Davidsen Annette
Research Unit for General Practice, Øster Farimagsgade 5, Copenhagen K, Denmark.
Patient Educ Couns. 2008 Aug;72(2):268-75. doi: 10.1016/j.pec.2008.03.020. Epub 2008 May 9.
To explore GPs' experience of carrying out 'talking therapy'.
Qualitative study using semi-structured interviews with 11 Danish GPs sampled purposively. The material was analysed by Interpretative Phenomenological Analysis.
The participants expressed difficulty in explaining how they carried out talking therapy. However, from their description of individual therapies their perception of important aspects of methodology could be obtained: (1) their own open receptiveness, e.g. attentive listening, not limited by time; (2) relational factors including trust and empathy developed over time, or more active therapeutic use of the relationship; (3) knowledge of the patient's life story, told or written, used to form a model of the patient's problems, thoughts and feelings. The sessions were not offered if the GPs lacked time.
Participants were mostly self-taught and did not use specific methods systematically despite having learnt them. GPs knew the patients beforehand; talking therapy developed from other treatment, and methodology had to fit into this. Specific methods are possibly not relevant in general practice.
Formulation of a theory of talking therapy based on the views and experience of GPs and including non-specific factors could professionalize the field.
探讨全科医生开展“谈话疗法”的经验。
采用定性研究,对11名丹麦全科医生进行有目的抽样的半结构式访谈。材料采用解释现象学分析方法进行分析。
参与者表示难以解释他们是如何开展谈话疗法的。然而,从他们对个别疗法的描述中,可以了解到他们对方法重要方面的看法:(1)他们自身开放的接受态度,如专注倾听,不受时间限制;(2)关系因素,包括随着时间推移建立的信任和同理心,或在治疗中更积极地利用这种关系;(3)了解患者讲述或书写的生活故事,用于构建患者问题、思想和感受的模型。如果全科医生没有时间,就不会提供这些诊疗环节。
参与者大多是自学的,尽管学过特定方法,但并未系统使用。全科医生事先了解患者;谈话疗法由其他治疗发展而来,方法必须与之相适应。特定方法在全科医疗中可能并不适用。
基于全科医生的观点和经验,制定包括非特定因素的谈话疗法理论,可使该领域专业化。