Department of General Medicine, Versailles Saint-Quentin-en-Yvelines University, Montigny-Le-Bretonneux, France
CESP, UVSQ, INSERM U1018, Primary Care and Prevention Team, University Paris-Saclay, Villejuif, France.
BMJ Open. 2023 Jul 31;13(7):e071701. doi: 10.1136/bmjopen-2023-071701.
This study aimed to explore patients' experiences and perceptions of touch, as practised by their general practitioner during their medical appointment.
Qualitative study using grounded theory method, based on individual interviews. Data collection and analysis occurred iteratively; themes were identified using constant comparison.
Recruitment among general practitioners' private practices and health centres in Ile-de-France.
Twenty-one patients aged 19-88 years old, interviewed between June 2018 and May 2019.
Physical examination was described as a ritual enabling the establishment of patients' and doctors' roles, the verification of the doctor's skills and the construction of a caring experience. Touch was also a media for the doctor to exercise power that the patient authorised. Finally, it had relational and emotional value.
Physical examination is so internalised by the patients that it becomes unquestionable. It may be inappropriate when this touch does not belong to physical examination or on the contrary represents a proof of the doctor's humanity. The patient is not necessarily aware of the relational dimension that underpins touching and, in particular, clinical examination. This raises the question of why should doctor use it and how they can communicate about it, so that it may become an active tool in favour of trust and the construction of the relationship.
本研究旨在探讨患者在就诊过程中对全科医生实施的触摸的体验和看法。
基于个体访谈的定性研究,采用扎根理论方法。数据收集和分析是迭代进行的;使用恒定比较法确定主题。
在法兰西岛的全科医生私人诊所和健康中心招募。
2018 年 6 月至 2019 年 5 月期间,对 21 名 19-88 岁的患者进行了访谈。
体格检查被描述为一种仪式,它确定了患者和医生的角色,验证了医生的技能,并构建了关爱的体验。触摸也是医生行使患者授权的权力的媒介。最后,它具有关系和情感价值。
体格检查被患者如此内化,以至于它变得无可置疑。当这种触摸不属于体格检查,或者相反代表医生的人性证明时,它可能是不适当的。患者不一定意识到触摸所依据的关系维度,特别是临床检查。这就提出了一个问题,即为什么医生要使用它,以及他们如何对此进行沟通,以便它可以成为一个有利于信任和关系构建的积极工具。