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Medknow Publications, Education for Health, 1(27), p. 39

DOI: 10.4103/1357-6283.134308

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Trust, continuity and agency: Keys to understanding older patients' attitudes to general practice trainees

Journal article published in 2014 by Andrew Bonney ORCID, Sc Jones ORCID, Don Iverson, Christopher Magee
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Background: Populations are ageing and therefore non-communicable diseases are becoming leading causes of global morbidity, which need to be the focus of primary care services and training. Some older patients are uncomfortable with general practitioner (GP) trainees managing their chronic conditions, reducing clinical experience opportunities for trainees. This Australian cross-sectional study explored the factors underlying patients' attitudes to trainees in an agency theory framework. Methods: Fifty patients aged 60 and over from each of 38 training practices were offered a questionnaire after their consultation. Principal component analysis of the results was undertaken. Factor scores were calculated. Binary logistic modelling was used to identify relationships between participant characteristics, behaviours, attitude items and factor scores. Results: The response rate was 47.9% (n = 911). Three factors were identified: 'Interpersonal Trust' (IPT); 'Institution/system Trust' (ST); and 'Interpersonal Continuity' (IPC). Lower self-rated health (SRH) was associated with higher IPT factor scores (P = 0.023); higher SRH with higher ST scores (P = 0.001); and chronic illness with higher IPC scores (P = 0.005). Higher ST scores were associated with greater comfort with trainees' involvement in chronic care (P