Patients' experiences with lifestyle counselling in general practice: A qualitative study

Abstract

OBJECTIVE. (1) To elucidate the relevance of Habermas's theory as a practical deliberation procedure in lifestyle counselling in general practice, using a patient perspective. (2) To search for topics which patients consider of significance in such consultations. DESIGN. Qualitative observation and interview study. SETTING. General practice. Subjects. A total of 12 patients were interviewed after lifestyle consultations with their GPs. MAIN OUTCOME MEASURES. How the patients perceived the counselling, how it affected them, and what they wanted from their GP in follow-up consultations. RESULTS. The GP should be a source of medical knowledge and a caretaker, but also actively discuss contextual reasons for lifestyle choices, and be a reflective partner exploring values and norms. The patients wanted their GP to acknowledge emotions and to direct the dialogue towards common ground where advice was adjusted to the concrete life situation. A good, personal doctor-patient relationship created motivation and obligation to change, and allowed counselling to be interpreted as care. CONCLUSION. The findings underscore the necessity of a patient-centred approach in lifestyle counselling and support the relevance of Habermas's theory as practical guidance for deliberation. IMPLICATIONS. The findings suggest that GPs should trust the long-term effects of investing in a good relationship and personalized care in lifestyle consultations. The study should incite the GP to act as an encouraging informer, an explorer of everyday life and reasons for behaviour, a reflective partner, and a caretaker, adjusting medical advice to patients' identity, context, and values.

To give the invisible child priority: Children as next of kin in general practice

“…Patients have reported that a trusting relationship can make it easier to bring up sensitive themes [24]. This has also been found with battered women, who have to be convinced of loyalty from their physicians before they admit to having been abused [25].…”

Implementation of healthy lifestyle promotion in primary care: Patients as coproducers

“…Thus, the findings may reassure practitioners and confirm the importance of a trustful patient-practitioner interaction, which is described repeatedly in the literature [18,32,33].…”

A qualitative study of citizens' experience of participating in health counseling

“…The feeling of being obliged to comply with an agreement is also seen in a study by Walseth et al . () dealing with lifestyle counseling in general practice. Walseth's study found that feeling an obligation to follow the advice of doctors played a major role for patients.…”

“…Few studies have examined how people experience health counseling (Chan, Fam & Ng, ; Dellasega, Anel‐Tiangco & Gabbay, ; Hardcastle & Hagger, ; O'Sullivan, Fortier, Faubert et al ., ; Walseth, Abildsnes & Schei, ), but none of these focus on health counseling for the general population wanting to change health behavior. In order to investigate why people sign up for health counseling, and in order to gain a deeper understanding of which aspects of health counseling are of greatest importance to the health behavior of the person, more studies are needed.…”