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The Doctor, the Task and the Group: Balint Groups as a Means of Developing New Understanding in the Physician-Patient Relationship
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general practitioner has a central position in the health care system, but demands have increased and there are signs of exhaustion in the corps. Patient-centredness is beneficial for the patients and probably for the outcome of health care. In Balint groups general practitioners study and gain further understanding of the physician-patient relationship by means of the participants’ own experiences.

This thesis aims at studying experienced effects of Balint groups on the working life of general practitioners. General practitioners with and without Balint group experience are compared by means of a questionnaire, using statistical methods. General practitioners with Balint group experience are interviewed. Both these studies show positive experiences of Balint group participation in the physicians’ working life in terms of feeling of control and satisfaction, and on relations to patients, particularly patients with complex problems.

A new instrument for measuring physicians’ degree of patient-centredness is presented. It can be used in groups of physicians to evaluate training programmes or by the individual physician to detect decline in patient-centredness as an early sign of burnout.

Balint groups are viewed critically in interviews with Balint group leaders, focussed on difficulties and dropouts from the groups. Balint groups are found to fit into modern theories of small groups as complex systems, submitted to group dynamics that are sometimes malicious. Professionally conducted Balint groups seem to be a gentle, efficient method to train physicians, but with limits. Participation of a member demands a stable psychological condition and an open mind, and obligatory Balint groups are questioned.

The thesis concludes that Balint groups are generally beneficial for general practitioners’ working life as a means to enable the physicians endure, even thrive in their job. The method facilitates development of new understanding of the physician-patient relationship with possible positive effects for the patient as well.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2006. , p. 76
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 157
Keywords [en]
Health services research, General practice, Balint group, Patient-centredness, Competence, Physician-patient relationship, Continuous professional development
Keywords [sv]
Hälso- och sjukvårdsforskning
Identifiers
URN: urn:nbn:se:uu:diva-6937ISBN: 91-554-6593-5 (print)OAI: oai:DiVA.org:uu-6937DiVA, id: diva2:168540
Public defence
2006-09-19, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjöldsväg 20, Uppsala, 13:15 (English)
Opponent
Supervisors
Available from: 2006-06-02 Created: 2006-06-02 Last updated: 2009-10-07Bibliographically approved
List of papers
1. Balint training makes GPs thrive better in their job
Open this publication in new window or tab >>Balint training makes GPs thrive better in their job
2004 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 55, no 2, p. 230-5Article in journal (Refereed) Published
Abstract [en]

In this study, we examined Balint group participants' sense of control and satisfaction in their work situation and their attitudes towards caring for patients with psychosomatic problems. Forty-one GPs filled in a questionnaire with a 10-point visual analogue scale. Of these, 20 had participated in Balint groups for more than one year and 21 were a reference group. The Balint physicians reported better control of their work situation (e.g. taking coffee breaks and participating in decision making), thought less often that the patient should not have come for consultation or that psychosomatic patients were a time-consuming burden, and were less inclined to refer patients or take unneeded tests to terminate the consultation with the patient. These results might indicate higher work-related satisfaction and better doctor-patient relationship.

Keywords
Balint group, General practice, doctor-patient relationship, psychosomatic, continuing medical education
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-67754 (URN)10.1016/j.pec.2003.09.009 (DOI)15530759 (PubMedID)
Available from: 2005-01-13 Created: 2005-01-13 Last updated: 2017-11-21Bibliographically approved
2. Difficulties and dropouts in Balint groups
Open this publication in new window or tab >>Difficulties and dropouts in Balint groups
(English)Manuscript (Other academic)
Identifiers
urn:nbn:se:uu:diva-94631 (URN)
Available from: 2006-06-02 Created: 2006-06-02 Last updated: 2010-05-20Bibliographically approved
3. Satisfaction and sense of security: GPs' experience of Balint group participation - a qualitative study
Open this publication in new window or tab >>Satisfaction and sense of security: GPs' experience of Balint group participation - a qualitative study
(English)Article in journal (Refereed) Submitted
Identifiers
urn:nbn:se:uu:diva-94630 (URN)
Available from: 2006-06-02 Created: 2006-06-02 Last updated: 2010-06-07Bibliographically approved
4. How patient-centred am I?: A new method to measure physicians' patient-centredness
Open this publication in new window or tab >>How patient-centred am I?: A new method to measure physicians' patient-centredness
2006 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 62, no 1, p. 31-37Article in journal (Refereed) Published
Abstract [en]

Objective

To describe a new method to determine physicians’ self-perceived degree of patient-centredness. A pilot study combining qualitative and quantitative methods.

Methods

Forty-one general practitioners (GPs) answered a questionnaire consisting of three open-ended questions about their view of the consultation and by choosing among 28 roles of the physician in the physician–patient relationship. Twenty of the GPs had participated in Balint groups while 21 had had no access to Balint group. Patient-centredness is central to Balint groups and consequently Balint group participants would be expected to be patient-centred.

Results

The answers to the two parts were divided into three groups each, patient-centred, non-patient-centred and intermediary, and analysed statistically. Significantly more Balint participants were patient-centred than the reference group.

Conclusion

The instrument describes physicians’ self-perceptions of their patient-centredness and can distinguish a group of patient-centred physicians from a group of non-patient-centred physicians.

Practice implications

The instrument can be useful to evaluate educational programmes and detect decline in patient-centredness as early sign of burnout.

Keywords
Education, Method, Physician–patient relationship, Balint groups, Patient-centredness
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-94629 (URN)10.1016/j.pec.2005.05.017 (DOI)000238917600006 ()16024208 (PubMedID)
Available from: 2006-06-02 Created: 2006-06-02 Last updated: 2017-12-14Bibliographically approved

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