Elisabeth Assing Hvidt

• Master of Arts, PhD
• associate professor at University of Southern Denmark

Video consultations represent a relatively new way of delivering face-to-face consultation in the context of general practice. The aim of the present analysis is to examine how video consultations influence patients’ experiences of their ability to communicate their emotions, needs, and vulnerabilities, as well as their experiences with their gener...

In this study, we examine how Danish general practitioners (GPs) and general practice staff have fitted their use of video consultation to align with their conceptualisations of good care. Political stakeholders are repeatedly encouraging the use of video consultation in the healthcare sector, discursively referring to optimised use of healthcare r...

Background The purpose of this interview study was to explore patients’ and general practitioners’ (GPs’) experiences of space, time, and presence in video consultation in general practice in Denmark. Methods The study included six GPs and seven patients from the Copenhagen area, with different experience of video consultations. The data consisted...

Objective The objective is to explore parents’ experiences with telephone contacts to out-of-hours primary care (OOH-PC) that include use of one-way video ( video triage ). Design A qualitative interview study using Braun and Clarke’s thematic analysis approach. Setting OOH-PC in the Central Denmark Region. Participants A convenience sampling st...

Objective To delineate the characteristics of the work undertaken by general practitioners (GPs) and staff in implementing and utilising video consultation within their situated clinical contexts. Methods The data material comprises 33 semi-structured interviews with GPs and staff and 132 hours of ethnographic fieldwork across seven clinics in Den...

Objective This qualitative study explores when and why patients book video consultations through an online booking platform within the context of Danish general practice and how the technology affects patients’ use of this consultation type. Methods We conducted thirteen semi-structured interviews with patients from the same general practice who w...

Background Empathy has been associated with a range of positive outcomes, including social connection, pro‐social behavior, and mental health. Nonetheless, acknowledging the multidimensional aspects of empathy, budding research indicates that sometimes empathy may precipitate negative health outcomes. Aim In the present paper, we explore the exten...

In this article we use an existential media framework to explore the asynchronous, written and digital form of GP‐patient communication that takes place through e‐consultations in a Danish general practice context. This approach acknowledges e‐consultation as more than a tool for information delivery and frames GP and patient not as skilful media u...

Objective: To explore possible challenges to General Practitioners' (GPs') interpersonal contact with patients in video consultations (VCs), and learn how they change their communication strategies to carry out medical work in a setting with altered sensory conditions. Design, setting, subjects: The study included 6 GPs from the Copenhagen area,...

In this paper we present findings from a qualitative ethnographic study investigating the experiences and perceptions of general practitioners and other practice staff when introducing a new point of care diagnostic test technology (point of care polymerase chain reaction (POC PCR)) in general practice in Denmark. The ethnographic study was conduct...

In this study, we discuss how email consultations in general practice operate as a temporal technology, transforming working conditions and power relations between general practitioners (GPs) and patients. We draw on empirical material from Denmark in the form of a set of 68 semi-structured interviews with patients aged 65 + and two focus group dis...

Background Empathy is widely recognized as a multi-dimensional construct, involving emotional and cognitive components. These may cause distinct experiences and behaviors that can be both beneficial and deleterious to individuals’ well-being and mental health. Aim We wished to examine the association between emotional and cognitive empathy of Dani...

This study uses socio-cognitive theory on technological frames to understand how and why general practitioners in Denmark use or choose not to use video consultations. Video consultations play a vital role in the digitalisation of the Danish healthcare system. Whilst political decision-makers continuously push for increased use of video consultatio...

Objective Video consultations enable a digital point of contact between the general practitioner and patient. With their medium-specific characteristics, video consultations may create novel conditions for the enactment of patient participation during consultations. Although numerous studies have explored patients’ experiences of video consultation...

The aim of this study was to identify (i) emotions experienced by healthcare professionals (HCPs) after adverse or traumatic events and (ii) needs for support after adverse or traumatic events. Data for this qualitative, descriptive study were collected at 27 seminars for 198 HCPs introducing a peer-support programme after adverse or traumatic even...

