Patientperspektivet på læge-patientrelationen i ... - Dagens Medicin

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ut rather a vulnerable human being. Other studies have shown that certain patient groups are vulnerable [29-32], but all patients are potentially vulnerable. The strength of this study is the in-depth qualitative approach that combines interview with patients seeing either a regular or an unfamiliar doctor. This made it possible to see nuances in the patients‟ preferences and analyse when and why they prefer a regular doctor. The empirical analysis that showed the vulnerability and difficulties in changing doctors made the theory convincing. A weakness of this study is that the analysis focused on the similarities of the 22 patients‟ preferences. However, it was necessary to focus on the common features of the patients to take the analysis above a subjective level and to create coherence between the interviews and form analytic validity as to the significance of interpersonal continuity. Furthermore, the most significant variations were included in the analysis in the form of the two patients who differed from the others. They showed the complexity by opposing to the need of attachment to a certain GP in the actual consultation, but may still confirm the theory by believing that their need of attachment would change when their life situations changed. A deeper understanding of the role of attachment within the doctor-patient relationship in primary care can lead to better patient care and enrich the GP‟s clinical experience. The attachment theory explains why it is valuable to have a regular doctor and is an argument for general practice having a special quality in relation to the remaining health care system. It provides the patients with the desired possibility of attaching themselves to a regular doctor. Several researchers have tried empirically to pin down the special quality about the good doctor-patient relationship in general practice [15,26,33]. However a theoretical depth is required to obtain a more comprehensive theoretical framework for human sickness [34]. This study adds a theoretical framework which may help in further research into the significance of relational continuity in the doctor-patient relationship. The results oppose a tendency in our time where the importance of the subjectivity of the doctor is being minimised [35]. Within contemporary society, the ascendancy of market rhetorics has made it difficult to see the difference between a consumer-provider relationship and a doctor-patient relationship. However, this study shows that patients should not be mistaken for consumers. Furthermore, there is a need of further knowledge about the patients‟ different attachment styles and how they affect the doctor-patient relationship. 116
Acknowledgements We are very grateful to the patients who agreed to be interviewed and acknowledge the doctors and their practice staff who participated. References [1] Pandhi N, Saultz JW. Patients' perceptions of interpersonal continuity of care. J Am Board Fam Pract 2006; 19: 390-397. [2] von Bultzingslowen I, Eliasson G, Sarvimaki A, Mattsson B, Hjortdahl P. Patients' views on interpersonal continuity in primary care: a sense of security based on four core foundations. Fam Pract 2006; 23: 210-219. [3] Kearley KE, Freeman GK, Heath A. An exploration of the value of the personal doctor- patient relationship in general practice. Brit J Gen Pract 2001; 51: 712-718. [4] Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, McKendry R. Continuity of care: a multidisciplinary review. BMJ 2003; 327: 1219-1221. [5] Baker R, Boulton M, Windridge K, Tarrant C, Bankart J, Freeman GK. Interpersonal continuity of care: a cross-sectional survey of primary care patients' preferences and their experiences. Brit J Gen Pract 2007; 57: 283-289. [6] Guthrie B, Wyke S. Personal continuity and access in UK general practice: a qualitative study of general practitioners' and patients' perceptions of when and how they matter. BMC Fam Pract 2006; 7: 11. 117
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Ph.d.-afhandling Patientperspektive
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BILAG 1 ...........................
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Tak til alle de gode kollegaer på
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jo mere brug for omsorg fra en fast
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of autonomy. It was valuable to the
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forbrugerorienterede, og hvad indeb
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listesystem, men i Danmark skal pat
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elationel kontinuitet (dvs. patient
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nødvendigt at starte analysen i in
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identitetsopfattelse (46:90). Samfu
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1.5.2. Udviklingspsykologisk teori
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Kapitel 2. Materiale og metode Dett
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Læge 1 Læge 2 Læge 3 Læge 4 Læ
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Fiktivt navn på patient (pt.) Pt.
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2.3. Udformning af interviewet Det
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ikke tale om en detaljeret sproglig
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evægelse. Abduktion kombinerer en
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Trin 2: Analyse af mening Ved trin
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Tema: krænkelse: ”Ikke at blive
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3.2. I hvilken grad ønsker patient
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Kapitel 4. Diskussion I det følgen
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præciseret, at en god læge-patien
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En undersøgelse publiceret i 2007
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4.1.3. Behov for tilknytning i læg
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forekom heller ikke rationelt, at d
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hvilket andre studier før har vist
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4.2. Diskussion af metode I det fø
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Adskillelsen mellem interviewfase o
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interviewpersonen, 2) af offentligh
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som de for analysen mest relevante,
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jævnbyrdige forhold mellem lægen
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Litteraturliste (1) National strate
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Page 67 and 68: (48) Christoffersen SA. Profesjonse
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Page 75 and 76: Bilag 1-5 Bilag 1 Information til p
Page 77 and 78: Bilag 3 Interviewguide Husk info om
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Page 81 and 82: Appendiks 1-3 Appendiks 1: Artikel
Page 83 and 84: Background Continuity of care has t
Page 85 and 86: Results The analysis showed two cor
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Page 91 and 92: Discussion Summary of main findings
Page 93 and 94: diseases. The unsatisfactory doctor
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Page 107 and 108: Appendiks 3: Artikel 3 Attachment i
Page 109 and 110: Abstract Objective. To explore why
Page 111 and 112: A phenomenological approach called
Page 113 and 114: ”If it relates to my back, and so
Page 115: attachment theory: when you are sic
Page 119 and 120: [16] Bowlby J. The Making and Break
Page 121 and 122: [35] Heath I, Nessa J. Objectificat
Page 123 and 124: Bensing, J. M., Verhaak, P. F. M.,
Page 125 and 126: Det Etiske Råd. 2003. Læge-patien
Page 127 and 128: Hantho, A., Jensen, L., & Malterud,
Page 129 and 130: Lewis, J. R. 1994. Patient Views on
Page 131 and 132: Ogden, J., Daniells, E., & Barnett,
Page 133 and 134: Smith, J. A. & Osborn Mike 2003. In
Page 135: Willaing, I., Folmann, N. B., & Gis
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Patientperspektivet på læge-patientrelationen i ... - Dagens Medicin

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