Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Jun;39(6):291-7.
doi: 10.1157/13106284.

[Stated theory of family doctors on their relationships with patients]

[Article in Spanish]
José Ramón Loayssa Lara  1 , Fermín González García, Roger Ruiz Moral
Affiliations

[Stated theory of family doctors on their relationships with patients]

[Article in Spanish]
José Ramón Loayssa Lara et al. Aten Primaria. 2007 Jun.

Abstract
in English, Spanish

Objective: To identify and analyse the "theory" expressed by family doctors on the essential features of an effective and functional doctor-patient relationship and on how to achieve one ("stated theory" of Argyris and Schon).

Design: Qualitative, based on discourse analysis.

Setting: Primary care.

Method: Interviews recorded with 10 family doctors selected by intentional sampling that were then transcribed. The propositions in the discourses were identified and conceptual maps were constructed. An inductive analysis classified the questions and positions that emerged and identified similarities and differences between subjects.

Results: Confidence and absence of conflict were the main desirable features of the doctor-patient relationship. Patients with a "demanding" attitude and their dishonesty were the most quoted obstacles. Doctors accepted negotiation, but held a very limited view of patient participation. Differences were appreciated on distance, the biomedical versus psychosocial focus and health education. Doctors' communication skills and qualities were little cited. Technical terminology in this area appeared little in the discourses.

Conclusions: Discourses highlighted "health consumerism" and revealed disagreements on distance in the relationship and the psycho-social approach. These points, which should be prioritised in training, along with education, can serve to define family doctors distinct professional orientations. Training methodology must bear in mind that experience dominates "stated theory" in this area.

Objetivo: Identificar y analizar cuál es la «teoría» que los médicos de familia expresan sobre las características esenciales de la relación médico-paciente efectiva y funcional y sobre cómo alcanzarla (“teoría declarada» de Argyris y Schon).

Diseño: Cualitativo, basado en análisis de discursos.

Emplazamiento: Atención primaria.

Método: Entrevistas audiograbadas a 10 médicos de familia seleccionados por muestreo intencional que fueron transcritas. Se identificaron las proposiciones de los discursos y se construyeron mapas conceptuales. Se realizó un análisis inductivo mediante la categorización de los temas y posiciones aparecidos, y la identificación de similitudes y diferencias intersujetos.

Resultados: La confianza y la ausencia de conflictos son las principales características deseables de la relación médico-paciente. La actitud «demandante» y la deshonestidad de los pacientes son los obstáculos más citados. Se acepta la negociación pero se mantiene una visión muy limitada de la participación del paciente. Se aprecian diferencias en la distancia, el foco biomédico frente a psicosocial y en la educación sanitaria. Las habilidades de comunicación y las cualidades del médico son poco citadas. La terminología técnica en esta área aparece poco en los discursos.

Conclusiones: Los discursos resaltan el «consumismo sanitario» y descubren desacuerdos sobre la distancia en la relación y el abordaje psicosocial. Estos puntos, que deben ser priorizados en la formación, junto con la educación, pueden servir para definir distintas orientaciones profesionales de los médicos de familia. La metodología de la formación debe tener en cuenta que la experiencia domina en la «teoría declarada» en esta área.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Cohen-Cole S. Mosby Year Book, Inc; St. Louis: 1991. The medical interview: The three-function approach.
    1. Stewart M., Brown J., Galajda J., Meredith L., Sangster M. Evidence on patient-doctor communication. Cancer Prev Control. 1999;3:25–30. - PubMed
    1. Blasi Z., Harkness E., Ernst E., Georgiou A., Kleijnen J. Influence of context effects on health outcomes: a systematic review. Lancet. 2001;357:757–762. - PubMed
    1. Muñoz Alamo M., Ruiz Moral R., Pérula de Torres L. Evaluation of a patient-centred approach in generalized musculoskeletal chronic pain/fibromyalgia patients in primary care. Patient Educ Couns. 2002;48:23–31. - PubMed
    1. Devine E., Cook T. A meta-analytic analysis of effects of psychoeducational interventions on length of post surgical hospital stay. Nurs Res. 1983;32:267–274. - PubMed

Publication types