Introduction Talking about existential issues with patients is often experienced as challenging for healthcare professionals. This paper describes our first steps towards developing existential communication training with particular attention to reflective learning methods. Blended learning was chosen to support reflection and an easier transition...

UNSTRUCTURED In the wake of the Covid-19 pandemic, video consultation was introduced in general practice in many countries around the world as a solution to provide healthcare to patients. It was assumed that video consultation would find widespread adoption in post-Covid 19 general practice. Howev-er, adoption rates remain low across countries, su...

In the wake of the COVID-19 pandemic, video consultation was introduced in general practice in many countries around the world as a solution to provide remote health care to patients. It was assumed that video consultation would find widespread adoption in post-COVID-19 general practice. However, adoption rates remain low across countries in Northe...

Objective In the past 10-12 years, the communication teaching for medical students at the University of Southern Denmark has taken place without significant changes in form and content. Therefore, a working group was established to bring the communication education "up to date," e.g., focusing more on the human-to-human relationship and how you can...

Background The modern medical education is predominantly grounded in the biomedical sciences. In recent years, medical humanities have been included into the medical curricula in many countries around the world one of the objectives being to promote patient-centred, empathic care by future physicians. Studies have been made of the impact of inclusi...

Background Video consultation was urgently introduced in general practice in connection with the COVID-19 pandemic, where a rapid implementation ensured patients’ continued access to their general practitioner (GP). With the Danish lockdown in March 2020, the use of video consultations in general practice increased drastically and then declined sig...

Background Clinical empathy has been associated with a range of positive patient- and clinician outcomes. Educating medical students to become empathic physicians has in recent years become a clearly pronounced learning objective in medical education in many countries worldwide. Research knowledge about how medical students experience the learning...

“The existential” is a concept that many people use albeit associated with different meanings. In order to increase research-based insight into the meaning of “the existential,” we conducted a questionnaire study in Denmark in 2018 in which we asked 1.106 Danes of various age, gender, educational and geographical background about personal associati...

This article contributes to social health research by presenting an analysis of the temporal dimensions of the “good” doctor-patient relationship as perceived and enacted by patients and general practitioners (GPs). The empirical data derive from ethnographic fieldwork comprising participant observation in four general practice clinics in Denmark,...

Background Professional empathy has been associated with a range of positive patient- and clinician outcomes and is therefore considered important to develop for future physicians. Measuring changes in empathy scores among medical students by using the Jefferson Scale of Empathy (Student version) (JSE-S) has led to mixed results. So far, no investi...

Objective To analyse how the patient's use of handheld technology in video consultations with their general practitioner affects communication and the possibilities for the delivery of quality healthcare. Focusing on the visually communicated aspects of the video consultation, we present three episodes from our recordings of eight video consultatio...

Objective To explore the experiences of Danish patients using video consultation (VC) to consult their general practitioner (GP) during COVID-19 lockdown and their attitudes towards continued use beyond COVID-19. Design A qualitative design was employed, consisting of individual semi-structured interviews where participants were asked to retrospec...

Background: Professional empathy has been associated with a range of positive patient- and clinician outcomes and is therefore considered important to develop for future physicians. Measuring changes in empathy scores among medical students by using the Jefferson Scale of Empathy (Student version) (JSE-S) has led to mixed results. So far, no invest...

Objectives: Defensive medicine has originally been defined as motivated by fear of malpractice litigation. However, the term is frequently used in Europe where most countries have a no-fault malpractice system. The objectives of this systematic review were to explore the definition of the term ‘defensive medicine’ in European original medical liter...

Background: Uncertainties are omnipresent in healthcare, but little is known about general practitioners' (GPs) professional uncertainties concerning digital consultations. This is problematic, as many countries has undergone an extensive digital transformation. Objective: The aim of this article is to explore the professional uncertainities tha...

BACKGROUND Uncertainties are omnipresent in health care, but little is known about general practitioners’ (GPs) professional uncertainties concerning digital consultations. This is problematic, as many countries have undergone an extensive digital transformation. OBJECTIVE The aim of this study was to explore the professional uncertainties that em...

