Michael Pentzek1, Sara Santos2, Anja Wollny3, Elisabeth Gummersbach4, Oliver Rudolf Herber5, Jürgen In der Schmitten6, Andrea Icks7, Heinz-Harald Abholz8, Stefan Wilm9. 1. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany. Electronic address: pentzek@med.uni-duesseldorf.de. 2. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany. Electronic address: sara.santos@med.uni-duesseldorf.de. 3. Institute of General Practice, University Medical Center Rostock, Doberaner Straße 142, 18057 Rostock, Germany. Electronic address: anja.wollny@med.uni-rostock.de. 4. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany. Electronic address: elisabeth.gummersbach@med.uni-duesseldorf.de. 5. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany. Electronic address: oliver.herber@med.uni-duesseldorf.de. 6. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany. Electronic address: jids@med.uni-duesseldorf.de. 7. Institute for Health Services Research and Health Economics, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany. Electronic address: andrea.icks@uni-duesseldorf.de. 8. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany. Electronic address: abholz@med.uni-duesseldorf.de. 9. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany. Electronic address: stefan.wilm@med.uni-duesseldorf.de.
Abstract
AIMS: To find factors that are associated with a general practitioner's (GP's) subjective impression of a patient being 'difficult' within a sample of patients with type 2 diabetes mellitus (T2DM). METHODS: Secondary cross-sectional analysis of a cohort of GP patients with T2DM. GP questionnaire on clinical data and GPs' subjective ratings of patient attributes (including 'patient difficulty'). Patient questionnaire on sociodemographics and illness perceptions. Bivariate and multivariate analyses, adjusted for cluster-effect of GP practice. RESULTS: Data from 314 patients from 49 GPs could be analysed. Independent associations with higher GP-rated difficulty were found for (odds ratio; 95% confidence interval): male patients from male GPs (1.27; 1.06-1.53), unmarried men (1.25; 1.04-1.51), men with non-German nationality (1.80; 1.24-2.61), patients perceiving more problems with diabetes (1.17; 1.04-1.30), patients with higher BMI (1.01; 1.00-1.02) and HbA1c values (1.06; 1.02-1.10), patients being perceived by the GP as less adherent (1.34; 1.22-1.46) and less health-literate (1.19; 1.04-1.35). CONCLUSIONS: The impact of patients' gender and illness perception yield new insights into GP-perceived complexity of care. Culturally and gender-sensitive communication techniques for adapting health care goals to patients' problems (rather than norm values) may alleviate GPs' work.
AIMS: To find factors that are associated with a general practitioner's (GP's) subjective impression of a patient being 'difficult' within a sample of patients with type 2 diabetes mellitus (T2DM). METHODS: Secondary cross-sectional analysis of a cohort of GPpatients with T2DM. GP questionnaire on clinical data and GPs' subjective ratings of patient attributes (including 'patient difficulty'). Patient questionnaire on sociodemographics and illness perceptions. Bivariate and multivariate analyses, adjusted for cluster-effect of GP practice. RESULTS: Data from 314 patients from 49 GPs could be analysed. Independent associations with higher GP-rated difficulty were found for (odds ratio; 95% confidence interval): male patients from male GPs (1.27; 1.06-1.53), unmarried men (1.25; 1.04-1.51), men with non-German nationality (1.80; 1.24-2.61), patients perceiving more problems with diabetes (1.17; 1.04-1.30), patients with higher BMI (1.01; 1.00-1.02) and HbA1c values (1.06; 1.02-1.10), patients being perceived by the GP as less adherent (1.34; 1.22-1.46) and less health-literate (1.19; 1.04-1.35). CONCLUSIONS: The impact of patients' gender and illness perception yield new insights into GP-perceived complexity of care. Culturally and gender-sensitive communication techniques for adapting health care goals to patients' problems (rather than norm values) may alleviate GPs' work.
Authors: Olga Estefania Escobar Florez; Gabriela Aquilera; Jose Maria De la Roca-Chiapas; Maciste Habacuc Macías Cervantes; Ma Eugenia Garay-Sevilla Journal: Psychol Res Behav Manag Date: 2021-12-11