Exploratory Mixed Methods Study Research Articles

Identifying and responding to fetal alcohol spectrum disorder in child and family health: Lessons from an exploratory mixed methods study.

Developmental outcomes for children and young people with fetal alcohol spectrum disorder (FASD) are optimised if their needs are identified early. Yet, health workers miss vital opportunities to identify and respond to FASD due to a lack of support, knowledge and skills. Through surveys and interviews, our study investigated what child and family health workers in an Australian metropolitan local health district understand, already do and want to learn about FASD. The study provided evidence of low FASD knowledge and confidence and a lack of referral options with some workers 'patching together' care planning in a 'referral black hole'. Qualitative data provided insight into how skilled clinicians engage families in FASD assessment and negotiate gaps in clinical knowledge. Health workers in this study requested high-quality training and the development of FASD practice guidelines to improve role clarity and clinical impact when working with FASD populations.

Barriers and facilitators to tuberculosis diagnosis in Lima, Peru: a mixed methods study

BackgroundTuberculosis (TB) infectiousness decreases significantly with only a few days of treatment, but delayed diagnosis often leads to late treatment initiation. We conducted a sequential explanatory mixed methods study to understand the barriers and facilitators to prompt diagnosis among people with TB.MethodsWe enrolled 100 adults who started TB treatment in the Carabayllo district of Lima, Peru, between November 2020 and February 2022 and administered a survey about their symptoms and healthcare encounters. We calculated total diagnostic delay as time from symptom onset to diagnosis. We conducted semi-structured interviews of 26 participants who had a range of delays investigating their experience navigating the health system. Interview transcripts were inductively coded for concepts related to diagnostic barriers and facilitators.ResultsOverall, 38% of participants sought care first from public facilities and 42% from the private sector. Only 14% reported being diagnosed with TB on their first visit, and participants visited a median of 3 (interquartile range [IQR] health facilities before diagnosis. The median total diagnostic delay was 9 weeks (interquartile range [IQR] 4–22), with a median of 4 weeks (IQR 0–9) before contact with the health system and of 3 weeks (IQR 0–9) after. Barriers to prompt diagnosis included participants attributing their symptoms to an alternative cause or having misconceptions about TB, and leading them to postpone seeking care. Once connected to care, variations in clinical management, health facility resource limitations, and lack of formal referral processes contributed to the need for multiple healthcare visits before obtaining a diagnosis. Facilitators to prompt diagnosis included knowing someone with TB, supportive friends and family, referral documents, and seeing a pulmonologist.ConclusionsMisinformation about TB among people with TB and providers, poor accessibility of health services, and the need for multiple encounters to obtain diagnostic tests were major factors leading to delays. Extending the hours of operation of public health facilities, improving community awareness and provider training, and creating a formal referral process between the public and private sectors should be priorities in the efforts to combat TB.

Untangling purpose: examining the nuanced influence of personal meaning and beyond-the-self orientation on youth mental health in unprecedented times

ABSTRACT This modified sequential explanatory mixed methods study explores how the components of purpose (personal meaningfulness and a beyond-the-self orientation) impact youth mental health outcomes (depressive and anxiety symptoms) in the context of COVID-19. We hypothesized that youth with higher scores on the components of purpose (goal-directedness, personal meaningfulness, and beyond-the-self orientation) would be less likely to experience anxiety and depressive symptoms during COVID-19. We also explored in what ways youths’ descriptions of their own prosocial behavior align with the relation between purpose and mental health. Data are from two waves of the Boy Scouts of America (BSA) Building Evidence in Scouting Together study. Quantitative data are from 4,896 youth and a subsample of 94 youth completed qualitative personal communication Results indicate the personal meaning component of purpose is protective against depressive and anxiety symptoms. However, the beyond-the-self orientation of purpose is associated with higher levels of depressive and anxiety symptoms. In addition, differences were found between youth who reported higher and lower levels of depressive and anxiety symptoms, and personal meaning and a beyond-the-self orientation for the following themes: 1) Empathy for others, 2) Desire to change the situation, 3) Solutions to change the situation, 4) Helping at home, 5) Following health advice, and 6) Scouting-specific examples. Taken together, this study provides useful insights into how each component of purpose can uniquely promote or provide a buffer for depression and anxiety among youth.

Satisfaction of chronic patients with community-based health insurance schemes and related factors: Explanatory sequential mixed methods study.

