Creating space to talk about patients’ personal goals: experiences from primary care stakeholders
Authors: Boeykens Dagje , Haverals Reini , Sirimsi Muhammed Mustafa , Timmermans Lotte , Van de Velde Dominique , De Vriendt Patricia , Boeckxstaens Pauline ,   on behalf of the Primary Care Academy, Remmen Roy , Verté Emily , Van Bogaert Peter , De Loof Hans , Van den Broeck Kris , Anthierens Sibyl , Huybrechts Ine , Raeymaeckers Peter , Buffel Veerle , Devroey Dirk , Aertgeerts Bert , Schoenmakers Birgitte , Timmermans Lotte , Foulon Veerle , Declerq Anja , Verhaeghe Nick , De Sutter An , Lahousse Lies , Pype Peter , Van Hecke Ann , Decat Peter , Roose Rudi , Martin Sandra , Rutten Erica , Pless Sam , Gauwe Vanessa , Reynaert Didier , Van Landschoot Leen , Hartmann Maja Lopez , Claeys Tony , Vandenhoudt Hilde , De Vliegher Kristel 
Published: January 2023

Abstract
Background
To address the many challenges health systems and communities face, primary care is constantly searching for new strategies to improve quality of care. One of the strategies is to focus on patients’ personal goals to direct the care process. To adopt an explicit focus on patients’ personal goals, actions at different levels are required. As a first step in this process, this study aims to explore the experiences of primary care stakeholders (i.e., scholars, primary care providers, and policy makers) and develop a comprehensive understanding on the idea ‘putting patients’ goals first’. This will help to formulate suggestions about what these actions should include.

Method
In this study, 41 primary care stakeholders participating in six focus groups between January 2020 and September 2020, were recruited via maximal variation purposive sampling. Data collection was done through an open-ended semi-structured interview guide. Focus groups were audio-recorded, transcribed verbatim, and analyzed following a phenomenological-hermeneutical philosophy of Lindseth and Norberg.

Results
All participants expressed a strong fundamental belief for putting patients’ personal goals first. The primary care providers shared that they created space for patients’ personal goals by letting them talk about their values and stories. They reported to integrate their medical expertise with patients’ personal goals in order to develop a balanced relationship. In this context, they also talked about the importance of taking into account the perspectives of patients’ significant others. Primary care providers also talked about how they used patients’ personal goals as a guide in interprofessional collaboration. Scholars denoted that (future) care providers need more training to acquire competencies to discuss patients’ personal goals. The providers and policy makers talked about organizational limitations in terms of time restrictions and the lack of registration systems to support a workflow oriented towards patients’ personal goals.

Conclusions
This study can be used to support the coherence of the development of different actions and strategies to get primary care stakeholders fully on board to support the adoption of patients’ personal goals in care delivery at different levels. However, models of practice and policy plans are needed to work towards a person-centered integrated system.