BMJ Open
Healthcare professionals’ experiences of providing care for patients with Graves’ disease: a qualitative interview study in Swedish secondary care
By Agneta Lindo, Sara Alsén, Andreas Fors and 1 others.
Abstract
Objective Graves’ disease (GD) is an autoimmune thyroid disease, mainly affecting women of working age. The hyperthyroidism in GD is characterised by physical symptoms (tachycardia, weight loss, sweating and tremors) as well as cognitive and psychological problems that have a major impact on the daily lives of patients. Mental symptoms are particularly distressing, with patients expressing a desire for more communication and support for the mental aspects of their care. The aim of this study was to explore the experience of healthcare professionals (HCPs) when providing care and treatment to patients with GD. Design A qualitative study based on interviews conducted digitally or face to face was performed with data evaluated according to Graneheim and Lundman’s qualitative content analysis. Setting The study was conducted within specialised care at the secondary level in a Swedish healthcare context. Participants 12 HCPs (6 physicians and 6 registered nurses) with experience in providing care and treatment for patients with GD were interviewed. Results The study highlighted shortcomings in the care of patients with GD, emphasising that GD is more complex than many other endocrine conditions due to its cognitive and psychological impact. Several obstacles hindered the ability to meet patient needs, including limited time, an organisational structure that is not adapted to the nature of GD, insufficient resources and a lack of interdisciplinary cooperation. HCPs acknowledged that patients often had needs that exceeded what the current system allowed them to address, which led to frustration and affected the work environment. There was a strong and shared desire among HCPs for changes that could improve the quality of care for this patient group. Conclusion Optimal care for patients with GD requires treatment tailored to the specific needs of each patient supported by organisational approaches that acknowledge the complexity of the condition, addressing both physical and psychological aspects. A way to achieve this is by enabling sufficient time for patient-HCP interaction, improving continuity of care and strengthening interdisciplinary collaboration. Key implications for practice include targeted training in the psychosocial aspects of GD and the integration of a contact registered nurse with specialised knowledge in thyroid diseases, which may improve both care quality and the HCP work environment.