Objective To analyse the reciprocal dynamics between patients’ choice of place and how they experience video consultations (VCs) with the general practitioner. Methods Qualitative, semi-structured interviews with 27 Danish patients were conducted over a period of 9 months, from February to October 2020. Interviews were analysed using thematic anal...

Many patients with cancer face existential challenges struggling to find mental respite from their illness and a space for processing and transforming difficult thoughts and concerns. Research has shown that providing a room for cancer patients’ own creative expression can foster healing processes and mental well-being. Using theories of Donald W....

Background Patients approaching the end of their life do not experience their existential and spiritual needs being sufficiently met by the healthcare professionals responsible for their care. Research suggest that this is partly due to a lack of insight about spiritual care among healthcare professionals. By developing, implementing, and evaluatin...

In recent years and throughout the developed world, policymakers have encouraged the implementation of digital patient-clinician interaction. Our focus is on the Danish general practice setting where email consultations were implemented as a mandatory service in 2009 and now constitute 21% of all consultations in general practice. Drawing upon stro...

BACKGROUND The COVID-19 pandemic has changed various spheres of healthcare. The general practitioners (GPs) have widely replaced face-to-face consultations with telephone or video consultation (VC) to reduce the risk of COVID-19 transmission. Using video consultations for health service deliveries is an entirely new way of practicing for many GPs....

Background The COVID-19 pandemic has changed various spheres of health care. General practitioners (GPs) have widely replaced face-to-face consultations with telephone or video consultations (VCs) to reduce the risk of COVID-19 transmission. Using VCs for health service delivery is an entirely new way of practicing for many GPs. However, this trans...

To explore patients’ existential challenges when living with chronic pain or multiple sclerosis, 23 semistructured patient interviews were conducted together with an interpretative, phenomenological analysis inspired by Søren Kierkegaard. Patients experienced their illness as a “stroke of fate” resulting in despair and a profound struggle to find o...

Many physicians remain reticent to initiate or partake in discussions about their patients’ religious and spiritual needs during the clinical encounter. Reasons for this may be insufficient time, capacity, education or training but may also be a product of variance in physicians’ own religious or spiritual characteristics. The aim of this paper was...

Burnout among general practitioners (GPs) is a problem in many countries. Research indicates that burnout is less likely to occur among intrinsically motivated employees. Based on self-determination theory, we investigate 1) whether intrinsically motivated GPs are less burned out than their colleagues, and 2) whether the most intrinsically motivate...

Healthcare professionals are socialized into a tacit, professional identity of competences and skills – to save lives, repair trauma and facilitate good and trustful relational care. When severe adverse events happen, healthcare professionals may struggle to accept their own fallibility, and the event may pose a threat to the selfdeclared ‘superior...

Objectives The overall study aim was to synthesise understandings and experiences regarding the concept of spiritual care (SC). More specifically, to identify, organise and prioritise experiences with the way SC is conceived and practised by professionals in research and the clinic. Design Group concept mapping (GCM). Setting The study was conduc...

Objective To explore GPs’ perspectives on and daily experiences with the relational potential of email consultations. Design Qualitative study with data from participant observation and semi-structured interviews Setting General practice setting in Denmark Subjects Practice personnel from four clinics were observed and 16 GPs (seven women and ni...

Objective: Email consultations have become part of everyday doctor-patient communication in many countries. The objective of this study is to investigate how patients and general practitioners (GPs) perceive the communicative advantages and disadvantages of access via email consultation drawing on a media-theoretical perspective. Design: We anal...

In the present study, we examine the correlation between religiosity and health-related risk behaviours among citizens aged 29–60 based on a cross-sectional survey in Denmark, known for its more secular culture. Health-related risk behaviours such as smoking and alcohol intake are known to increase the risk of developing one or more chronic or life...

Several studies in different countries have investigated the influence of physician characteristics (such as ethnicity, gender and personal values) on attitudes in end-of-life (EOL) decision-making. While patients and relatives formally decide about issues related to EOL, the physician often ends up with a pivotal role in the decision-making proces...

