Patients' perceptions of climate-sensitive health counselling in primary care: Qualitative results from Germany

Eur J Gen Pract. 2023 Dec;29(1):2284261. doi: 10.1080/13814788.2023.2284261. Epub 2023 Nov 27.

Abstract

Background: Climate change is the greatest threat to global health in the twenty first century, yet combating it entails substantial health co-benefits. Physicians and other health professionals have not yet fully embraced their responsibilities in the climate crisis, especially about their communication with patients. While medical associations are calling on physicians to integrate climate change into health counselling, there is little empirical evidence about corresponding perceptions of patients.

Objectives: This study aimed to explore primary care patients' perceptions of climate-sensitive health counselling.

Methods: From July to December 2021, 27 qualitative interviews with patients were conducted and analysed using thematic analysis. A purposive sampling technique was applied to identify patients who had already experienced climate-sensitive health counselling in Germany.

Results: Patients' perceptions of climate-sensitive health counselling were characterised by a high level of acceptance, which was enhanced by stressing the link between climate change and health, being credible concerning physician's own climate-friendly lifestyle, building upon good therapeutic relationships, creating a sense of solidarity, and working in a patient centred manner. Challenges and risks for acceptance were patients' disinterest or surprise, time constraints, feared politicisation of consultations, and evoking feelings of guilt and shame.

Conclusion: These findings suggest that primary care patients can accept climate-sensitive health counselling, if it follows certain principles of communication, including patient-centredness. Our findings can be useful for developing communication guidelines, respective policies as well as well-designed intervention studies, which are needed to test the health and environmental effects of climate-sensitive health counselling.

Keywords: Climate change; climate-sensitive health counselling; general practice; health communication; patient education; patient-centeredness; primary care.

Plain language summary

Climate-sensitive health counselling was accepted in a qualitative patient sample in Germany.Patient-centred communication and a link to individual health contributed to acceptance while time-constraints, politisation and feelings of guilt were potential challenges.Further research is needed to investigating patients’ acceptance and effects of climate-sensitive health counselling in larger samples.

MeSH terms

  • Communication*
  • Counseling
  • Germany
  • Humans
  • Life Style*
  • Primary Health Care
  • Qualitative Research

Grants and funding

Else Kröner-Fresenius-Stiftung within the Heidelberg Graduate School of Global Health (SG, CQ), Robert Bosch Foundation (ID). For the publication fee we acknowledge financial support by Deutsche Forschungsgemeinschaft within the funding programme “Open Access Publikationskosten“ as well as by Heidelberg University.