The uncertain consultation and patient satisfaction: the impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills

To identify predictors of patient satisfaction among a range of patient and practitioner variables. In particular, to focus on patients' illness perceptions and the impact of a randomized controlled trial on the training of physicians in general communication skills and how to treat patients pr...

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Veröffentlicht in:Psychosomatic medicine 2005-11, Vol.67 (6), p.897-905
Hauptverfasser: Frostholm, Lisbeth, Fink, Per, Oernboel, Eva, Christensen, Kaj S, Toft, Tomas, Olesen, Frede, Weinman, John
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container_end_page 905
container_issue 6
container_start_page 897
container_title Psychosomatic medicine
container_volume 67
creator Frostholm, Lisbeth
Fink, Per
Oernboel, Eva
Christensen, Kaj S
Toft, Tomas
Olesen, Frede
Weinman, John
description To identify predictors of patient satisfaction among a range of patient and practitioner variables. In particular, to focus on patients' illness perceptions and the impact of a randomized controlled trial on the training of physicians in general communication skills and how to treat patients presenting with poorly defined illness. A randomized controlled follow-up study conducted in 28 general practices in Aarhus County, Denmark. Half of the physicians were randomized into an educational program on treatment of patients presenting with medically unexplained symptoms (somatization). One thousand seven hundred eighty-five general practice attenders presenting a new health problem completed questionnaires on illness perceptions, physical functioning, and mental distress before the consultation. After the consultation, a questionnaire including relational and communicative domains of patient satisfaction with the current consultation was completed. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Predictors of patient satisfaction were determined by logistic regression. A large number of patient and practitioner variables predicted satisfaction in univariate logistic regression models. Results from a multivariate logistic model showed that the illness perceptions "uncertainty" (patient not knowing what is wrong) and "emotional representations" (the complaint making the patient feel worried, depressed, helpless, afraid, hopeless) predicted dissatisfaction at OR (CI) = 1.8 (1.3-2.4), p < .001 and OR (CI) = 1.5 (1-2.3), p = .03 respectively. Trained physicians were associated with dissatisfaction at OR (CI) 0.7 (0.5-1), p = .06 in the multivariate model. Furthermore, uncertain patients consulting a trained physician were less likely to be dissatisfied OR (CI) = 0.6 (0.3-1), p = .04. A randomized controlled trial on the training of general practitioners' communication skills improved patient satisfaction. Illness perceptions predict satisfaction. In particular, patients feeling uncertain and negatively emotionally involved in their health problem were more inclined to being dissatisfied with the consultation.
doi_str_mv 10.1097/01.psy.0000188403.94327.5b
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source MEDLINE; Journals@Ovid Complete; Applied Social Sciences Index & Abstracts (ASSIA)
subjects Adolescent
Adult
Aged
Attitude to Health
Attitudes
Communication
Family Practice - education
Family Practice - methods
Family Practice - standards
Female
Follow-Up Studies
Health Services Research
Health Status
Humans
Male
Middle Aged
Multivariate Analysis
Patient Satisfaction
Personality Inventory
Physician patient relationships
Physicians - psychology
Physicians - standards
Primary care
Prognosis
Psychiatric Status Rating Scales
Referral and Consultation - standards
Regression Analysis
Sensory perception
Somatoform Disorders - diagnosis
Somatoform Disorders - psychology
Somatoform Disorders - therapy
Surveys and Questionnaires
Teaching
title The uncertain consultation and patient satisfaction: the impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills
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