Chronic disease poses a serious threat to accessible, high-quality healthcare. Community-based health insurance (CBHI) schemes provide the poor with financial security. However, there is no evidence in Ethiopia on how satisfied chronic patients are with the schemes. The objective of the current study was to evaluate the satisfaction of chronic patients with the schemes and identify contributing factors. A hospital-based explanatory sequential mixed methods study on 632 chronic patients and 12 key informants was carried out between February 28 and May 31, 2022, in the hospitals of East Gojjam, Northwest Ethiopia. Hospitals and study participants were selected using multistage sampling methods. Quantitative data was entered using Epi Data 3.1 and exported to SPSS version 25 for analysis. P value <0.05 was used to consider significant association in multivariable binary logistic regression. Thematic analysis was a method to manually review qualitative data. A narrative approach was used for integrating the two data. The mean age of study participants was 46.1 (46.1± 5.2, range: 25-82). Patients aged 45 to 64 made up the majority of the population (60.6%). Rheumatoid arthritis affected the preponderance of individuals (36.4%). The overall level of satisfaction of chronic patients with the CBHI scheme was 31% (95% CI; 27-35%). Respect and friendliness (AOR = 7.05; CI: 3.71-13.36), knowledge of benefits packages (AOR = 2.02; CI: 1.24-3.27), partial or non-availability of drugs (AOR = 0.24, AOR = 0.21, respectively), waiting times (AOR = 1.84; CI: 1.12-3.0), and availability of laboratory tests (AOR = 1.59; CI: 1.01-2.48) were significantly associated with participants' satisfaction with the schemes. Our study revealed that the overall satisfaction of chronic patients was quite low and affected by the availability of drugs and laboratory tests, caregivers' respect and friendliness, waiting times, and participant knowledge. Therefore, stakeholders must concentrate on reducing waiting times, improving the availability of drugs and laboratory tests at each hospital, opening back up community pharmacies, and promoting awareness about benefits packages primarily through health education. The main focus of researchers needs to be on nationally representative studies that include more important factors.

Antiretroviral therapy adherence among peripartum women with HIV in Kenya: an explanatory mixed methods study using dry blood spot measures and narrative interviews

ABSTRACT Adherence to antiretroviral therapy (ART) remains sub-optimal among pregnant and postpartum women with HIV (PPWH) in high HIV prevalence low resource settings with few effective behavioral interventions. A large body of qualitative literature has established general barriers and facilitators to ART adherence in PPWH at various levels (individual, interpersonal, structural). However, research exploring the underlying behavioral mechanisms of ART adherence in PPWH with objectively verified adherence biomarkers is extremely limited. We conducted 24 in-depth interviews with postpartum women in western Kenya who had linked ART drug concentrations obtained from three dried blood spot samples across the peripartum period. Among PPWH with a low drug concentration (n = 13) compared to those with continuously high drug concentrations (n = 11), distinct themes emerged related to HIV status disclosure, social support, interactions with the health system, and health beliefs. By combining ART biomarkers with patient reported challenges, there is the potential for real-time interventions to support sustained ART adherence among PPWH and improve maternal and infant health outcomes.

Implementation, delivery, and utilization of iron fortified rice supplied through public distribution system across different states in India: An exploratory mixed-method study.

Food fortification with micronutrients is one of the cost-effective and sustainable methods to prevent micronutrient deficiencies at community level. The rice fortified with iron, folic acid, and vitamin B12 is being supplied through various social welfare schemes in India in a phased manner and planned to cover the entire country by March 2024. We have conducted a situational analysis to assess the rollout of fortified rice supplied through the Public Distribution System (PDS) and to evaluate the accessibility, availability, acceptability, and utilization of fortified rice by the beneficiaries of the PDS. This was a mixed-method, sequential exploratory study conducted in six districts from six different states of India that had begun distribution of fortified rice through PDS in pilot mode during 2020-2021. In each district, the district supply officer of the PDS, Food Corporation of India (FCI) or State Food Corporation (SFC) warehouse supervisor, and four Fair Price Shop (FPS) dealers were interviewed. Under each FPS, a minimum of seven beneficiary households were randomly selected and interviewed using a structured questionnaire. The in-depth interviews were conducted with different stakeholders using theme guides. All the interviewed stakeholders were aware about their roles and responsibilities and purpose to distribute fortified rice. There was a continuous supply of fortified rice (across all visited districts) to beneficiaries through a well-established system. Acceptability and compliance to intake of fortified rice was good with no reported gastrointestinal adverse outcomes following fortified rice intake. There was an efficient roll-out of fortified rice though PDS with a good compliance to intake of fortified rice. It is feasible to design and conduct a study to assess the impact of fortified rice on anemia and iron storage at the community level.

