Little, Paul and Everitt, Hazel and Williamson, Ian and Warner, Greg and Moore, Michael and Gould, Clare and Ferrier, Kate and Payne, Sheila (2001) Observational study of patient-centeredness and 'positive' approach on outcomes of general practice consultations. BMJ, 323 (7318). pp. 908-911. ISSN 0959-8138Full text not available from this repository.
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 =0.96); personal relationship (a doctor who knows the patient and their emotional needs, =0.89); health promotion (=0.87); positive approach (being definite about the problem and when it would settle, =0.84); and interest in effect on patient's life (=0.89). Satisfaction was related to communication and partnership (adjusted =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 (=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.
|Journal or Publication Title:||BMJ|
|Subjects:||R Medicine > R Medicine (General)|
|Departments:||Faculty of Health and Medicine > Health Research|
|Deposited By:||Mr Richard Ingham|
|Deposited On:||29 Mar 2010 12:21|
|Last Modified:||07 Jan 2015 14:35|
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