OBJECTIVE: To examine patients' experiences of fairness and commitment in the health care context with an emphasis on primary care providers. DESIGN: Qualitative, semistructured, individual interviews were used to gather evidence for the justice and commitment frameworks across a variety of settings with an emphasis on primary care relationships. SETTING: Rural, urban, and semiurban communities in Nova Scotia. PARTICIPANTS: Patients (ages ranged from 19 to 80 years) with varying health care needs and views on their health care providers. METHODS: Participants were recruited through a variety of means, including posters in practice settings and communication with administrative staff in clinics. Individual interviews were conducted and were audiotaped and transcribed verbatim. A modified grounded theory approach was used to interpret the data. MAIN FINDINGS: Current conceptualizations of justice (distributive, procedural, interpersonal, informational) and commitment (affective, normative, continuance) capture important elements of patient-health care provider interactions and relationships. CONCLUSION: Justice and commitment frameworks developed in other contexts encompass important dimensions of the patient-health care provider relationship with some exceptions. For example, commonly understood subcomponents of justice (eg, procedural consistency) might require modification to apply fully to patient-health care provider relationships. Moreover, the results suggest that factors outside the patient-health care provider dyad (eg, familial connections) might also influence the patient's commitment to his or her health care provider.
OBJECTIVE: To examine patients' experiences of fairness and commitment in the health care context with an emphasis on primary care providers. DESIGN: Qualitative, semistructured, individual interviews were used to gather evidence for the justice and commitment frameworks across a variety of settings with an emphasis on primary care relationships. SETTING: Rural, urban, and semiurban communities in Nova Scotia. PARTICIPANTS: Patients (ages ranged from 19 to 80 years) with varying health care needs and views on their health care providers. METHODS:Participants were recruited through a variety of means, including posters in practice settings and communication with administrative staff in clinics. Individual interviews were conducted and were audiotaped and transcribed verbatim. A modified grounded theory approach was used to interpret the data. MAIN FINDINGS: Current conceptualizations of justice (distributive, procedural, interpersonal, informational) and commitment (affective, normative, continuance) capture important elements of patient-health care provider interactions and relationships. CONCLUSION: Justice and commitment frameworks developed in other contexts encompass important dimensions of the patient-health care provider relationship with some exceptions. For example, commonly understood subcomponents of justice (eg, procedural consistency) might require modification to apply fully to patient-health care provider relationships. Moreover, the results suggest that factors outside the patient-health care provider dyad (eg, familial connections) might also influence the patient's commitment to his or her health care provider.