In the following article, the restorative potential of the environment in a cancer rehabilitation programme is analysed and discussed. The programme was developed as a transdisciplinary cooperation of psychologists, theologians, philosophers, and artists. To investigate the importance of environments, six qualitative focus group interviews were per...

Spiritual care has been a growing focus in international healthcare research over the last decades. The approaches to spiritual care are many and derive from many different medical fields and different cultural contexts and often remain unknown across healthcare areas. This points to a potential knowledge gap between existing instruments and the kn...

Objective Previous research indicate that the FACIT‐Sp instrument is susceptible to bias when measuring spiritual well‐being in older patients. Our first focus was to evaluate the 2‐factor vs the 3‐factor model of the FACIT‐Sp and our second focus was to explore how these models behave for different age groups. Methods We used a large national coh...

Purpose To describe the development process of an existential support program and to explore participants' evaluation of supportive/unsupportive processes of change. Method A five-day existential support program called “Energy for life” was designed including three main elements: 1. existential group counseling, 2. art therapy and 3. interaction w...

Background: Clinical empathy has been associated with positive outcomes for both physicians and patients such as: more accurate diagnosis and treatment, increased patient satisfaction and compliance, and lower levels of burnout and stress among physicians. International studies show mixed results regarding the development of empathy among future p...

Background: Empathy allows a physician to understand the patient's situation and feelings and respond appropriately. Consequently, empathy gives rise to better diagnostics and clinical outcomes. This systematic review investigates the level of empathy among medical students across the number of educational years and how this level relates to gende...

Introduction The term defensive medicine, referring to actions motivated primarily by litigious concerns, originates from the USA and has been used in medical research literature since the late 1960s. Differences in medical legal systems between the US and most European countries with no tort legislation raise the question whether the US definition...

Objective Research suggests that existential, spiritual, and religious issues are important for patient’s psychological adjustment when living with chronic pain and multiple sclerosis. However, there is a paucity of studies investigating how physicians experience and approach these patients’ needs. Design Physicians’ experiences with and approache...

Purpose The purpose of this study was to examine the associations between self-reported spiritual/religious concerns and age, gender, and emotional challenges among cancer survivors who have completed a 5-day rehabilitation course at a rehabilitation center in Denmark (the former RehabiliteringsCenter Dallund (RC Dallund)). Methods The data stem f...

Research documents that many chronic non-malignant pain patients experience existential, spiritual and religious needs; however, research knowledge is missing on if and how physicians approach these needs. We conducted a systematic review to explore the extent to which physicians address these needs in their communication with chronic non-malignant...

Secularization impacts most cultures and seems to be spreading still. What can we learn from the most secular nations in the world on how secularization impacts the relationship between religiousness, spirituality and health? Does secularization mean that religious and spiritual considerations during crisis vanish? Or is it rather the opposite, tha...

Background: Facing a severe, chronic disease can be experienced as an existential crisis that may lead to a lower quality of life and even risk of suicide. Existential, spiritual and religious ways of meaning-making are in many cases positively related to health and can be important in times of crises. This project aims to study a gap in the curren...

The aim of this article is to show how Jürgen Habermas’ communicative action theory serves as a useful tool in analysing and interpreting empirical data on how Danish general practitioners experience defensive medicine in their everyday working life. Through six qualitative focus group interviews with a total of 28 general practitioners (14 men and...

This project is part of a larger research effort focusing on incorporating the patient's existential needs in the communicative encounter through communication training programs for healthcare professionals across the healthcare system. The purpose of this research project is to develop a generic blended-learning training course on existential matt...

This study investigated the association between physicians' R/S characteristics and frequency of addressing patients' R/S issues. Information was obtained through a questionnaire mailed to 1485 Danish physicians (response rate 63%) (42% female). We found significant associations between physicians' personal R/S and the frequency of addressing R/S i...

This project is part of a larger research effort focusing on incorporating the patient's existential needs in the communicative encounter through communication training programs for healthcare professionals across the healthcare system. The purpose of this research project is to develop a generic blended-learning training course on existential matt...

