In search of existential health in Swedish primary care: perspectives from older adults who took part in an existential group treatment.

چکیده اصلی

BACKGROUND: Although interest in existential perspectives on health is growing, little is known about how such perspectives are experienced by older adults in primary care. The aim of this study was to understand how older adults who took part in a primary care-based existential group treatment describe the role of existential challenges in relation to their health and in primary care. METHODS: Seventeen patients (75+) with psychological distress who had completed a 7-week existential group treatment took part in individual interviews. Transcripts were analyzed using thematic analysis. RESULTS: Three main themes were derived from the participants' experiences: (1) Existential challenges are embedded in health in later life; (2) Existential challenges are not usually addressed in primary care consultations; and (3) Engagement with existential challenges is possible within primary care. Older adults with psychological distress describe existential challenges in terms of age-related losses which raise questions of health-related agency. However, barriers to addressing existential challenges in this care setting persist in the form of time constraints, perceived ageism and a one-sided focus on physical health. Relational and trustful healthcare encounters helped to overcome these barriers, as did the existential group treatment. CONCLUSION: While existential challenges are embedded in older adults' health, addressing these issues is not yet an integrated part of primary care services. In search of existential health in Swedish primary care, relational and trustful healthcare encounters as well as structured existential interventions, were found to facilitate the integration of existential perspectives in older adults' primary care experience.

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