Evaluation of a tactic to engage hard-to-reach patients during the exercise referral process: a longitudinal qualitative study
Buckingham University Press
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Objectives: General practitioners (GPs) have been reluctant to promote physical activity with overweight and obese patients due to concerns about damaging the GP - patient relationship, a central component of person-centered healthcare. A longitudinal qualitative study was conducted to evaluate a small group of health professionals (HPs) and their patients’ perspectives of the referral process for exercise in a Primary Care setting. Methods: Twelve patients aged 55-74 and their 6 referring HPs, including 5 GPs and 1 Practice Nurse participated in the study. Semi-structured interviews took place on 2 occasions over an 8 month period in a Primary Care Health Centre. Transcripts of recorded interviews were coded and thematically analysed using a grounded theory approach. Results: HPs and patients identified difficulties associated with broaching the subject of obesity. HPs identified that tensions could arise when discussing weight management and exercise. Patients indicated that they disliked the way in which their HP had introduced the subject of obesity and the need for physical activity. The patients later acknowledged, however, that the consultation where a direct approach was used (shock tactic), was the motivation necessary to engage them with the exercise referral scheme. Discussion and Conclusion: Shock tactics by HPs can be an effective method of engaging hard-to-reach patients with a physical activity intervention. NHS service commissioners should consider training HPs to identify and engage patients that would benefit from such an approach. The place of such interventions within the emerging models of person-centered healthcare within international health systems has not been worked out and requires legitimate enquiry as part of further investigations.
European Journal for Person Centered Healthcare;
Queen, M., Crone, D. and Parker, A. (2015) 'Evaluation of a tactic to engage hard-to-reach patients during the exercise referral process: a longitudinal qualitative study', European Journal of Person Centered Healthcare, 3(3), pp.288-294. DOI: 10.5750/ejpch.v3i3.955.
Article published in European Journal for Person Centered Healthcare in 2015, available at: http://dx.doi.org/10.5750/ejpch.v3i3.955.
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