Livsstilsrelaterede sygdomme er en samfundsmaessig udfordring, som har stor betydning for borgernes livskvalitet og koster samfundet dyrt. Personer, der er storrygere, har et højt alkoholforbrug og fører en stillesiddende livsform, har naesten syv gange højere dødelighed end personer, der ikke ryger, drikker moderat og er fysisk aktive, og 80% af h...

Background: The consequences of lifestyle-related disease represent a major burden for the individual as well as for society at large. Individual preventive health checks to the general population have been suggested as a mean to reduce the burden of lifestyle-related diseases, though with mixed evidence on effectiveness. Several systematic review...

Objective: Our objective was to describe the development and evaluation of a course programme in existential communication targeting general practitioners (GPs). Design: The UK Medical Research Council’s (MRC) framework for complex intervention research was used as a guide for course development and evaluation and was furthermore used to structure...

At Sygehus Lillebaelt, a Danish hospital, there has been a focus for several years on patient communication. This paper reflects on a course focusing on engaging with the patient's existential themes in particular the negotiations around the creation of video scenes. In the initial workshops, we have been drawing on improvised theatre. The fiction...

Objectives Recent years have witnessed a progressive increase in defensive medicine (DM) in several Western welfare countries. In Danish primary and secondary care, documentation on the extent of DM is lacking. Before investigating the extent of DM, we wanted to explore how the phenomenon is understood and experienced in the context of general prac...

Objective: This paper aims to demonstrate how the use of participatory action research (PAR) helped us identify ways to respond to communication challenges associated with shared decision-making (SDM) training. Methods: Patients, relatives, researchers, and health professionals were involved in a PAR process that included: (1) two theatre worksh...

Formålet med indeværende kvalitative projekt er at undersøge samarbejdet om sundhedsfremme og forebyggelse mellem almen praksis og kommune med særligt fokus på erfaringer med, holdninger til og perspektiver på samarbejdet blandt praktiserende læger og kommunale sundhedsprofessionelle. Undersøgelsen søger at besvare følgende forskningsspørgsmål: 1....

Although it is broadly recognized that health problems often involve existential and spiritual dimensions, recent research shows that these aspects of illness are rarely attended to by health professionals. Studies explain this in terms of barriers to communication, but health professionals' firsthand experiences and interpretations have so far bee...

Background: General practice recognizes the existential dimension as an integral part of multidimensional patient care alongside the physical, psychological and social dimensions. However, general practitioners (GPs) report substantial barriers related to communication with patients about existential concerns. Objectives: To describe the developmen...

Objective: The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP-patient encounter. Design: A qualitative methodology with semi-structured focus group interviews was employed....

Purpose – Telephone crisis services are increasingly subject to a requirement to “prove their worth” as a suicide prevention strategy. The purpose of this paper is to: first, provide a detailed overview of the evidence on the impact of telephone crisis services on suicidal users; second, determine the limitations of the outcome measures used in thi...

In the past couple of decades, there has been significant interest in the research literature and patient narratives that focus on describing the cancer journey as involving existential and spiritual transformative experiences. The purpose of this article is to contribute with a new and deepened understanding of the existing literature by offering...

The aim of this article is to present findings about self-reported spirituality of a group of Danish cancer survivors. The findings derive from a qualitative study that was carried out during rehabilitation week courses at a Danish rehabilitation centre. Methods comprised participant observation, semi-structured interviews and focus group interview...

The aim of this article is to shed light on the different ways in which a group of Danish cancer survivors fulfil their need of emotional support. The study comprised participant observation at a Danish cancer rehabilitation centre, individual semi-structured interviews and focus group interviews with course participants. The analytical process com...

A Secular Age (2007) as a useful tool for interpreting empirical data on cancer patients' meaning orientations during rehabilitation. The data is taken from a qualitative project on Danish patients' self-reported secular existential, religious and/or spiritual orien-tations. The authors will show how concepts that lie at the heart of Taylor's secul...