Patients' perspectives on involvement in general practice: A thematic analysis of free-text comments

Background: General practice (GP) plays a core role in managing the clinical pathways of patients with chronic diseases. Despite well-established knowledge of the benefits of involvement and personalized care, involvement in GP appears to be challenged. This study aimed to explore patient involvement in GP from the patients' perspectives. Method: The study involved a questionnaire survey investigating patient involvement in GP from the patients' perspectives. The validated questionnaire includes an open-ended question encouraging responders to provide additional comments regarding their involvement in GP. The results from these comments are presented in this paper. A thematic analysis was applied. Results: Of the 468 responses, 139 included additional comments to the free-text question. Through our analysis, six analytic themes were generated—To be seen, met or heard, To feel safe or not, To be involved or dictated to, Accessibility, COVID-19, and For the resourceful—across 116 codings and 25 descriptive themes. The themes' interwovenness underscores the complexity of both involvement and how it is to live with a chronic disease. Our analysis indicates that involvement in GP is for the resourceful. Conclusion: The six themes describing involvement in GP from the perspectives of patients with T2DM and/or COPD were deeply intertwined. Involvement is dependent on being seen, met and heard, all of which contribute to the patients' sense of feeling safe (or not). These aspects are dependent on accessibility to a general practitioner; thus, COVID-19 was a barrier during the data-collection period. Furthermore, it appeared that being resourceful not only contributed to a sense of being involved in GP but was perhaps even a prerequisite for being involved.