Patients' views on interpersonal continuity in primary care: a sense of security based on four core foundations

Abstract

A deep and comprehensive understanding of what patients value about having a personal doctor in primary care is lacking. To acquire a comprehensive understanding of the core values of having a personal doctor in a continuing doctor-patient relationship in primary care among long-term, chronically ill patients. In this qualitative study, 14 chronically ill patients at three primary health care centres were strategically selected. The centres were selected to include patients with experiences from both long-term and short-term doctors. The patients were asked about their views on having a personal doctor in a continuing doctor-patient relationship in primary care compared with having different short-term doctors. Sixteen health care professionals were interviewed about what chronically ill patients convey to them about having a personal doctor in contrast to seeing different short-term locum doctors. The in-depth interviews were transcribed verbatim and analysed by qualitative content analysis. The core category, i.e. a universal concept that many patients used to describe the impact of having access to a personal doctor, was a sense of security. This was based on four main categories or core foundations which were: feelings of coherence, confidence in care, a trusting relationship and accessibility. In turn, the four main categories emerged from two to four of subcategories. The foundations that underpin the value of personal care from the patients' perspective could be based on categories found in this study.