Queen's University, Department of Family Medicine, Kingston, ON, Canada.
Can Fam Physician. 2012 Feb;58(2):178-85.
To explore conceptions of continuity of care among family physicians in traditional practices, family medicine-trained physicians working in episodic care, and family medicine residents to better understand the emotional effects on physicians of establishing long-term relationships with patients as a starting point for developing a tool to measure the qualitative connections between physicians and their patients.
Qualitative descriptive study using focus groups.
Traditional family practice, family medicine residency training, and episodic-care settings in Kingston, Ont.
Three groups of first-year family medicine residents (n = 18), 2 groups of family physicians in established traditional practice (n = 9), and 2 groups of family physicians working in episodic-care settings (n = 10).
Using focus groups, a semistructured discussion guide, and a phenomenologic approach, we explored residents' and practising physicians' conceptions about continuity of care, predominantly exploring the emotional effects on physicians of providing care for a group of patients over time.
Providing care for patients over time and developing a deep knowledge of, and often a deep connection to, patients affected physicians in various ways. Most of these effects were rewarding: feelings of connection, trust, curiosity, enhanced professional competence (diagnostically and therapeutically), personal growth, and being cared for and respected. Some, however, were distressing: anxiety, grief, frustration, boundary issues, and negative effects on personal life.
Family physicians experience myriad emotions connected with providing care to patients. Knowledge of what physicians find rewarding from their long-term connections with patients, and of the difficulties that arise, might be useful in further understanding interpersonal continuity of care and the therapeutic relationship, and in informing resident education about developing therapeutic relationships, evaluating resident educational experiences with continuity of care, and addressing physician burnout.
探索传统行医模式下的家庭医生、从事偶发性医疗服务的家庭医学培训医师以及家庭医学住院医师对连续性护理概念的理解，以便更好地了解医生与患者建立长期关系对其产生的情感影响，进而开发一种衡量医生与其患者之间定性联系的工具。
采用焦点小组的定性描述性研究。
安大略省金斯顿的传统家庭实践、家庭医学住院医师培训和偶发性医疗服务环境。
三组一年级家庭医学住院医师（n=18）、两组在传统行医模式下工作的家庭医生（n=9）和两组在偶发性医疗服务环境中工作的家庭医生（n=10）。
使用焦点小组、半结构化讨论指南和现象学方法，我们探讨了住院医师和执业医师对连续性护理概念的理解，主要探索随着时间的推移为一组患者提供护理对医生产生的情感影响。
随着时间的推移为患者提供护理，并深入了解患者，通常与患者建立深厚的联系，这对医生产生了多种影响。这些影响大多是有益的：有联系感、信任感、好奇心、增强的专业能力（诊断和治疗）、个人成长、被关心和尊重。然而，有些则令人痛苦：焦虑、悲伤、沮丧、边界问题以及对个人生活的负面影响。
家庭医生在为患者提供护理时会经历各种情绪。了解医生从与患者的长期关系中获得的有益之处，以及出现的困难，可能有助于进一步理解人际连续性护理和治疗关系，并为住院医师教育提供信息，包括发展治疗关系、评估住院医师连续性护理教育体验以及解决医生倦怠问题。
