Becoming the kind of doctor that you want to be. A qualitative study about participation in Balint group work

Balint groups' possible role in self-care and job satisfaction of general practitioners-A qualitative study

BACKGROUND

Concerns are growing when it comes to the shortage of primary care physicians, therefore it seems necessary to take a closer look at job satisfaction and self-care as one of many influences on career choice. A higher job satisfaction reduces the risk to experience burnout and job-related stress and in addition it will contribute to staying in the profession. The objective of this study is to investigate the impact of regular participation in Balint groups on job satisfaction and self-care among general practitioners.

METHODS

Descriptive qualitative study with semi-structured expert interviews of 7 general practitioners. Thematical analysis of data and narrative summary.

RESULTS

A total of 402 coded segments were categorized into 8 main themes and 39 subthemes. Interviewees emphasized changes in self-care and job satisfaction as a result of Balint work and mentioned Balint work as a burnout prophylaxis for themselves. Competences that were learnt or improved through Balint work were described as well as aspects such as feedback and connection with colleagues or professional challenges and difficulties.

CONCLUSION

The results of the study give rise to the assumption that regular participation in Balint groups might help to improve self-care, resilience, and contribute to job satisfaction. Further research is needed before a general recommendation can be made. Many positive aspects were described by the experts, while no harmful negative influences of Balint work were identified.

Balint groups: an effective tool for improving health professionals' perceived well-being

BACKGROUND

Physician burnout is a common problem that negatively impacts their well-being and patient care. Balint groups (BGs) deal with doctor-patient relationships. Previous studies that have demonstrated the positive effects of BGs are descriptive and based on small sample sizes. This study aims to evaluate the perceptions of health professionals who participated in BGs, determine the impact of BGs on their personal and professional well-being, and identify the factors related to these positive outcomes.

METHODS

On January and February 2023 the authors have distributed a questionnaire to 142 healthcare providers in a conference and internet networks. Most respondents were family physicians.

RESULTS

Participation in BGs is seen to have a positive impact on healthcare professionals' perceived well-being and professional development. Respondents who had participated in the BG reported a reduction in burnout, increased empathy, and enhanced professional identity and relationships with patients and colleagues. The study also highlighted the importance of duration of participation in BG, with attendance longer than 5 years linked to significantly more positive outcomes compared to less than 1 year. In a logistic regression analysis two factors were significantly associated with self-reported well-being: attending BGs for more than five years and perceiving BGs as a means of relieving burnout.

CONCLUSIONS

The findings suggest that medical organizations should encourage the regular availability of BGs to support physicians' well-being.

A mixed-methods SWOT analysis of a medical student Balint group programme

BACKGROUND

Balint groups use case-based discussions to explore, reflect on, and enhance the clinician-patient relationship. They facilitate the development of empathy and reflective practice and reduce burnout. This study aimed to explore how the benefits of a traditional Balint group format can be accessed and optimised for medical students during a one-year pilot programme.

METHODS

Eight medical student Balint groups ran for six weeks during 2022-2023, with 90 students participating. Themes were identified from student feedback using qualitative content analysis. Group leaders kept reflective session notes and used these alongside student feedback to undertake a strengths, weaknesses, opportunities, and threats analysis.

RESULTS

Strengths of the programme were emotional containment, learning to reflect, and community identity. Weaknesses were themed as strange situations, dragging along, and facilitator as an object. Opportunities were identified in expanding the scope and sharpening focus. Psychological defences and the engagement dilemma threatened the future success of the Balint group programme.

DISCUSSION

Medical student Balint groups provide a unique space to combine learning and emotional support with personal, professional and community development. However, the traditional Balint group format may need adapting to be widely accessible to undergraduate learners. Sustainably integrating Balint groups into the medical school curriculum requires ongoing engagement work at both an individual and organisational level.

Will the implementation process for goal-oriented primary care succeed? A qualitative study investigating five perceived attributes of goal-oriented care

Throughout the western world, goal oriented care (GOC) is increasingly promoted as a strategy towards more person-centered, integrated care. The implementation of goal-oriented care not only takes place at the micro-level with individual primary care providers (PCPs) changing their approach, but also requires meso- and macro-level investment. In this study, we zoom in on experiences and actions of various meso- and macro-level actors that are actively engaged with implementing GOC, both within their organization or at the policy level. In-depth interviews were conducted with n = 23 actors from a variety of different organizations (governmental institutions, provider organizations, patient organizations, health/social care organizations, primary care zones/care councils, etc.), using a semi- interview guide inspired by realist interviewing. Three main drivers for implementation were identified: recognition, commitment and coordination. On top of that, results were interpreted through Rogers' Diffusion of Innovations (Dol) theory in which five attributes are discussed that contribute to or hinder implementation success. Our findings can help define actions to support and facilitate the implementation process of an innovation such as GOC.

Balint in the Animal World: Balint Groups for Veterinary Professionals

OBJECTIVE

Veterinary medical providers face many of the same stressors related to the therapeutic relationship that human medical providers face, and have reported high rates of emotional distress as an aspect of Veterinary practice. Balint Group work is relatively novel in Veterinary Medicine, and the Balint method has yet to be evaluated in the veterinary community. We hypothesized that applying the Balint method in veterinary medicine would be feasible and offer similar benefits to veterinary providers.

METHOD

The authors offered monthly in-person Balint groups, co-led by two American Balint Society trained leaders and evaluated feedback from Balint group attendees to determine the value and feasibility of adapting Balint groups from Human Medicine to veterinary professionals. Balint groups were offered to the veterinary community at a non-profit urban specialty and emergency hospital. During the pandemic, the group transitioned to an online format. All participants were sent an anonymous email survey to collect feedback about their experience.

RESULTS

Monthly Balint Groups were offered to veterinary professionals, with traditional Balint structure and parameters and co-led by ABS trained leaders. Feedback was obtained, indicating that Balint Group discussions were helpful to Veterinarians.

CONCLUSIONS

Balint Groups are a useful tool for veterinary professionals and are likely to provide similar benefits to those enjoyed by human healthcare providers.