How to learn skilled communication in primary care MUS consultations: a focus group study

Scandinavian Journal of Primary Health Care

Tim C. olde Hartman¹  Peter L. B. J. Lucassen²  Aniek van Duijnhoven²  Hugo W. Stappers²  Juul Houwen²  Sandra van Dulmen²  Karel van Spaendonck² 

[1] Department of Primary and Community Care, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center;Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center;

关键词: medically unexplained symptoms;    consultation;    intervention;    general practice;    communication;    education;    focus group;   

DOI  :  10.1080/02813432.2021.1882088

来源: DOAJ

【 摘 要 】

Background Many general practitioners (GPs) experience communication problems in medically unexplained symptoms (MUS) consultations as they are insufficiently equipped with adequate communication skills or do not apply these in MUS consultations. Objective To define the most important learnable communication elements during MUS consultations according to MUS patients, GPs, MUS experts and teachers and to explore how these elements should be taught to GPs and GP trainees. Methods Five focus groups were conducted with homogeneous groups of MUS patients, GPs, MUS experts and teachers. MUS patients and GPs formulated a list of important communication elements. MUS experts identified from this list the most important communication elements. Teachers explored how these elements could be trained to GPs and GP trainees. Two researchers independently analysed the data applying the principles of constant comparative analysis. Results MUS patients and GPs identified a list of important communication elements. From this list, MUS experts selected five important communication elements: (1) thorough somatic and psychosocial exploration, (2) communication with empathy, (3) creating a shared understanding of the problem, (4) providing a tangible explanation and (5) taking control. Teachers described three teaching methods for these communication elements: (1) awareness and reflection of GPs about their feelings towards MUS patients, (2) assessment of GPs’ individual needs and (3) training and supervision in daily practice. Conclusion Teachers consider a focus on personal attitudes and needs, which should be guided by opportunities to practice and receive supervision, as the best method to teach GPs about communication in MUS consultations.KEY POINTS Many GPs experience difficulties in communication with patients with MUS. There is a need to equip GPs with communication skills to manage MUS consultations more adequately. Role-playing with simulation patients, reflection on video-consultations and joint consultations with the supervisor may increase the GPs’ awareness of their attitude towards MUS patients and may help GPs to identify their individual learning-points.

【 授权许可】

Unknown