Rural general practice patients' coping with hazards and harm: an interview study

Abstract

Objective: The aim of this study is to identify and analyse rural general practice patients' experiences of hazards and harm that comprise adverse events, and their strategies for coping with them.

Design: Interview study using systematic text condensation and coping strategy theory in an abductive analysis process.

Setting: Nine rural general practice clinics in Norway.

Participants: Twenty participants, aged 21-79 years, all presenting with recent onset of somatic and/or psychiatric complaints.

Results: Participating rural general practice patients described their experiences of a variety of hazards and harms. Their three most discussed cognitive and behavioural coping strategies were: (1) to accept the events; (2) to confront them and (3) to engage in planful problem-solving. While the participants demonstrated a tendency toward accepting hazards and harm that their regular general practitioner created, they were often willing to confront those that locum (ie, substitute) general practitioners created. Participants used planful problem-solving in situations they deemed hazardous, such as breaches of confidentiality or not being taken seriously, as well as during potential/actual emergencies.

Conclusions: Patients at rural general practice clinics actively identify and respond to hazards and harm, applying three coping strategies. Thus, patients themselves may serve as an important safety barrier against hazards and harm; their potential contributions to improving patient safety must be appreciated accordingly and reflected in future research as well as in everyday clinical practice.

Keywords: adverse events; primary care; qualitative research; quality in health care.

Figure 1

Patients as safety barriers against hazards in general practice.