Where the joy comes from: a qualitative exploration of deep GP-patient relationships
Abstract Background Relationship-based, whole person care is foundational to quality general practice. Previous research has identified several characteristics of deep General Practitioner (GP)-patient relationships and their association with improved patient concordance, satisfaction and perceived...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-023-02224-0 |
| _version_ | 1797388141278003200 |
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| author | Hayley Thomas Johanna Lynch Emily Burch Megan Best Lauren Ball Elizabeth Sturgiss Nancy Sturman |
| author_facet | Hayley Thomas Johanna Lynch Emily Burch Megan Best Lauren Ball Elizabeth Sturgiss Nancy Sturman |
| author_sort | Hayley Thomas |
| collection | DOAJ |
| description | Abstract Background Relationship-based, whole person care is foundational to quality general practice. Previous research has identified several characteristics of deep General Practitioner (GP)-patient relationships and their association with improved patient concordance, satisfaction and perceived health outcomes. Psychological attachment theory has been used to understand therapeutic relationships, but has only been explored to a limited extent in the general practice context. Additionally, evolving changes in sociocultural and commercial practice contexts may threaten relationship-based care. In view of this, we aimed to explore the nature and experience of deep GP-patient relationships, as identified by patients, from GP and patient perspectives. Methods Semi-structured interview design. An initial survey assessed patients’ perceived depth of their relationship with their GP, using the Health Care Provider Attachment Figure Survey and Patient-Doctor Depth of Relationship Scale. Patients who reported a deep relationship, and their GPs, were purposively selected for individual interviews exploring their experience of these relationships. A post-interview survey assessed interviewees’ attachment styles, using the Modified and Brief Experiences in Close Relationships Scale. Patient interviewees also rated the patient-centredness of their GP’s clinic using the Person-Centred Primary Care Measure. Transcripts were analysed using thematic analysis. Results Thirteen patients and five GPs were interviewed. Four themes characterised deep relationships: the ‘professional’; human connection; trust; and ‘above and beyond’. Patient, GP and practice team all contributed to their cultivation. Conclusions We present a revised conceptual framework of deep GP-patient relationships. Deep relationships come to the fore in times of patient trouble. Like attachment relationships, they provide a sense of safety, caring and support for patients experiencing vulnerability. They can stretch GP boundaries and capacity for self-care, but also provide joy and vocational satisfaction. Patients may not always desire or need deep relationships with their GP. However, findings highlight the importance of enabling and cultivating these for times of patient hardship, and challenges of doing so within current healthcare climates. |
| first_indexed | 2024-03-08T22:36:32Z |
| format | Article |
| id | doaj.art-8a00a669b17a4bce81409e3c121da36d |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-03-08T22:36:32Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-8a00a669b17a4bce81409e3c121da36d2023-12-17T12:25:33ZengBMCBMC Primary Care2731-45532023-12-0124111410.1186/s12875-023-02224-0Where the joy comes from: a qualitative exploration of deep GP-patient relationshipsHayley Thomas0Johanna Lynch1Emily Burch2Megan Best3Lauren Ball4Elizabeth Sturgiss5Nancy Sturman6General Practice Clinical Unit, Faculty of Medicine, The University of QueenslandGeneral Practice Clinical Unit, Faculty of Medicine, The University of QueenslandFaculty of Health, Southern Cross UniversityInstitute for Ethics and Society, University of Notre Dame AustraliaCentre for Community Health and Wellbeing, The University of QueenslandSchool of Primary and Allied Health Care, Monash UniversityGeneral Practice Clinical Unit, Faculty of Medicine, The University of QueenslandAbstract Background Relationship-based, whole person care is foundational to quality general practice. Previous research has identified several characteristics of deep General Practitioner (GP)-patient relationships and their association with improved patient concordance, satisfaction and perceived health outcomes. Psychological attachment theory has been used to understand therapeutic relationships, but has only been explored to a limited extent in the general practice context. Additionally, evolving changes in sociocultural and commercial practice contexts may threaten relationship-based care. In view of this, we aimed to explore the nature and experience of deep GP-patient relationships, as identified by patients, from GP and patient perspectives. Methods Semi-structured interview design. An initial survey assessed patients’ perceived depth of their relationship with their GP, using the Health Care Provider Attachment Figure Survey and Patient-Doctor Depth of Relationship Scale. Patients who reported a deep relationship, and their GPs, were purposively selected for individual interviews exploring their experience of these relationships. A post-interview survey assessed interviewees’ attachment styles, using the Modified and Brief Experiences in Close Relationships Scale. Patient interviewees also rated the patient-centredness of their GP’s clinic using the Person-Centred Primary Care Measure. Transcripts were analysed using thematic analysis. Results Thirteen patients and five GPs were interviewed. Four themes characterised deep relationships: the ‘professional’; human connection; trust; and ‘above and beyond’. Patient, GP and practice team all contributed to their cultivation. Conclusions We present a revised conceptual framework of deep GP-patient relationships. Deep relationships come to the fore in times of patient trouble. Like attachment relationships, they provide a sense of safety, caring and support for patients experiencing vulnerability. They can stretch GP boundaries and capacity for self-care, but also provide joy and vocational satisfaction. Patients may not always desire or need deep relationships with their GP. However, findings highlight the importance of enabling and cultivating these for times of patient hardship, and challenges of doing so within current healthcare climates.https://doi.org/10.1186/s12875-023-02224-0General practitioner-patient relationshipPrimary careGeneral practiceQualitative researchAttachment theory |
| spellingShingle | Hayley Thomas Johanna Lynch Emily Burch Megan Best Lauren Ball Elizabeth Sturgiss Nancy Sturman Where the joy comes from: a qualitative exploration of deep GP-patient relationships BMC Primary Care General practitioner-patient relationship Primary care General practice Qualitative research Attachment theory |
| title | Where the joy comes from: a qualitative exploration of deep GP-patient relationships |
| title_full | Where the joy comes from: a qualitative exploration of deep GP-patient relationships |
| title_fullStr | Where the joy comes from: a qualitative exploration of deep GP-patient relationships |
| title_full_unstemmed | Where the joy comes from: a qualitative exploration of deep GP-patient relationships |
| title_short | Where the joy comes from: a qualitative exploration of deep GP-patient relationships |
| title_sort | where the joy comes from a qualitative exploration of deep gp patient relationships |
| topic | General practitioner-patient relationship Primary care General practice Qualitative research Attachment theory |
| url | https://doi.org/10.1186/s12875-023-02224-0 |
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