Assessment of knowledge, attitude, and practices toward malaria in the Lunglei district, Mizoram, North-East India

BackgroundThe western districts of Mizoram (Lunglei, Mamit, and Lawngtlai) are malaria hotspots. Understanding the knowledge, attitude, and practices of the tribal communities in Mizoram’s western districts will aid the development of specific interventions.MethodsAn explanatory sequential mixed-method study was conducted from April to November 2023 in the Lunglei district. In a community-based cross-sectional survey of 353 participants, the knowledge, attitude, practices, and care-seeking behaviour toward malaria were assessed using a semi-structured questionnaire. Data was analysed using SPSS version 29 software; univariate variables were presented in percentage, and bivariate and multivariate variables were analysed using the chi-square test and logistic regression, respectively. This was followed by in-depth telephonic interviews of twelve participants, and the data was analysed using NVivo.ResultsOut of the 353 respondents, 77.9%, 82.7%, 55.5%, and 63.2% of the participants had good knowledge, attitude, practices, and care-seeking behaviour, respectively. The in-depth qualitative interviews highlighted the villagers’ good knowledge of the various aspects of malaria transmission, treatment, and prevention practices (indoor residual spraying and use of insecticide-treated nets).ConclusionHigh disease endemicity, awareness programmes and vector control interventions might be contributing to the overall good knowledge, attitude, and practices toward malaria among the villagers. In addition to vector control measures, active parasite surveillance is key to malaria control in this region.

Doctoral program support impacts student educational experience: examining the virtual holding environment across DSW cohorts

ABSTRACT In this exploratory mixed-methods study, we applied Fletcher, Davis Comer, and Dunlap’s conceptual framework of Virtual Holding Environments (VHEs), spaces where supportive relationships can be developed and maintained using technology over time. We investigated the role of VHEs in enhancing educational experiences among doctoral students who completed their degrees primarily (or fully) online. Using survey data collected over the spring/summer of 2019, we examined Doctorate in Social Work (DSW) students’ (n = 34) experiences of VHEs in a Midwestern university in the United States as they began, worked toward, and completed their doctoral degrees. Qualitative findings included themes such as togetherness and connectedness, importance, and relevance, and quantitative descriptive analysis of responses to Likert-scale questions portrayed doctoral students’ experiences of the VHEs. Recommendations for social work online and hybrid educational programs are to consider implementation of VHEs during orientation programs, to focus developmental processes on embracing differences among cohort members, and to adjust the delivery of curricula to meet the current needs of students.

The BaMidbar Mental Health training program for educators: a Mixed Methods case study

The purpose of this study was to examine the BaMidbar Mental Health Training program and the influence the training had on community educator populations. This was a mixed method exploratory case study which utilized observational data and five interviews. A survey which examined the possible impacts of the trainings (through relevance and confidence variables) was utilized. We found that participants’ confidence had a higher correlation to the likelihood of implementing training materials than the relevance the training had to participants’ job placements. We also found categories of perceived skill development articulated by the participants interviewed. These skills included: checking in, changing spaces, giving students choices, giving feedback and identifying behaviors. There were concerns that the training programs did not create enough knowledge retention of specific therapeutic terms or scaffolding skills for educators to embed the training content into their job placements. Suggestions for further research and training programs are listed in the conclusion.

Effectiveness of a Group Counseling Intervention for Turkish University Students with Childhood Trauma

This research aimed to examine the effects of an eclectic group counseling intervention based on the cognitive and behavioral counseling approach and positive psychology-based practices on the rumination and life satisfaction levels of university students with childhood trauma in Turkey. The research was designed as an exploratory sequential mixed-method study. The first phase of the research focused on discovering what university students with traumatic stories needed to reduce their rumination levels and increase their life satisfaction. The themes that were obtained contributed to the content of the program. In the second phase, forty-two participants were randomly assigned to the experimental and control groups. The Rumination Scale and the Satisfaction with Life Scale were applied as data collection tools. A 12-session group psychological counseling program was provided once a week to the experimental group. No intervention was made in the control group. One week after the sessions were completed, the posttest was administered to the experimental and control groups, and follow-up measurements were carried out two months later. The participants in the experimental group showed significant improvements in decreasing rumination levels and increasing life satisfaction compared to the participants in the control group, and these improvements were maintained in the follow-up measurements. In the last phase, the qualitative data collected during the sessions were analyzed to evaluate the program. In conclusion, the group counseling intervention was effective in reducing the rumination levels and increasing the life satisfaction levels of university students.

