ArticleBMJ open2021
Positive Health dialogue tool and value-based healthcare: a qualitative exploratory study during residents' outpatient consultations.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 19 citations in OpenAlex.
- Improving cardiac care with Positive Health and lifestyle interventions: a patient journey in a peripheral hospital setting.BMJ open quality · 2025Observational
- Skills to act from a Positive Health approach: in comparison with shared decision-making: a scoping review.Frontiers in public health · 2025Article
- The broad positive health perspective on health as common ground for tackling current and future interdisciplinary health challenges.Frontiers in public health · 2025Article
- Designing a Positive Health Dialogue Tool for Adolescents and Young Adults: A Mixed Methods Study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Towards an integrative approach of healthcare: implementing positive health in three cases in the Netherlands.BMC health services research · 2024Article
- Rapid Review on the Concept of Positive Health and Its Implementation in Practice.Healthcare (Basel, Switzerland) · 2024Review
- Letting people flourish: defining and suggesting skills for maintaining and improving positive health.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo explore how residents experienced the application of the Positive Health dialogue tool (PH-tool) during outpatient consultations and its influence on the delivery of value-based healthcare (VBHC).
designQualitative study using non-participant observations of outpatient consultations during which residents used the PH-tool, followed by longitudinal individual, semistructured interviews. To analyse the data from observations and interviews, observational form notes' summarisation and categorisation, and an iterative-inductive thematic approach was used.
participantsEight residents-five from the ear, nose, and throat-department and three from the gastroenterology-hepatology-department-were selected through convenience sampling, accounting for 79 observations and 79 interviews.
resultsResidents had bivalent experiences with using the PH-tool. Residents discussed three main benefits: a gained insight into the individual patient's context and functioning, a changed dynamics in resident-patient communication, and an increased awareness regarding value in terms of patient-related outcomes and healthcare costs. Three barriers became apparent: doubts regarding the PH-tool's relevance and scope, boundaries of superspecialised medical professionals, and a lack of demarcation in clinical practice.
conclusionThe PH-tool use can be beneficial for residents during outpatient consultations with new patients and follow-up in cases of multidimensional problems, particularly in cases of chronic conditions and generalist care. In these situations, the tool yielded valuable patient information beyond physical health, helped foster patient engagement, and enabled tailoring the treatment plan to individual patients' needs. On the other hand, the PH-tool was not a good fit for simple problems, clearly demarcated help requests, periodic follow-up consultations, or verbose patients. In addition, it was not suitable for superspecialised care, because it yielded an abundance of general information. For particular patients and problems, using the PH-tool seems a promising strategy to increase VBHC delivery. Nevertheless, further research and detailing is needed to better align the PH-tool's broad intent and clinical practice.
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