Evidence map›Paper›PMID 27233772›Full record

ArticleBMC health services research2016

'It just has to click': Internists' views of: what constitutes productive interactions with chronically ill patients.

N M H Kromme, C T B Ahaus, R O B Gans, H B M van de Wiel

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

N M H KrommeDivision of Chronic and Vascular Disease, University of Groningen, University Medical Centre, Hanzeplein 1, 9751 RB, Groningen, The Netherlands. n.m.h.kromme@umcg.nl.
C T B AhausFaculty of Economics and Business, Centre of Expertise Healthwise, University of Groningen, University Medical Centre Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands.
R O B GansDepartment of Internal Medicine, University of Groningen, University Medical Centre Groningen, 9751 RB, Groningen, The Netherlands.
H B M van de WielWenckebach Institute, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9751 RB, Groningen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccording to the Chronic Care Model, productive interactions are crucial to patient outcomes. Despite productive interactions being at the heart of the Model, however, it is unclear what constitutes such an interaction. The aim of this study was to gain a better understanding of physician views of productive interactions with the chronically ill.

methodWe conducted a qualitative study and interviewed 20 internists working in an academic hospital. The data were analyzed using a constructivist approach of grounded theory. To categorize the data, a coding process within which a code list was developed and tested with two other coders was conducted.

resultsThe participants engaged in goal-directed reasoning when reflecting on productive interactions. This resulted in the identification of four goal orientations: (a) health outcome; (b) satisfaction; (c) medical process; and (d) collaboration. Collaboration appeared to be conditional for reaching medical process goals and ultimately health outcome and satisfaction goals. Achieving rapport with the patient ('clicking,' in the term of the participants) was found to be a key condition that catalyzed collaboration goals. Clicking appeared to be seen as a somewhat unpredictable phenomenon that might or might not emerge, which one had to accept and work with. Goal orientations were found to be related to the specific medical context (i.e., a participant's subspecialty and the nature of a patient's complaint).

conclusionsThe participants viewed a productive interaction as essentially goal-directed, catalyzed by the two parties clicking, and dependent on the nature of a patient's complaint. Using the findings, we developed a conceptual process model with the four goal orientations as wheels and with clicking in the center as a flywheel. Because clicking was viewed as important, but somewhat unpredictable, teaching physicians how to click, while taking account of the medical context, may warrant greater attention.

Indexed as

Attitude of Health PersonnelChronic DiseaseInternship and ResidencyPhysician-Patient RelationsAdultFemaleHumansMalePhysiciansQualitative ResearchChronic Care ModelGoal orientationsMedical contextProductive patient–physician interactionRapportSubspecialty

Identifiers

PMID27233772
PMCPMC4884358

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.