Exploring behaviour change in general practice consultations: A realist approach

Author:

Advocat Jenny1ORCID,Sturgiss Elizabeth1,Ball Lauren2,Williams Lauren T2,Prathivadi Pallavi3,Clark Alexander M4

Affiliation:

1. School of Primary and Allied Health Care, Monash University, Melbourne, Australia

2. Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Brisbane, Australia

3. Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

4. University of Athabasca, Athabasca, Canada

Abstract

Objectives While general practice involves supporting patients to modify their behaviour, General Practitioners (GPs) vary in their approach to behaviour change during consultations. We aimed to identify mechanisms supporting GPs to undertake successful behaviour change in consultations for people with T2DM by exploring (a) the role of GPs in behaviour change, (b) what happens in GP consultations that supports or impedes behaviour change and (c) how context moderates the behaviour change consultation. Methods Semi-structured interviews with academic clinicians ( n = 13), GPs ( n = 7) and patients with T2DM ( n = 16) across Australia. Data were analysed thematically using a realist evaluation approach. Results Perspectives about the role of GPs were highly variable, ranging from the provision of test results and information to a relational approach towards shared goals. A GP–patient relationship that includes collaboration, continuity and patient-driven care may contribute to a sense of successful change. Different patient and GP characteristics were perceived to moderate the effectiveness and experience of behaviour change consultations. Discussion When patient factors are recognised in consultations, a relational approach becomes possible and priorities around behaviour change, that might be missed in a transactional approach, can be identified. Therefore, GP skills for engaging patients are linked to a person-centred approach.

Publisher

SAGE Publications

Subject

Health Policy,General Medicine

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