How patients in general practice voice and value their gut feelings about health: a qualitative interview study

Abstract

Background: General practitioners (GP) consider their gut feelings a valuable tool in clinical reasoning. The literature offers strong indications that patients’ gut feelings may also be a useful contribution to that process. To improve the primary care professionals’ recognition of a patient’s gut feeling and insight into their background, it is useful to describe patients’ gut feelings more precisely. Additionally, these descriptions will enable us to thoroughly examine the validity of patients’ gut feelings and their contribution to professionals’ clinical reasoning. Aim: To gather the expressions that patients or their relatives use to share their gut feelings with primary care professionals and what they convey and imply. Design and Setting: Qualitative research. Dutch and Belgian patients (n=47) visiting an out-of-hours GP service or a GP’s office. Method: Face-to-face semi-structured interviews. Descriptive content analysis in an iterative process. Data sufficiency achieved. Results: Patients or their relatives expressed their gut feelings by using words relating to trusting or not trusting the situation, or to changes in normal patterns. Their gut feelings are most often regarded a sense of alarm. In general, patients with a sense of alarm were convinced that something was wrong and had often learned to trust their gut feeling, in particular mothers of sick children. A gut feeling was mostly the reason to contact a primary care professional. Conclusion: Our results may improve the professionals’ recognition of patients’ gut feelings and enable further research into their validity.