The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark

TY - JOUR

T1 - The existential dimension in general practice

T2 - identifying understandings and experiences of general practitioners in Denmark

AU - Assing Hvidt, Elisabeth

AU - Søndergård, Jens

AU - Ammentorp, Jette

AU - Bjerrum, Lars

AU - Gilså Hansen, Dorte

AU - Olesen, Frede

AU - Pedersen, Susanne S.

AU - Timm, Helle

AU - Timmermann, Connie

AU - Hvidt, Niels Christian

PY - 2016/10/1

Y1 - 2016/10/1

N2 - OBJECTIVE: The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP-patient encounter.DESIGN: A qualitative methodology with semi-structured focus group interviews was employed.SETTING: General practice setting in Denmark.SUBJECTS: Thirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews.RESULTS: Although understood to involve broad life conditions such as present and future being and identity, connectedness to a society and to other people, the existential dimension was primarily reported integrated in connection with life-threatening diseases and death. Furthermore, integration of the existential dimension was characterized as unsystematic and intuitive. Communication about religious or spiritual questions was mostly avoided by GPs due to shyness and perceived lack of expertise. GPs also reported infrequent referrals of patients to chaplains.CONCLUSION: GPs integrate issues related to the existential dimension in implicit and non-standardized ways and are hindered by cultural barriers. As a way to enhance a practice culture in which GPs pay more explicit attention to the patients' multidimensional concerns, opportunities for professional development could be offered (courses or seminars) that focus on mutual sharing of existential reflections, ideas and communication competencies. KEY POINTS:Although integration of the existential dimension is recommended for patient care in general practice, little is known about GPs’ understanding and integration of this dimension in the GP-patient encounter.The existential dimension is understood to involve broad and universal life conditions having no explicit reference to spiritual or religious aspects.The integration of the existential dimension is delimited to patient cases where life-threatening diseases, life crises and unexplainable patient symptoms occur. Integration of the existential dimension happens in unsystematic and intuitive ways.Cultural barriers such as shyness and lack of existential self-awareness seem to hinder GPs in communicating about issues related to the existential dimension. Educational initiatives might be needed in order to lessen barriers and enhance a more natural integration of communication about existential issues.

AB - OBJECTIVE: The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP-patient encounter.DESIGN: A qualitative methodology with semi-structured focus group interviews was employed.SETTING: General practice setting in Denmark.SUBJECTS: Thirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews.RESULTS: Although understood to involve broad life conditions such as present and future being and identity, connectedness to a society and to other people, the existential dimension was primarily reported integrated in connection with life-threatening diseases and death. Furthermore, integration of the existential dimension was characterized as unsystematic and intuitive. Communication about religious or spiritual questions was mostly avoided by GPs due to shyness and perceived lack of expertise. GPs also reported infrequent referrals of patients to chaplains.CONCLUSION: GPs integrate issues related to the existential dimension in implicit and non-standardized ways and are hindered by cultural barriers. As a way to enhance a practice culture in which GPs pay more explicit attention to the patients' multidimensional concerns, opportunities for professional development could be offered (courses or seminars) that focus on mutual sharing of existential reflections, ideas and communication competencies. KEY POINTS:Although integration of the existential dimension is recommended for patient care in general practice, little is known about GPs’ understanding and integration of this dimension in the GP-patient encounter.The existential dimension is understood to involve broad and universal life conditions having no explicit reference to spiritual or religious aspects.The integration of the existential dimension is delimited to patient cases where life-threatening diseases, life crises and unexplainable patient symptoms occur. Integration of the existential dimension happens in unsystematic and intuitive ways.Cultural barriers such as shyness and lack of existential self-awareness seem to hinder GPs in communicating about issues related to the existential dimension. Educational initiatives might be needed in order to lessen barriers and enhance a more natural integration of communication about existential issues.

U2 - 10.1080/02813432.2016.1249064

DO - 10.1080/02813432.2016.1249064

M3 - Journal article

C2 - 27804316

SN - 0281-3432

VL - 34

SP - 385

EP - 393

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

IS - 4

ER -