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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 universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
2006 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis , 2006. , s. 76
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 157
Nyckelord [en]
Health services research, General practice, Balint group, Patient-centredness, Competence, Physician-patient relationship, Continuous professional development
Nyckelord [sv]
Hälso- och sjukvårdsforskning
Identifikatorer
URN: urn:nbn:se:uu:diva-6937ISBN: 91-554-6593-5 (tryckt)OAI: oai:DiVA.org:uu-6937DiVA, id: diva2:168540
Disputation
2006-09-19, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjöldsväg 20, Uppsala, 13:15 (Engelska)
Opponent
Handledare
Tillgänglig från: 2006-06-02 Skapad: 2006-06-02 Senast uppdaterad: 2009-10-07Bibliografiskt granskad
Delarbeten
1. Balint training makes GPs thrive better in their job
Öppna denna publikation i ny flik eller fönster >>Balint training makes GPs thrive better in their job
2004 (Engelska)Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 55, nr 2, s. 230-5Artikel i tidskrift (Refereegranskat) 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.

Nyckelord
Balint group, General practice, doctor-patient relationship, psychosomatic, continuing medical education
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Hälso- och sjukvårdsforskning
Identifikatorer
urn:nbn:se:uu:diva-67754 (URN)10.1016/j.pec.2003.09.009 (DOI)15530759 (PubMedID)
Tillgänglig från: 2005-01-13 Skapad: 2005-01-13 Senast uppdaterad: 2017-11-21Bibliografiskt granskad
2. Difficulties and dropouts in Balint groups
Öppna denna publikation i ny flik eller fönster >>Difficulties and dropouts in Balint groups
(Engelska)Manuskript (Övrigt vetenskapligt)
Identifikatorer
urn:nbn:se:uu:diva-94631 (URN)
Tillgänglig från: 2006-06-02 Skapad: 2006-06-02 Senast uppdaterad: 2010-05-20Bibliografiskt granskad
3. Satisfaction and sense of security: GPs' experience of Balint group participation - a qualitative study
Öppna denna publikation i ny flik eller fönster >>Satisfaction and sense of security: GPs' experience of Balint group participation - a qualitative study
(Engelska)Artikel i tidskrift (Refereegranskat) Submitted
Identifikatorer
urn:nbn:se:uu:diva-94630 (URN)
Tillgänglig från: 2006-06-02 Skapad: 2006-06-02 Senast uppdaterad: 2010-06-07Bibliografiskt granskad
4. How patient-centred am I?: A new method to measure physicians' patient-centredness
Öppna denna publikation i ny flik eller fönster >>How patient-centred am I?: A new method to measure physicians' patient-centredness
2006 (Engelska)Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 62, nr 1, s. 31-37Artikel i tidskrift (Refereegranskat) 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.

Nyckelord
Education, Method, Physician–patient relationship, Balint groups, Patient-centredness
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-94629 (URN)10.1016/j.pec.2005.05.017 (DOI)000238917600006 ()16024208 (PubMedID)
Tillgänglig från: 2006-06-02 Skapad: 2006-06-02 Senast uppdaterad: 2017-12-14Bibliografiskt granskad

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