Knowing patients as persons: senior and junior general practitioners explore a professional resource

Mjølstad, Bente Prytz; Kirkengen, Anna Luise; Getz, Linn; Hetlevik, Irene

doi:10.5750/ejpch.v1i1.637

Cited by 3 publications

(9 citation statements)

References 22 publications

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“…The GPs who participated in the focus groups during the first phase of this project claimed to be knowledgeable about their patients as persons [15]. Although a different group of doctors participated in the present study, the findings indicate that physicians' knowledge is, in fact, limited and that the patterns of those limitations are shaped both by professional and social phenomena.…”

Section: Reflections On Validitymentioning

confidence: 52%

“…In a previous study [15] we focused on what, in general, it is like to be a GP who knows her/his patients' biography and especially when cooperating with other parts of the healthcare system. In the present study, we investigate more concretely what person-related knowledge GPs actually tend to have.…”

Section: Discussionmentioning

confidence: 99%

“…In the initial, exploratory phase, 2 groups of GPs were invited to reflect upon and discuss the potential significance of having knowledge about their assigned patients as persons. The participating GPs in that study were confident that they possessed medically relevant knowledge about their patients' life-world, for example, in the case of admission for rehabilitation [15]. In this second part of the project, as outlined in this paper, we explore the knowledge the GPs actually have about their patients as persons by comparing the information the GPs share to the narratives offered by the patients themselves.…”

Section: Motivation For This Projectmentioning

confidence: 99%

“…Though they consider such knowledge to be medically relevant, they often find it difficult to formulate and record, both for the immediate patient record and for potential transfer to other actors and institutions in the healthcare system [15].…”

Section: Introductionmentioning

confidence: 99%

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What do GPs actually know about their patients as persons?

Mjølstad¹,

Kirkengen²,

Getz³

et al. 2013

EJPCH

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Background and Aims: Life experience and existential circumstances have an impact on health. Within medicine, however, the significance to patient care of person-related, biographical knowledge receives only rudimentary emphasis and its substantial theoretical underpinnings are inadequately understood and infrequently applied. This study explores the types and extent of some Norwegian general practitioners' (GPs') person-related knowledge, exemplified by patients on the GPs respective lists who are currently in a state of frail health. Methods: Nine GPs were interviewed regarding one of their patients who had recently been admitted to the rehabilitation unit of a nursing home. Subsequent interviews with the individual patients served both to validate the GPs' information and as a starting point for further inquiry into patient life stories. Interview transcripts were analyzed within a phenomenological-hermeneutical framework.

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Section: Reflections On Validitymentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Motivation For This Projectmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

What do GPs actually know about their patients as persons?

Mjølstad¹,

Kirkengen²,

Getz³

et al. 2013

EJPCH

Self Cite

View full text Add to dashboard Cite

show abstract

“…As the third step in a three-phased project (Mjølstad, Kirkengen, Getz, & Hetlevik, 2013a, b), the present study aims to explore the medical relevance of person-related knowledge both in general practice and at the interface between primary care and institutional care. In the initial phase, two groups of GPs were invited to reflect upon and discuss the potential significance of knowing their patients as persons.…”

Section: Aim Of the Present Studymentioning

confidence: 99%

Standardization meets stories: Contrasting perspectives on the needs of frail individuals at a rehabilitation unit

Mjølstad

Kirkengen

Getz

et al. 2013

International Journal of Qualitative Studies on Health and Well

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BackgroundRepeated encounters over time enable general practitioners (GPs) to accumulate biomedical and biographical knowledge about their patients. A growing body of evidence documenting the medical relevance of lifetime experiences indicates that health personnel ought to appraise this type of knowledge and consider how to incorporate it into their treatment of patients. In order to explore the interdisciplinary communication of such knowledge within Norwegian health care, we conducted a research project at the interface between general practice and a nursing home.MethodsIn the present study, nine Norwegian GPs were each interviewed about one of their patients who had recently been admitted to a nursing home for short-term rehabilitation. A successive interview conducted with each of these patients aimed at both validating the GP's information and exploring the patient's life story. The GP's treatment opinions and the patient's biographical information and treatment preferences were condensed into a biographical record presented to the nursing home staff. The transcripts of the interviews and the institutional treatment measures were compared and analysed, applying a phenomenological–hermeneutical framework. In the present article, we compare and discuss: (1) the GPs’ specific recommendations for their patients; (2) the patients’ own wishes and perceived needs; and (3) if and how this information was integrated into the institution's interventions and priorities.ResultsEach GP made rehabilitation recommendations, which included statements regarding both the patient's personality and life circumstances. The nursing home staff individualized their selection of therapeutic interventions based on defined standardized treatment approaches, without personalizing them.ConclusionWe found that the institutional voice of medicine consistently tends to override the voice of the patient's lifeworld. Thus, despite the institution's best intentions, their efforts to provide appropriate rehabilitation seem to have been jeopardized to some extent.

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Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

Pedersen

Pétursson

Hetlevik

et al. 2021

BMC Health Serv Res

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Background The acute treatment for stroke takes place in hospitals and in Norway follow-up of stroke survivors residing in the communities largely takes place in general practice. In order to provide continuous post stroke care, these two levels of care must collaborate, and information and knowledge must be transferred between them. The discharge summary, a written report from the hospital, is central to this communication. Norwegian national guidelines for treatment of stroke, issued in 2010, therefore give recommendations on the content of the discharge summaries. One ambition is to achieve collaboration and knowledge transfer, contributing to integration of the health care services. However, studies suggest that adherence to guidelines in general practice is weak, that collaboration within the health care services does not work the way the authorities intend, and that health care services are fragmented. This study aims to assess to what degree the discharge summaries adhere to the guideline recommendations on content and to what degree they are used as tools for knowledge transfer and collaboration between secondary and primary care. Methods The study was an analysis of 54 discharge summaries for home-dwelling stroke patients. The patients had been discharged from two Norwegian local hospitals in 2011 and 2012 and followed up in primary care. We examined whether content was according to guidelines’ recommendations and performed a descriptive and interpretative discourse analysis, using tools adapted from an established integrated approach to discourse analysis. Results We found a varying degree of adherence to the different advice for the contents of the discharge summaries. One tendency was clear: topics relevant here and now, i.e. at the hospital, were included, while topics most relevant for the later follow-up in primary care were to a larger degree omitted. In most discharge summaries, we did not find anything indicating that the doctors at the hospital made themselves available for collaboration with primary care after dischargeof the patient. Conclusions The discharge summaries did not fulfill their potential to serve as tools for collaboration, knowledge transfer, and guideline implementation. Instead, they may contribute to sustain the gap between hospital medicine and general practice.

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Knowing patients as persons: senior and junior general practitioners explore a professional resource

Cited by 3 publications

References 22 publications

What do GPs actually know about their patients as persons?

What do GPs actually know about their patients as persons?

Standardization meets stories: Contrasting perspectives on the needs of frail individuals at a rehabilitation unit

Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

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