A comfortable relationship: a patient-derived dimension of ongoing care.

BACKGROUND AND OBJECTIVES Continuity of care is considered essential to primary care and improves health outcomes. However, it is unclear whether patients and physicians define this concept similarly. This study examined how patients perceive a continuity relationship, from its development through its consequences. METHODS This was a qualitative study using grounded theory methodology. Researchers selected and interviewed a purposeful sample of 14 primary care patients. Audiotapes of the interviews were transcribed and analyzed using open, axial, and selective coding schemes. RESULTS Although the majority of patients were not familiar with the phrase continuity of care, all patients in the study identified comfort with their doctor as important to establishing and maintaining an ongoing relationship. Comfort with a physician was developed in several ways. Patients described their level of comfort with a physician as influencing making and keeping appointments, the likelihood that they would discuss concerns about sensitive issues, their perception that medical problems were resolved faster, and their trust in the physician's treatment plan. CONCLUSIONS For patients, comfort appears to be an important dimension of the physician-patient continuity relationship. Primary care physicians and researchers should further explore how to use patient comfort as an element of care.