WHAT EFFECTS DID PRACTICAL EXPERIENCES IN JAPANESE RURAL ISLANDS HAVE ON NEGATIVE EMOTIONAL CONTROL IN PHYSICIANS? - A QUALITATIVE RESEARCH

•Introduction and objective Physicians experience negative feelings for a variety of reasons during medical practice. Methods of controlling negative feelings are diverse and may depend on fields of medical care. Methods of controlling negative feelings in rural islands have not been reported previously. In this qualitative research, we intended to clarify how physicians are dealing with negative feelings in the island clinics. •Method Between April 2013 and March 2016, we carried out individual interviews with four physicians who practiced for two years at clinics in remote islands of Okinawa prefecture, Japan. We conducted and recorded semi-structured interviews with the physicians, for which written records are created afterward. Analysis was performed based on Steps for Coding and Theorization method to extract concepts and produce categories from similar concepts. •Results and Conclusions 21 concepts were extracted, and 3 categories were generated. Category 1:  "induction of negative feelings" contained patients’ attitudes different from physicians toward health and patient-doctor relationships, and difficult collaborations with other doctors in hospitals because of weak interaction. Category 2: "Reduction of negative feelings" was given by long-time involvement with the islanders and the importance of good interpersonal relationships with other medical staff. Category 3: "Awareness of negative feelings" indicated emotional control depended on where they are practicing medicine, and the inevitability of negative feelings. Through clinical experiences in island clinics, smooth human relations, islanders’ consciousness and presence of supporters possibly lessen physicians‘ negative feelings. There is a possibility that a passage of time has eased negative feelings.