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BMJ. 2001 Oct 20;323(7318):908-11.

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

Author information

  • 1Primary Medical Care Group, Community Clinical Sciences Division, Faculty of Medicine, Southhampton University, Southampton SO165ST. psl3@soton.ac.uk

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.

Comment in

PMID:
11668137
[PubMed - indexed for MEDLINE]
PMCID:
PMC58543
Free PMC Article
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