Ideas, concerns and expectations from Primary Care consultations

Abstract

BACKGROUND: It is important for the primary care physicians to ascertain their patient’s illness perception and thereby practice patient-centered medicine. It will enhance the doctor patient relationship and improve the outcome of the consultation. OBJECTIVE: To describe patient’s ideas, concerns and expectations (ICE) from the doctor regarding their health in primary care consultations. METHODS: A descriptive cross sectional study was carried out at the principal investigator’s (PI) general practice. Every other adult (>18 years of age) patient who consulted the PI during a period of three months, participated in the study. Self-administered questionnaire was given to 422 patients prior to consultation to ascertain the ICE. Multiple linear regression model was used to determine the relationship between ICE and the selected variables using SPSS 18. RESULTS: Of the total sample 50.1% were females. 22.4% considered the illness as serious and 71.8% had the power to influence their illness. More than 40% of patients were emotionally affected as a result of falling ill. Almost all the patients had more than one expectation from the doctor, more than 95% of patients expected the doctor to provide both advice and drugs and to clearly explain their problem and to understand their emotional needs. 45% expected a referral prior to the consultation. There was a statistically significant correlation between ideas and concerns (ideas score -1.5, concerns score -0.9). All ICPC (International Classification of Primary Care) chapters excluding psychological reasons for the encounter had negative scores for ideas and concerns. CONCLUSIONS: Majority of the patients’ have positive ideas about their illnesses and are emotionally less affected. Patients expect more explanation. Patient centered approach in consultations, giving more importance to “perceptions regarding illness” will ensure overall improvement of the quality of health care provided.