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Annals of Family Medicine 6:307-314 (2008)
© 2008 Annals of Family Medicine, Inc.
doi: 10.1370/afm.838

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Healing in Primary Care: A Vision Shared by Patients, Physicians, Nurses, and Clinical Staff

Clarissa Hsu, PhD1, William R. Phillips, MD, MPH2, Karen J. Sherman, PhD, MPH3, Rene Hawkes, BS3 and Daniel C. Cherkin, PhD3

1 Group Health Center for Community Health and Evaluation, Seattle, Washington
2 Department of Family Medicine, University of Washington, Seattle
3 Group Health Center for Health Studies, Seattle, Washington

CORRESPONDING AUTHOR: Clarissa Hsu, PhD, Center for Community Health and Evaluation 1730 Minor Ave, Suite 1600 Seattle, WA 98101 hsu.c{at}ghc.org

PURPOSE 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.

Key Words: Healing • health • patient care • delivery of health care • physician patient relationship




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