title: Factors affecting the physician-patient relationship regarding patient participation in medical encounters in primary care.
abstract: BACKGROUND
  Supporting the patient's right to participate more actively in medical encounters is recommended. However, the physician-patient relationship in the context of the respect for patient participation is unclear.
  
  
  OBJECTIVE
  To reveal the factors affecting the physician-patient relationship regarding patient participation in medical encounters in primary care.
  
  
  METHODS
  A qualitative study incorporating a focus group interview with five female participants. They belonged to a consumer organization, which represents patients who actively participate in medical consultations. Patient behaviors, which constitute active participation, are designated as expressing their concern, asking questions, and stating their expectations in medical consultations. The recorded interview was transcribed, and analyzed with a constant comparison method.
  
  
  RESULTS
  Four categories explaining the physician-patient relationship were extracted: Physicians' attitude; Patients' attitude; Other medical professionals' attitudes; Time environmental factors. Story lines were described; Other Medical professionals' attitudes and Time environmental factors were involved in the physician-patient relationship in accordance with the situation; Physicians' attitude and Patients' attitude had borne some mutual relations; when Patients' attitude to consultation had been active, physicians sometimes could have an aversion to these patients.
  
  
  CONCLUSIONS
  The patients' behaviors of active participation in medical encounters contributed to physicians' aversion to patients and lead the physician-patient relationship in an unfavorable direction. Physicians' attitude is of central concern for establishing the physician-patient relationship.
authors.affiliation: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Kawabata
authors.forename: Keiji
authors.initials: K
authors.lastname: Konishi
authors.forename: Manabu
authors.initials: M
authors.lastname: Murakami
authors.forename: Kengo
authors.initials: K
authors.lastname: Kisa
authors.forename: Masaji
authors.initials: M
authors.lastname: Maezawa
mesh_terms: D001294:Attitude to Health; D005260:Female; D006801:Humans; D010358:Patient Participation; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011320:Primary Health Care; D012017:Referral and Consultation