期刊论文详细信息
BMC Family Practice
Concerns voiced by patients and GPs’ responses during psychosocial visits in primary care: a historical cross-sectional study
Research Article
Ligaya Butalid1  Peter FM Verhaak2  Sandra van Dulmen3  Jozien M Bensing4 
[1] NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands;NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands;Department of General Practice, Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands;NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands;Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands;Department of Health Sciences, Buskerud University College, Drammen, Norway;NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands;Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands;
关键词: Doctor-patient relations;    General practice;    Cues;    Empathy;    Psychosocial factors;   
DOI  :  10.1186/s12875-014-0188-3
 received in 2014-08-25, accepted in 2014-11-07,  发布年份 2014
来源: Springer
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【 摘 要 】

BackgroundIn a recent study comparing psychosocial consultations prior to and after the implementation of national clinical guidelines in the Netherlands, we found that general practitioners (GPs) showed less empathy in the more recent consultations. As a consequence, patients possibly have less scope to express their worries. The objective is to investigate whether patients have become more reluctant to open up about their concerns during psychosocial consultations and how GPs respond.MethodsConsultations from previous study samples videotaped between 1977 and 2008 and categorized by GPs as `completely psychosocial’ were selected for the present study. These consultations were observed using the Verona Coding Definitions of Emotional Sequences (VR-CoDES) to capture cues and concerns expressed by patients and GPs’ immediate responses. We compared consultations prior to (N = 121) and after (N = 391) introduction of national clinical guidelines in the 1990s.ResultsIn 92% of the consultations, patients presented at least one worry. These were most often expressed implicitly. However, the proportion of consultations containing at least one explicit concern changed from 24% to 37% over time. The increased number of expressed cues and concerns was partly explained by a change in GP characteristics; the latter sample contained more female and more experienced GPs. Furthermore, cues and concerns were more often expressed during later phases of consultations in recent years.ConclusionsOur study shows that patients have become somewhat more explicit in expressing their worries. However, GPs need to be aware that, still, most worries are expressed implicitly and that new concerns may appear towards the end of consultations.

【 授权许可】

CC BY   
© Butalid et al.; licensee BioMed Central Ltd. 2014

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