How patients in general practice voice and value their gut feelings about health: a qualitative interview study

BACKGROUND: GPs consider their gut feelings a valuable tool in clinical reasoning. Research suggests patients' gut feelings may be a useful contribution to that process. Describing these feelings more precisely could improve primary care professionals' (PCPs) recognition of patients' gut feelings and insight into the underlying reasons. These descriptions would also enable a thorough examination of the validity of patients' gut feelings and their contribution to professionals' clinical reasoning. AIM: To gather the words and phrases that patients or their relatives use to share their gut feelings with primary care professionals and what they convey and imply. DESIGN AND SETTING: Qualitative study of Dutch and Belgian patients visiting an out-of-hours GP service or a GP's office. METHOD: Face-to-face semi-structured interviews were carried out with 47 patients. Interviews were coded using a descriptive content analysis in an iterative process until data sufficiency. RESULTS: Patients or their relatives expressed their gut feelings by using words relating to trusting or not trusting the situation, or to changes in normal patterns. Their gut feelings are most often felt as a sense of alarm. In general, patients experiencing a sense of alarm, particularly mothers of sick children, were convinced that something was wrong and had often learned to trust their gut feeling. A gut feeling was the main reason to contact a PCP. Patients generally felt that their gut feelings were taken seriously. CONCLUSION: The findings of this study provide an insight into how patients and relatives may express their gut feelings about their own or their relative's health and how they share these feelings with healthcare professionals. This may help clinicians improve their recognition of patients' gut feelings, being particularly alert to a patient or relative using phrases that relate to feelings of not trusting a situation, things seeming wrong or different from normal, and experiencing a sense of alarm. Further research should be carried out into the validity of patients' gut feelings.