Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care
Abstract Background How interactions during patient-provider encounters in Swedish primary care construct access to further care is rarely explored. This is especially relevant nowadays since Standardized Cancer Patient Pathways have been implemented as an organizational tool for standardizing the d...
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ftdatacite:10.6084/m9.figshare.c.4822395 2023-05-15T17:45:13+02:00 Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care Hultstrand, Cecilia Anna-Britt Coe Lilja, Mikael Hajdarevic, Senada 2020 https://dx.doi.org/10.6084/m9.figshare.c.4822395 https://springernature.figshare.com/collections/Negotiating_bodily_sensations_between_patients_and_GPs_in_the_context_of_standardized_cancer_patient_pathways_an_observational_study_in_primary_care/4822395 unknown figshare https://dx.doi.org/10.1186/s12913-020-4893-4 CC BY 4.0 https://creativecommons.org/licenses/by/4.0 CC-BY 59999 Environmental Sciences not elsewhere classified FOS Earth and related environmental sciences Ecology FOS Biological sciences 69999 Biological Sciences not elsewhere classified Science Policy Collection article 2020 ftdatacite https://doi.org/10.6084/m9.figshare.c.4822395 https://doi.org/10.1186/s12913-020-4893-4 2021-11-05T12:55:41Z Abstract Background How interactions during patient-provider encounters in Swedish primary care construct access to further care is rarely explored. This is especially relevant nowadays since Standardized Cancer Patient Pathways have been implemented as an organizational tool for standardizing the diagnostic process and increase equity in access. Most patients with symptoms indicating serious illness as cancer initially start their diagnostic trajectory in primary care. Furthermore, cancer symptoms are diverse and puts high demands on general practitioners (GPs). Hence, we aim to explore how presentation of bodily sensations were constructed and legitimized in primary care encounters within the context of Standardized Cancer Patient Pathways (CPPs). Methods Participant observations of patient-provider encounters (n = 18, on 18 unique patients and 13 GPs) were carried out at primary healthcare centres in one county in northern Sweden. Participants were consecutively sampled and inclusion criteria were i) patients (≥18 years) seeking care for sensations/symptoms that could indicate cancer, or had worries about cancer, Swedish speaking and with no cognitive disabilities, and ii) GPs who met with these patients during the encounter. A constructivist approach of grounded theory method guided the data collection and was used as a method for analysis, and the COREQ-checklist for qualitative studies (Equator guidelines) were employed. Results One conceptual model emerged from the analysis, consisting of one core category Negotiating bodily sensations to legitimize access, and four categories i) Justifying care-seeking, ii) Transmitting credibility, iii) Seeking and giving recognition, and iv) Balancing expectations with needs. We interpret the four categories as social processes that the patient and GP constructed interactively using different strategies to negotiate. Combined, these four processes illuminate how access was legitimized by negotiating bodily sensations. Conclusions Patients and GPs seem to be mutually dependent on each other and both patients’ expertise and GPs’ medical expertise need to be reconciled during the encounter. The four social processes reported in this study acknowledge the challenging task which both patients and primary healthcare face. Namely, negotiating sensations signaling possible cancer and further identifying and matching them with the best pathway for investigations corresponding as well to patients’ needs as to standardized routines as CPPs. Article in Journal/Newspaper Northern Sweden DataCite Metadata Store (German National Library of Science and Technology) |
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DataCite Metadata Store (German National Library of Science and Technology) |
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language |
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59999 Environmental Sciences not elsewhere classified FOS Earth and related environmental sciences Ecology FOS Biological sciences 69999 Biological Sciences not elsewhere classified Science Policy |
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59999 Environmental Sciences not elsewhere classified FOS Earth and related environmental sciences Ecology FOS Biological sciences 69999 Biological Sciences not elsewhere classified Science Policy Hultstrand, Cecilia Anna-Britt Coe Lilja, Mikael Hajdarevic, Senada Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care |
topic_facet |
59999 Environmental Sciences not elsewhere classified FOS Earth and related environmental sciences Ecology FOS Biological sciences 69999 Biological Sciences not elsewhere classified Science Policy |
description |
Abstract Background How interactions during patient-provider encounters in Swedish primary care construct access to further care is rarely explored. This is especially relevant nowadays since Standardized Cancer Patient Pathways have been implemented as an organizational tool for standardizing the diagnostic process and increase equity in access. Most patients with symptoms indicating serious illness as cancer initially start their diagnostic trajectory in primary care. Furthermore, cancer symptoms are diverse and puts high demands on general practitioners (GPs). Hence, we aim to explore how presentation of bodily sensations were constructed and legitimized in primary care encounters within the context of Standardized Cancer Patient Pathways (CPPs). Methods Participant observations of patient-provider encounters (n = 18, on 18 unique patients and 13 GPs) were carried out at primary healthcare centres in one county in northern Sweden. Participants were consecutively sampled and inclusion criteria were i) patients (≥18 years) seeking care for sensations/symptoms that could indicate cancer, or had worries about cancer, Swedish speaking and with no cognitive disabilities, and ii) GPs who met with these patients during the encounter. A constructivist approach of grounded theory method guided the data collection and was used as a method for analysis, and the COREQ-checklist for qualitative studies (Equator guidelines) were employed. Results One conceptual model emerged from the analysis, consisting of one core category Negotiating bodily sensations to legitimize access, and four categories i) Justifying care-seeking, ii) Transmitting credibility, iii) Seeking and giving recognition, and iv) Balancing expectations with needs. We interpret the four categories as social processes that the patient and GP constructed interactively using different strategies to negotiate. Combined, these four processes illuminate how access was legitimized by negotiating bodily sensations. Conclusions Patients and GPs seem to be mutually dependent on each other and both patients’ expertise and GPs’ medical expertise need to be reconciled during the encounter. The four social processes reported in this study acknowledge the challenging task which both patients and primary healthcare face. Namely, negotiating sensations signaling possible cancer and further identifying and matching them with the best pathway for investigations corresponding as well to patients’ needs as to standardized routines as CPPs. |
format |
Article in Journal/Newspaper |
author |
Hultstrand, Cecilia Anna-Britt Coe Lilja, Mikael Hajdarevic, Senada |
author_facet |
Hultstrand, Cecilia Anna-Britt Coe Lilja, Mikael Hajdarevic, Senada |
author_sort |
Hultstrand, Cecilia |
title |
Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care |
title_short |
Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care |
title_full |
Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care |
title_fullStr |
Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care |
title_full_unstemmed |
Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways – an observational study in primary care |
title_sort |
negotiating bodily sensations between patients and gps in the context of standardized cancer patient pathways – an observational study in primary care |
publisher |
figshare |
publishDate |
2020 |
url |
https://dx.doi.org/10.6084/m9.figshare.c.4822395 https://springernature.figshare.com/collections/Negotiating_bodily_sensations_between_patients_and_GPs_in_the_context_of_standardized_cancer_patient_pathways_an_observational_study_in_primary_care/4822395 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
https://dx.doi.org/10.1186/s12913-020-4893-4 |
op_rights |
CC BY 4.0 https://creativecommons.org/licenses/by/4.0 |
op_rightsnorm |
CC-BY |
op_doi |
https://doi.org/10.6084/m9.figshare.c.4822395 https://doi.org/10.1186/s12913-020-4893-4 |
_version_ |
1766148056364875776 |