Talking with women about personal health resources in general practice. Key questions about salutogenesis.
We want to share experiences from an approach for clinical communication and research, intended to identify and mobilize personal health resources in female patients, and promote strategies for resource oriented talk in general practice. We used an action research design with qualitative evaluation to summarize the process where we developed a key question about self-assessed health resources in women, based on The Health Resource/Risk Balance Model, including salutogenesis, patient-centredness and gender perspectives. From consultations with 49 female patients in our own practices, we have drawn a narrative description of the development process, a summary of issues that facilitated resource talk, and our final version of the key question. We suggest that resource talk is based on 1) an explicit shift of language from disease to health, but nevertheless recognizing the fact that illness occurs, 2) options for answers given by the female patient and not by the doctor, 3) signification of the woman's assessment of her own situation (in contrast to the doctor's assessment), and 4) taking for granted that women's personal health resources exist as numerous strategies which are utilized, and may be identified. We have learnt that communicative action can provide tools for shifting the attention of doctor and patients from risks and diseases to resources and strengths. This is an example of one way to change your practice through systematic reflection in dialogue with a colleague.
Department of Public Health and Primary Health Care, University of Bergen, Norway.
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Malterud
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Hollnagel
D001294:Attitude to Health; D003718:Denmark; D005194:Family Practice; D005260:Female; D006293:Health Promotion; D006295:Health Resources; D006801:Humans; D009664:Norway; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D014932:Women's Health Services