Describing the factors that influence the process of making a shared-agenda in Japanese family physician consultations: a qualitative study.

Q1 Medicine
Asia Pacific Family Medicine Pub Date : 2015-06-05 eCollection Date: 2015-01-01 DOI:10.1186/s12930-015-0023-6
Michiko Goto, Shoji Yokoya, Yousuke Takemura, Alberto Alexander Gayle, Tsukasa Tsuda
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引用次数: 2

Abstract

Background: Patients cannot always share all necessary relevant information with doctors during medical consultations. Regardless, in order to ensure the best quality consultation and care, it is imperative that a doctor clearly understands each patient's agenda. The purpose of this study was to analyze the process of developing a shared-agenda during family physician consultations in Japan.

Methods: We interviewed 15 first time patients visiting the outpatient clinic of the Department of Family Medicine in the hospital chosen for the investigation, and the 8 family physicians who examined them. In total we observed 16 consultations. We analyzed both patients' and doctors' narratives using a modified grounded theory approach.

Results: For patients, we found four main factors that influenced the process of making a shared-agenda: past medical experiences, undisclosed but relevant information, relationship with the family physician, and the patient's own explanatory model. In addition, we found five factors that influenced the shared agenda making process for family physicians: understanding the patient's explanatory model, constructing the patient-doctor relationship, physical examination centered around the patient's explanatory model, discussion-styled explanation, and self-reflection on action.

Conclusions: The findings suggest that patient satisfaction would be increased if family physicians are proactive in considering these factors with respect to both the patient's agenda, and their own.

Abstract Image

描述影响日本家庭医生会诊中制定共享议程过程的因素:一项定性研究。
背景:在医疗咨询中,患者不能总是与医生分享所有必要的相关信息。无论如何,为了确保最好的咨询和护理质量,医生必须清楚地了解每个病人的日程。本研究的目的是分析日本家庭医生会诊时制定共同议程的过程。方法:选取调查医院家庭内科门诊首次就诊的患者15例,对其进行检查的家庭医生8名。我们总共观察了16次咨询。我们用一种改良的扎根理论方法分析了病人和医生的叙述。结果:对于患者,我们发现了四个主要因素影响共享议程的过程:过去的医疗经历,未公开但相关的信息,与家庭医生的关系,以及患者自己的解释模型。此外,我们还发现了影响家庭医生共同议程制定过程的五个因素:理解患者的解释模式、构建医患关系、以患者的解释模式为中心的体检、讨论式解释和对行动的自我反思。结论:研究结果表明,如果家庭医生在考虑患者和他们自己的议程时积极主动地考虑这些因素,患者满意度将会提高。
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来源期刊
Asia Pacific Family Medicine
Asia Pacific Family Medicine Medicine-Family Practice
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