design A qualitative phenomenological study was conducted.Setting A specialised headache unit at two university hospitals in Spain between February 2017 and December 2018.Participants Patients diagnosed with NDPH according to the International Classification of Headache disorders (third beta edition).Methods Purposeful sampling was performed. Data were collected using unstructured and semistructured interviews, researchers’ field notes and patients’ drawings. An inductive thematic analysis was used to identify significant emerging themes from interviews, field notes and descriptions of patients’ drawings. Also, Guillemin’s proposal was used to analyse the contents of drawings.Results Nineteen patients with a mean age of 45.3 were recruited. Four main themes emerged: (1) Seeking a diagnosis, patients visit many doctors without receiving a clear answer and their diagnosis is delayed; (2) Self-medication—minimising pill intake, medication is ineffective, and therefore, some patients discontinue treatment, or are flexible with how they take medication; (3) Trying other non-pharmacological options, many patients turn to other therapies and complementary and/or alternative therapies as a second option, however these are ineffective and (4) Medical care, with two subthemes, referrals and lacking continuity of care, and building the doctor–patient relationship. Patients describe how the referral breaks the continuity of care, and how they identify the traits of a doctor who is approachable and which behaviours the doctor should avoid when caring for patients.Conclusions An in-depth knowledge of the beliefs and expectations of patients with NDPH will allow the professional to establish a relationship of trust, which will improve the patients’ knowledge of which therapies are the most appropriate, and to establish expectations based on the relationship with the doctor, and not only on patients’ beliefs.https://bmjopen.bmj.com/content/11/8/e048552.full |
| spellingShingle | Domingo Palacios-Ceña David García-Azorín María Luz Cuadrado Blanca Talavera Víctor Gómez-Mayordomo María Gallego-Gallego Ángel Luis Guerrero-Peral Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain BMJ Open |
| title | Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain |
| title_full | Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain |
| title_fullStr | Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain |
| title_full_unstemmed | Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain |
| title_short | Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain |
| title_sort | understanding the diagnoses and medical care experience of patients with new daily persistent headache a qualitative study in spain |
| url | https://bmjopen.bmj.com/content/11/8/e048552.full |
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