Alcohol Dependence Among Adult Males in Chengalpattu District, South India: A Mixed Methods Study.

Introduction Post-pandemic alcohol consumption is on the rise due to people starting to adapt themselves to the practice of consuming alcoholic beverages at home. In addition to the direct effects of intoxication and addiction, estimates suggest that alcohol contributes to approximately 20-30% of global cases of oesophagal cancer, liver cancer, cirrhosis of the liver, homicide, epilepsy, and motor vehicle accidents. In India, one-fifth of alcohol consumers were found to be alcohol dependent. The study was done with the primary objective of finding out the prevalence of alcohol dependence among alcohol users and exploring the reasons for alcohol dependence among alcohol users in an urban area of Chengalpattu District, Tamil Nadu. Methodology The study design is an explanatory sequential mixed-methods study. It was done among 624 adult male alcohol consumers in the Chennai district, selected by the cluster sampling method in a community setting. The Alcohol Use Disorders Identification Test (AUDIT) was used to diagnose alcohol dependence. Using the purposive sampling method, in-depth interviews were conducted among 24 alcohol-dependent people to explore and understand their experiences, identify common themes, and provide insights into the problem. Quantitative data were analysed using Statistical Package for Social Sciences (SPSS) version 26 (IBM Corp., Armonk, NY), and qualitative data were analysed using deductive content analysis using Qualcoder software. Results The mean age of the study participants was 38±7 years. Among current alcohol consumers, 16.9% (106/624) were found to be suffering from alcohol dependence. The significant predictors of alcohol dependence were found to be unskilled occupation (adjusted odds ratio [AOR] = 2.09), having suicidal ideation (AOR = 2.4), alcohol consumption by family members (AOR = 1.90), depression (AOR = 3.98), drinking pattern-affected interpersonal relationships (AOR = 2.29), and not receiving health education about alcohol use in school/college (AOR = 1.74). The major themes and codes identified among alcohol dependents were factors related to mental health, physical health, and social factors. Conclusion This study provides essential points of reference for policymakers and primary care physicians to develop prevention strategies for people to understand and overcome the problem of alcohol addiction, and it also sheds light on the burden of alcohol dependence and their lived experiences.

Barriers to Physical Activity in Pregnant Women: An Explanatory Sequential Mixed-method Study (Study Protocol)

Barriers to Physical Activity in Pregnant Women: An Explanatory Sequential Mixed-method Study (Study Protocol)

Unani Tibb students’ and educators’ perceptions of spirituality and spiritual care in education in South Africa: A mixed-methods study

Background. Unani Tibb promotes holistic patient care, yet spirituality and spiritual care seem to be neglected in education. This theory-practice gap was previously highlighted in studies on Unani Tibb practitioners. The role of spirituality and spiritual care in Unani Tibb education in South Africa (SA) remains unclear. Objectives. To explore Unani Tibb students’ and educators’ perceptions and attitudes of spirituality and spiritual care in SA. Methods. A two-stage sequential explanatory mixed-method study was conducted. Quantitative data from stage 1 was obtained using a cross-sectional descriptive study followed by in-depth interviews for the qualitative study in stage 2. Stage 1 guided the interview questions in stage 2. Descriptive data analysis was performed for the quantitative study, followed by thematic analysis for the qualitative data. Results. A total of 18 (90%) participants took part in the quantitative study followed by 10 participants (50%) in the qualitative study. Three study findings emerged: i) a heightened level of spiritual awareness was recorded for this cohort despite the lack of spirituality and spiritual care content in the curriculum, ii) participants viewed spiritual care as integral to Unani Tibb philosophy, education and practice and iii) formal integration of spirituality and spiritual care concepts in Unani Tibb education was identified as a necessity to ensure the integrity of the holistic approach required by the profession. Conclusion. This study has implications across the health education sector and more specifically for Unani Tibb educators to consider the inclusion of spiritual care content in education programmes.

