Aims: In rural areas, workforce shortages, high patient load and large distances highlight the importance of ensuring that personalised information and management plans developed within rheumatology consultations go with the patient when leaving the practice. Interestingly, rheumatology literature tends to focus on responsive communication within the consultation or on standardized written communication beyond the consultation. Thus a gap was identified to understand more deeply rural patients’ perceptions of personalised written consultation summaries.
Methods: A multidisciplinary research team (including two patients) used collaborative inquiry to explore the research question: What is the value of personalised written consultation summaries for patients?. The context was a rheumatology practice in north-west NSW. Twenty-nine semi-structured interviews were undertaken by a medical registrar who analysed them with the qualitative research team member. For participant confidentiality, other members of the research team engaged with de-identified segments of the data. Data was interpreted iteratively and dialogically.
Results: Interpreted themes were: INVOLVEMENT in the process, CONTINUITY of information and SECURITY for ongoing management. Quotes demonstrate internal diversity and inherent interrelatedness.
Conclusion: INVOLVEMENT in the process of developing the summary provided opportunities to influence health literacy, as patients negotiated, clarified and confirmed shared understandings of what was discussed and decided. The CONTINUITY of information beyond the consultation room and patient’s discretion to share and store the summary as they liked, influenced their control over and approaches to their personal health information management. With its reminders of management plans and as a basis for re-checking details, the summary provided SECURITY for ongoing management thus fostering patients’ responsibility for their medication adherence. Importantly, the findings are not intended to instruct clinicians how to practice, but rather inform reflections and conversations about their patient-centred strategies in their practice. Schatzki’s Theory of Practice provides a theoretical basis for further research in this area.