Article Figures & Data
Tables
Step Description 1 All the interviews were read through repeatedly to get a good grasp of the whole 2 The text was divided into meaning units. A meaning unit starts when the content of meaning shifts 3 Each meaning unit was examined closely and condensed into what was relevant to the research question, and the informant’s language was changed into the researcher’s language 4 The transformed meaning units were reformulated into themes and subthemes 5 The themes and subthemes were related to each other in a general structure of the studied phenomenon Themes Subthemes Competence in the physician-patient encounter gained in the Balint group Naming, tracing, and handling difficult emotions Knowing oneself Preparing oneself for difficult encounters Understanding mechanisms of bad encounters Viewing the patient as a whole person in a biopsychosocial coherence Understanding why patients seek health care Being proactive in consultations Professional identity as recognized in the group Recognizing difficult encounters as a special and challenging task as a general practitioner Learning the limits of one’s abilities and obligations Understanding patient-centeredness as a prerequisite of being a general practitioner Having a shared working condition, showing tolerance toward colleagues Mirroring oneself in others’ stories leading to increased understanding of the tasks of a general practitioner Sense of security developed in the group Long relationship with the other group members Weaknesses and mishaps are tolerated Permissiveness, openness, and sincerity in the group Confidentiality, frames, and firm structure Feeling of not being alone even between group meetings Long experience leads to feeling of security Parallel process: general practitioner–patient and Balint group–general practitioner Long relationship with both patients and group Learning to listen patiently to narratives of discomfort Acknowledging changes over time in both group and patients Changing one’s behavior permanently takes time Endurance and satisfaction Having good times together, breathing space Balint group enhances satisfaction with work Balint group counteracts burnout Together recognizing the good sides of work
Additional Files
The Article in Brief
Balint Groups as a Means to Increase Job Satisfaction and Prevent Burnout Among General Practitioners
Dorte Kjeldmand, GP, PhD and Inger Holmstrom, RN, PhD
Background Doctors can reduce or avoid burnout by joining groups (called Balint groups) in which they reflect on their relationships with patients and learn strategies for handling their work life. The aim of this study is to explore general practitioners' experience of Balint group participation and its influence on their work life.
What This Study Found Participants in this study describe Balint group participation as beneficial and essential to their working life as general practitioners. It strengthens their competence in patient visits, helps them remain in their jobs, and helps them find joy and enthusiasm in their patient relationships.
Implications
- Balint groups can help general practitioners handle a demanding work life and prevent burnout.
- Balint groups might not suit all general practitioners; additional ways to reduce stress and increase job satisfaction should be offered.
Annals Journal Club Selection:
Mar/Apr 2008
The Annals Journal Club is designed to encourage a learning community of those seeking to improve health care and health through enhanced primary care. Additional information is available on the Journal Club home page.
The Annals of Family Medicine encourages readers to develop the learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club, and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for: Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care, and then acting on those discussions.1Article for Discussion
- Kjeldmand D, Holmström I. Balint groups as a means to increase job satisfaction and prevent burnout among general practitioners. Ann Fam Med. 2008;6(2):138-145.
Discussion Tips
Balint groups are commonly used in family medicine training programs but actually had their roots in general practice.2,3 It may be worthwhile to consider how this study of long-term practicing generalist physicians might affect your current opportunity to develop or participate in a Balint group. Balint Societies exist in more than 20 countries.4,5Discussion Questions
- What questions are addressed by the article? Why do they matter?
- How well does the study design fit the research questions?
- What are the main findings?
- To what degree can the findings be accounted for by:
- How participants were selected?
- How information was gathered?
- Confounding (false attribution of causality because two factors thought to be associated actually are associated with a third factor)?
- How well are data sources and analysis triangulated; that is, how well are multiple sources of information and viewpoints used to generate trustworthiness?
- How transportable are the findings to your practice setting? How might they be adapted?
- What are the implications of the findings for training, development, and preventing burnout?
- What questions do you have for further research or application?
Reference
- Stange KC, Miller WL, McLellan LA, et al. Annals journal club: It�s time to get RADICAL. Ann Fam Med. 2006;4:196-197. Available at: http://annfammed.org/cgi/content/full/4/3/196.
- Lakasing E. Michael Balint–an outstanding medical life. Br J Gen Pract. 2005;55(518):724-725. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1464079.
- Balint, Michael. The Doctor, His Patient, and the Illness. New York, NY: International Universities Press; 1957.
- The Balint Society. http://www.balint.co.uk/. Accessed Jan 27, 2008.
- The American Balint Society. http://americanbalintsociety.org/. Accessed Jan 27, 2008.
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