Maartje C Meijers1, Amy Potappel2, Corelien Kloek3, Tim Olde Hartman4, Peter Spreeuwenberg2, Sandra van Dulmen5, Janneke Noordman2. 1. Nivel, Netherlands institute for health services research, Utrecht, the Netherlands; Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands; Department of Medical Psychology, Academic Medical Center, University of Amsterdam, the Netherlands. Electronic address: m.meijers@nivel.nl. 2. Nivel, Netherlands institute for health services research, Utrecht, the Netherlands. 3. Research Group Innovation of Human Movement Care, HU University of Applied Sciences, Utrecht, the Netherlands. 4. Department of Primary and Community Care, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands. 5. Nivel, Netherlands institute for health services research, Utrecht, the Netherlands; Radboud university medical center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands; Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
Abstract
OBJECTIVE: To gain insight into patient participation in general practice by examining if and how patients' question-asking behaviour has changed over the years (2007-2016). METHODS: A random set of real-life video-recorded consultations collected in 2015-2016 (n = 437) was observed and compared with that of a former study in 2007-2008 (n = 533). Patients' question-asking behaviour was coded using an adapted RIAS protocol containing six categories: medical condition/therapeutic regimen; psychosocial; social context; lifestyle; ask for opinion doctor; practical. GPs and patients completed questionnaires about their background characteristics. Data were analysed using multi-level analysis. RESULTS: Patients asked fewer questions in 2016 than in 2007. The type of question-asking behaviour changed significantly: in particular medical questions decreased while practical questions increased. Less educated patients asked significantly more practical questions than higher educated patients. CONCLUSION: Contrary to our expectations, patients' question-asking has decreased in 2016 compared to 2007, while the average consultation length has increased. The type of questions shifted from medical to practical, especially in less educated patients. It seems that GPs' professional role has expanded over time, since patients nowadays ask their GP more non-medical questions. PRACTICE IMPLICATIONS: GPs probably could continue facilitating patient involvement by more frequently using partnership-building and supportive communication.
OBJECTIVE: To gain insight into patient participation in general practice by examining if and how patients' question-asking behaviour has changed over the years (2007-2016). METHODS: A random set of real-life video-recorded consultations collected in 2015-2016 (n = 437) was observed and compared with that of a former study in 2007-2008 (n = 533). Patients' question-asking behaviour was coded using an adapted RIAS protocol containing six categories: medical condition/therapeutic regimen; psychosocial; social context; lifestyle; ask for opinion doctor; practical. GPs and patients completed questionnaires about their background characteristics. Data were analysed using multi-level analysis. RESULTS:Patients asked fewer questions in 2016 than in 2007. The type of question-asking behaviour changed significantly: in particular medical questions decreased while practical questions increased. Less educated patients asked significantly more practical questions than higher educated patients. CONCLUSION: Contrary to our expectations, patients' question-asking has decreased in 2016 compared to 2007, while the average consultation length has increased. The type of questions shifted from medical to practical, especially in less educated patients. It seems that GPs' professional role has expanded over time, since patients nowadays ask their GP more non-medical questions. PRACTICE IMPLICATIONS: GPs probably could continue facilitating patient involvement by more frequently using partnership-building and supportive communication.