Evaluation of the counseling concept “Positive Health” in primary care. An explorative investigation of video-documented conversations using the Rating Inventory of solution-oriented Interventions (RLI).

Natalie Seuken, Ottomar Bahrs, Achim Mortsiefer

Background:

Positive Health is a counseling concept developed by Dutch GPs that focuses less on diseases and more on the patients' existing resources in order to make possible courses of action visible and strengthen the motivation for change. Based on a simple tool (spider web with six health-related dimensions) patients can reflect on their own health first, which than provides the basis for a dialogue between patient and doctor. There is no evidence how these dialogues can be implemented in primary care in Germany.

Research questions:

The aim of the study is to examine the content and structure of the "Positive Health" conversation and how it differs from usual consultations. This study is part of a research program to develop better health-promoting interventions in primary care.

Method:

The study is designed as explorative study. Positive Health consultations are video recorded and the film material is analyzed using the rating inventory of solution-oriented interventions (RLI). The GP is main subject of analysis, but both, GP and patient, will be recorded in order to analyze the interaction between the two of them. Two consultations are planned with a maximum duration of 30 minutes. After coding, the conversation characteristics will be compared in terms of their frequency and characteristics. Furthermore, conversation elements will be grouped into different clusters in order to compare patterns of the conversations.

Results:

This is an ongoing study. As to this date 4 GPs support the study and 6 consulting conversations have been recorded on camera in a duration of maximum 30 minutes each. Further results will be presented at the conference.

Conclusions:

Before new consulting concepts are introduced into practice, the potential benefits and feasibility should be examined. This study contributes to answering the question of whether and with which adaptations the Positive Health approach could be implemented in Germany.

Points for discussion:

1. What experience do you have with video analysis of consultations and which evaluation methods are suitable in your opinion?

2. Based on your experience, which methods do you recommend to investigate the benefits and feasibility of health-promoting interventions in primary care?

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