Experiences with a structured conversation tool: a qualitative study on feasibility in general practice in Norway

Area of Science:

• General Practice
• Psychosomatic Medicine
• Healthcare Innovation

Background:

• Medically Unexplained Physical Symptoms (MUPS) pose challenges in general practice, impacting patient recovery and physician workload.
• Effective communication and management strategies are crucial for addressing MUPS and associated sick leave.
• A structured approach can enhance physician competence and patient engagement in managing these conditions.

Purpose of the Study:

• To evaluate the feasibility and benefits of a structured conversation tool (ICIT) in Norwegian general practice for patients with MUPS.
• To assess the impact of the ICIT on patient self-coping abilities and physician management strategies.
• To explore the tool's role in sick leave assessment and patient recovery.

Main Methods:

• Development of a structured conversation tool (ICIT) incorporating Cognitive Behavioral Therapy (CBT) elements.
• Training eight general practitioners (GPs) to use the ICIT with 49 patients diagnosed with MUPS.
• Qualitative analysis of focus group interviews with participating GPs using systematic text condensation.

Main Results:

• Physicians reported the ICIT effectively clarified patient issues and improved their management of MUPS.
• The tool fostered greater patient responsibility, leading to reduced physician fatigue and increased job satisfaction.
• A salutogenic approach within the ICIT provided deeper patient insight, enabling new treatment options and aiding recovery.

Conclusions:

• The ICIT is a feasible and beneficial tool for GPs managing patients with MUPS in general practice.
• The tool enhances physician competence, improves patient engagement, and supports effective sick leave assessment.
• Implementing the ICIT can lead to quicker patient recovery and return to work, highlighting the need for communication skills training.