Exploring newly referred patients' and their caregivers' display of needs: A microanalysis in specialized outpatient care.

Abstract

Awareness and responsiveness to patients' needs are essential for practicing person-centered care in specialized outpatient clinics. This study explored how newly referred patients with severe rheumatic autoimmune disease, and their caregivers display needs during their first clinical interaction. We conducted a qualitative microanalysis of clinical interaction using 20 video recordings involving patients, their caregivers, and eleven physicians. The interactions took place in 2024 at two specialized outpatient clinics at a university hospital in Denmark. 105 sequences where patients or caregivers expressed needs were identified, averaging five expressions per interaction. The study revealed that patients expressed needs in four ways: explicitly, implicitly, by requesting information, and by displaying emotions. Patients expressed needs regarding having certainty, understanding, psychological comfort, and the ability to manage daily activities. The findings address how patients and their caregivers express cognitive and socioemotional needs related to their disease, as well as motivational needs regarding living with illness in their first clinical interaction at a specialized outpatient clinic. The findings highlight the importance of healthcare providers developing competencies to identify and respond to patients' and caregivers' needs, and to create care trajectories that reflect both clinical goals and patients' individual needs.