The perceived relevance, utility and retention of basic sciences in general practice

BackgroundBasic sciences are crucial for clinical medicine, yet studies focusing on their perceived utility among general practitioners (GPs) are sparse. Considering the broad scope of GPs’ practice, an in-depth understanding of basic sciences is fundamental for making informed clinical decisions. This study evaluated GP registrars’ retention and perceptions of the utility of basic sciences in clinical practice.MethodsUsing sequential explanatory mixed methods study design, knowledge retention was assessed by a multiple-choice question (MCQ) examination followed by interviews on the perception of the relevance and utility of basic sciences among GP registrars at James Cook University's (JCU) General Practice Training (GPT) program. Descriptive and inferential statistical analyses were conducted on the MCQ exam data, while thematic analysis was employed for the qualitative interview data.ResultsSixty-one GP registrars participated in the MCQ exam, while 11 of them were involved in the interviews. The highest mean score was obtained in biochemistry (75.1 ± 2.23) while the lowest mean score was in anatomy (56.07 ± 3.16). Key performance predictors included the formative clinical examination scores (β = 0.83, 95% CI: 0.45 to 1.2, p < 0.001) and gender (β = -9.7, 95% CI: -17 to -2.3, p = 0.011). The qualitative data analysis revealed five themes, including the backbone of clinical medicine, varying utility over time and by specialty, clinical synthesis integrates encapsulated knowledge, professional pressures hinder revisitation of knowledge and knowledge renewal enhances updates.ConclusionBasic sciences were considered relevant in clinical practice. Development of continuing professional development (CPDs) sessions and clinically relevant online resources were measures proposed to enhance the retention of knowledge. Future research could focus on innovative educational strategies for GPs.

Aging as Online Faculty: Attitudes Toward Work and Retirement

Aging, an often-neglected aspect of diversity in universities, is an important issue, as the rate of people working who are 75 and older is growing faster than the rate for any other age group. The present sequential explanatory mixed-method study explored 129 older online faculty’s attitudes and opinions on work and retirement in an online survey and in 13 faculty interviews. Data were examined cross-sectionally to assess differences by decade: 50s, 60s, and 70s and above. The results indicated that while older faculty were collecting some form of retirement payment, money was not a primary motivator for working. These individuals enjoyed their work and saw it as providing mental stimulation and giving their lives meaning. Older faculty indicated they did not want traditional retirement, but instead planned to work part time as long as they physically and cognitively were capable. Further, they indicated that online faculty’s retirement should be based on their own judgment of their mental and physical capability to do the job adequately. Results may be used by academic institutions to better serve their aging faculty.

Specialist Financial Counseling for Women Affected by Domestic and Family Violence: Staff and Client Perspectives on an Australian Initiative.

This article examines staff and client perspectives on an initiative providing co-located specialist Domestic and Family Violence (DFV) financial counseling in women's legal services. An exploratory mixed-method study in five service locations captured perspectives via a client survey (n = 42), online interviews with staff (n = 15), and a review of services' progress reports. For staff and clients, integrating financial counseling into women's legal services contributed to a more comprehensive model of support which helped address the economic harms associated with violence. Findings highlight the benefits of service integration and co-location, which enabled staff to share knowledge and build capacity, and helped improve outcomes for women following violence.

A Different View of Health Information Technology Workarounds in Critical Care.

When health information technology (HIT) was introduced into the hospital setting there was an obvious disruption to nursing workflow. In many cases it took a nurse extra steps or extra time to complete processes such as clinical documentation and medication administration. In response to HIT problems, nurses developed workarounds. Research on nursing workarounds has been hindered by a lack of variable definitions, measures and research models. This paper offers the results of an exploratory mixed methods study that proposes definitions for workarounds and describes the variable relationships with turbulence and patient safety in critical care.

Designing a model of emergency medical services preparedness in response to mass casualty incidents: a mixed-method study

