Literature DB >> 11668137

Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations.

P Little1, H Everitt, I Williamson, G Warner, M Moore, C Gould, K Ferrier, S Payne.   

Abstract

OBJECTIVE: To measure patients' perceptions of patient centredness and the relation of these perceptions to outcomes.
DESIGN: Observational study using questionnaires.
SETTING: Three general practices. PARTICIPANTS: 865 consecutive patients attending the practices. MAIN OUTCOME MEASURES: Patients' enablement, satisfaction, and burden of symptoms.
RESULTS: Factor analysis identified five components. These were communication and partnership (a sympathetic doctor interested in patients' worries and expectations and who discusses and agrees the problem and treatment, Cronbach's alpha=0.96); personal relationship (a doctor who knows the patient and their emotional needs, alpha=0.89); health promotion (alpha=0.87); positive approach (being definite about the problem and when it would settle, alpha=0.84); and interest in effect on patient's life (alpha=0.89). Satisfaction was related to communication and partnership (adjusted beta=19.1; 95% confidence interval 17.7 to 20.7) and a positive approach (4.28; 2.96 to 5.60). Enablement was greater with interest in the effect on life (0.55; 0.25 to 0.86), health promotion (0.57; 0.30 to 0.85), and a positive approach (0.82; 0.52 to 1.11). A positive approach was also associated with reduced symptom burden at one month (beta=-0.25; -0.41 to -0.10). Referrals were fewer if patients felt they had a personal relationship with their doctor (odds ratio 0.70; 0.54 to 0.90).
CONCLUSIONS: Components of patients' perceptions can be measured reliably and predict different outcomes. If doctors don't provide a positive, patient centred approach patients will be less satisfied, less enabled, and may have greater symptom burden and higher rates of referral.

Entities:  

Keywords:  Empirical Approach; Professional Patient Relationship

Mesh:

Year:  2001        PMID: 11668137      PMCID: PMC58543          DOI: 10.1136/bmj.323.7318.908

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  21 in total

1.  Patient-centredness in the consultation. 2: Does it really make a difference?

Authors:  R J Henbest; M Stewart
Journal:  Fam Pract       Date:  1990-03       Impact factor: 2.267

2.  Patients' unvoiced agendas in general practice consultations: qualitative study.

Authors:  C A Barry; C P Bradley; N Britten; F A Stevenson; N Barber
Journal:  BMJ       Date:  2000-05-06

3.  Preferences of patients for patient centred approach to consultation in primary care: observational study.

Authors:  P Little; H Everitt; I Williamson; G Warner; M Moore; C Gould; K Ferrier; S Payne
Journal:  BMJ       Date:  2001-02-24

4.  Misunderstandings in prescribing decisions in general practice: qualitative study.

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Authors:  P Kinnersley; N Stott; T J Peters; I Harvey
Journal:  Br J Gen Pract       Date:  1999-09       Impact factor: 5.386

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7.  Communication styles in the cancer consultation: preferences for a patient-centred approach.

Authors:  S M Dowsett; J L Saul; P N Butow; S M Dunn; M J Boyer; R Findlow; J Dunsmore
Journal:  Psychooncology       Date:  2000 Mar-Apr       Impact factor: 3.894

8.  Continuity of care in general practice: effect on patient satisfaction.

Authors:  P Hjortdahl; E Laerum
Journal:  BMJ       Date:  1992-05-16

Review 9.  Patient participation in decision-making.

Authors:  E Guadagnoli; P Ward
Journal:  Soc Sci Med       Date:  1998-08       Impact factor: 4.634

10.  Effect of a general practitioner's consulting style on patients' satisfaction: a controlled study.

Authors:  R Savage; D Armstrong
Journal:  BMJ       Date:  1990-10-27
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  258 in total

1.  Effect of patient centredness and positive approach. Airing uncertainty can be positive.

Authors:  David Shepherd
Journal:  BMJ       Date:  2002-03-02

2.  Engaging patients with psychosis in consultations. Design of study has several problems.

Authors:  Gomathinayagam S Rajesh
Journal:  BMJ       Date:  2003-03-08

3.  Arthritis patients' motives for (not) wanting to be involved in medical decision-making and the factors that hinder or promote patient involvement.

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Authors:  Peter G Cawston; Rosaline S Barbour
Journal:  Br J Gen Pract       Date:  2003-09       Impact factor: 5.386

5.  Therapeutic consultations for patients with depressive symptoms.

Authors:  Christopher Dowrick
Journal:  Br J Gen Pract       Date:  2015-10       Impact factor: 5.386

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Authors:  Samantha Hallam; David Arnot
Journal:  Br J Gen Pract       Date:  2016-01       Impact factor: 5.386

7.  Associations between thin slice ratings of affect and rapport and perceived patient-centeredness in primary care: Comparison of audio and video recordings.

Authors:  Stephen G Henry; Louis A Penner; Susan Eggly
Journal:  Patient Educ Couns       Date:  2016-12-19

8.  Does patient-centered care improve provision of preventive services?

Authors:  Stephen D Flach; Kimberly D McCoy; Thomas E Vaughn; Marcia M Ward; Bonnie J Bootsmiller; Bradley N Doebbeling
Journal:  J Gen Intern Med       Date:  2004-10       Impact factor: 5.128

9.  [Perspective of patients on type-2 diabetes and their relationship with primary care health professionals: a qualitative study].

Authors:  E Bolaños; A Sarría-Santamera
Journal:  Aten Primaria       Date:  2003       Impact factor: 1.137

10.  Triptan education and improving knowledge for optimal migraine treatment: an observational study.

Authors:  Eric P Baron; Shira Y Markowitz; Alyssa Lettich; Eric Hastriter; Brigitte Lovell; Kavita Kalidas; David William Dodick; Todd J Schwedt
Journal:  Headache       Date:  2014-02-12       Impact factor: 5.887

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