Patient-clinician collaboration in making care fit: a qualitative analysis of clinical consultations in diabetes care
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Share Citehttps://doi.org/10.1016/j.pec.2024.108295 Get rights and contentUnder a Creative Commons licenseOpen access Highlights•We explored patient-clinician collaboration in diabetes care to make care fit.•We sampled consultations on biomedical characteristics and patients’ biographies.•We confirmed eight described dimensions and provided seven new sub-dimensions.•Patients and clinicians explored patients’ context and responsively adapted care plans. Abstract ObjectiveTo confirm described dimensions of making care fit and explore how patients and clinicians collaborate to make care fit in clinical practice. MethodsAs part of an ongoing study, we audiotaped and transcribed patient-clinician consultations in diabetes care. We purposively selected consultations based on participants’ demographical, biomedical and biographical characteristics. We analysed transcripts using reflexive thematic analysis. We combined a deductive and inductive approach, using the pre-described dimensions of making care fit and adding new (sub-)dimensions when pertinent. ResultsWe analysed 24 clinical consultations. Our data confirmed eight previously described dimensions and provided new sub-dimensions of making care fit with examples from clinical practice (problematic situation, influence of devices, sense of options, shared agenda setting, clinician context, adapting to changing organization of care, and possibility to reconsider). ConclusionOur study confirmed, specified and enriched the conceptualization of making care fit through practice examples. We observed patient-clinician collaboration in exploration of patients’ context, and by responsively changing, adapting or maintaining care plans. Practice implicationsOur findings support clinicians and researchers with insights in important aspects of patient-clinician collaboration. Ultimately, this would lead to optimal design of care plans that fit well in each patient life.
