"More than eliciting goals: Provider competencies that enable patients to experience goal-oriented care, a dyadic...

Goal-oriented care (GOC) has been proposed as a strategy for advancing person-centred integrated care by organising care around patients' personal goals. Although patients may experience empathic and trusting relationships with their providers, they often report that their personal goals are insufficiently integrated into care planning and follow-up. Providers likewise report a need for further training to implement GOC. However, evidence linking patient and provider perspectives within the same care relationship remains scarce, limiting insight into which competencies enable patients to experience care as organised around their goals.

To identify competencies of primary care providers that enable patients to experience goal-oriented care.

A qualitative dyadic study was conducted in Flemish primary care using multi-perspective interpretative phenomenological analysis. Twelve participants formed nine patient-provider dyads, comprising nine patients and three providers. Separate semi-structured interviews were analysed idiographically, within dyads, and across dyads to identify provider competencies enabling patients' experiences of GOC.

Patients experienced GOC when providers listened attentively over time, developed contextual understanding of the person beyond their diagnosis, and approached them without judgment. Care was experienced as aligned with what mattered when plans were flexibly shaped in dialogue, information was clear, and uncertainty and professional boundaries were communicated transparently. Patients also valued human openness and getting to know the person behind the provider, although providers described personal self-disclosure as a difficult balance.

Patients' experiences of GOC depended on how relational, communicative, and reasoning competencies were combined to align care with what mattered to them. Training initiatives should therefore address how providers integrate listening, contextual reasoning, shared planning, and information-giving in practice. An additional key insight was the importance of providers' ability to coordinate and pace care by being transparent about professional boundaries and tolerating uncertainty, particularly in complex situations.