title: Healing in primary care: a vision shared by patients, physicians, nurses, and clinical staff.
abstract: OBJECTIVE
  We wanted to understand the views of patients and clinicians on the central concept of healing and to identify major facilitators of and barriers to promoting healing in primary care.
  
  
  METHODS
  We undertook a qualitative analysis of focus group discussions. Participants were drawn from primary care clinics of a large, integrated, health care system in Washington State in 2005. Nine focus groups included 84 participants: 28 patients, 23 primary care physicians (19 family physicians), 20 registered nurses, 11 licensed practical nurses, and 2 medical assistants. Randomly sampled established patients were aged from 21 to 65 years; 71% were female.
  
  
  RESULTS
  We found remarkable concordance across focus groups and among types of participants in the definition of healing: Healing is a dynamic process of recovering from a trauma or illness by working toward realistic goals, restoring function, and regaining a personal sense of balance and peace. Healing is a multidimensional process with physical, emotional, and spiritual dimensions. The key themes are as follows: (1) healing is multidimensional and holistic; (2) healing is a process, a journey; (3) the goal of healing is recovery or restoration; (4) healing requires the person to reach a place of personal balance and acceptance; and (5) relationships are essential to healing. Factors that facilitate healing help build relationships, improve communication, and share responsibility between the patient and clinician. Major barriers are logistical factors that limit high-quality time with healing professionals.
  
  
  CONCLUSIONS
  Patients and health care team members share a vision of healing and agree on ways to enhance the process in primary care.
authors.affiliation: Group Health Center for Community Health and Evaluation, Seattle, Washington, USA. hsu.c@ghc.org
authors.forename: Clarissa
authors.initials: C
authors.lastname: Hsu
authors.forename: William R
authors.initials: WR
authors.lastname: Phillips
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Sherman
authors.forename: Rene
authors.initials: R
authors.lastname: Hawkes
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Cherkin
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D003695:Delivery of Health Care / Q000592:standards; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006694:Holistic Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D020127:Recovery of Function; D012944:Social Support