BackgroundEmergency medical services preparedness in mass casualty incidents is one of the most important concerns in emergency systems. A mass casualty incident is a sudden event with several injured individuals that overwhelms the local health care system. This study aimed to identify and validate the components of emergency medical services readiness in mass casualty incidents which ultimately led to designing a conceptual model.MethodsThis research was an explanatory mixed-method study conducted in five consecutive stages in Iran between November 2021 and September 2023. First, a systematic review was carried out to extract the components of emergency medical services preparedness in mass casualty incidents based on the PRISMA guideline. Second, a qualitative study was designed to explore the preparedness components through in-depth semi-structured interviews and analyzed using the content analysis approach. Third, the integration of the components extracted from the two stages of the systematic review and qualitative study was done by an expert panel. Fourth, the obtained components were validated using the Delphi technique. Two rounds were done in the Delphi phase. Finally, the conceptual model of emergency medical services preparedness in mass casualty incidents was designed by a panel of experts.Results10 articles were included in the systematic review stage and sixteen main components were extracted and classified into four categories. In the second stage, thirteen components were extracted from the qualitative study and classified into five categories. Then, the components of the previous two phases were integrated into the panel of experts and 23 components were identified. After validation with the Delphi technique, 22 components were extracted. Lastly, the final components were examined by the panel of experts, and the conceptual schematic of the model was drawn.ConclusionsIt is necessary to have an integrated framework and model of emergency medical service readiness in the planning and management of mass casualty incidents. The components and the final model of this research were obtained after the systematic scientific steps, which can be used as a scheme to improve emergency medical service preparedness in response to mass casualty incidents.

Understanding the capacity development of faculty development programs: a sequential explanatory mixed methods study

BackgroundFaculty development programs can bring about both individual and organizational capacity development by enhancing individuals’ attitudes, values, and skillsto enable them to implement organizational change. Understanding how faculty development programs produce capacity development, and the influencing factors, requires further understanding. This study aimed to explore the perceptions of the participants of a faculty development program about the capacity development features of the program and the influencing factors.MethodsA sequential explanatory mixed methods design was used. Faculty members were surveyed about their perspectives on capacity development of faculty development. Subsequently, 22 interviews were conducted with the respondents to deepem understanding of the survey results. Interview transcripts underwent conventional content analysis.ResultsA total of 203 completed the questionnaire. Most of the faculty highly agreed that the faculty development programs had produced capacity development. The combined data identified (a) “quality of faculty development programs”, underscoring the significance of robust and comprehensive initiatives, (b) “development in instruction”, emphasizing the importance of continuous improvement in pedagogical approaches (c) “development in professionalism”, highlighting the necessity for cultivating a culture of professionalism among faculty members, (d) “development in attitude towards education”, emphasizing the role of mindset in fostering effective teaching practices, and (e) “supporting faculty development programs”, with fostering organizational growth and innovation. Important barriers and facilitators of the capacity development process included several organizational, interpersonal, and individual factors.ConclusionThe study identified specific features of the capacity development process in the context of a faculty development program and highlighted the importance of these programs in producing changes in both individuals and within the wider organizational system. Several factors that enabled and constrained the capacity development process were also identified. The findings of the study can inform future implementation of faculty development programs for capacity development.

Somatoform Disorders in Primary Care-An Exploratory Mixed-Methods Study on Experiences, Challenges and Coping Strategies of General Practitioners in the Federal Republic of Germany.

Somatoform symptoms are widely spread in outpatient care. For treating physicians, it can be challenging to establish a relationship that is conducive to compliance and to take stabilising action when dealing with affected patients. As primary care providers, GPs are usually the first point of contact for patients with somatoform disorders; they set the course for stabilisation and further care. To date, there is a lack of studies that focus on how GPs respond to such patients. In particular, strategies for establishing a stable doctor-patient relationship have hardly been explored. Consequently, this study investigated how GPs recognise the symptoms of somatoform disorders, what significance they attach to them and how they handle patients. The primary focus is on experienced patient properties, assumed causes of somatoform disorders, obstacles and complexities in consultation, care and stabilisation strategies, as well as diagnostic forms of support. A total of 2797 GPs in the German federal states of Hesse, Rhineland-Palatinate and Baden-Württemberg were surveyed anonymously by means of a written questionnaire between January and August 2023. A t-test was performed with independent samples to determine significant differences between two groups. In addition, 64 GPs were interviewed between March and April by means of qualitative semi-standardised interviews. The respondents make use of a wide range of communication and stabilisation strategies when treating somatoform physical complaints. The GPs combine the establishment of a tangential doctor-patient relationship with measures to consistently exclude physical causes and to enable the best possible assessment of patients, as well as to gently introduce them to the clinical picture of somatoform disorders. Most physicians are not familiar with current clinical guidelines. Cooperation with specialists and therapists is widely described as complicated. GPs have access to a wide range of communication and stabilisation strategies for the management of somatoform physical complaints. Yet, they experience interaction with this patient group as difficult in daily practice. GPs articulate a clear need for more external support. Apart from increasing therapeutic care capacities and interdisciplinary structures, it seems advisable to extend low-threshold therapy and support services.