ArticleBMC family practice2019
Which difficulties do GPs experience in consultations with patients with unexplained symptoms: a qualitative study.
Article in BMC family practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis.BMC medical education · 2024Pooled it
- BMC family practice integrated GP care for patients with persistent physical symptoms: feasibility cluster randomised trial.BMC family practice · 2020Trial
- Explaining persistent physical symptoms to patients in general practice: can tests to measure central sensitisation add value? A mixed-methods study.BMC primary care · 2024Article
- Article
- General practitioners' experiences with chronic abdominal symptoms and a faecal calprotectin guided referral strategy in children: A Dutch qualitative study.The European journal of general practice · 2024Article
- Explanation for symptoms and biographical repair in a clinic for persistent physical symptoms.SSM. Qualitative research in health · 2024Article
- The Assessment of the Rationale for Urgent Head CT-Comparative Analysis of Referrals and Results of Examinations without and with Contrast Enhancement.Medicina (Kaunas, Lithuania) · 2022Article
- Discovering strengths in patients with medically unexplained symptoms - a focus group study with general practitioners.Scandinavian journal of primary health care · 2022Article
- How to learn skilled communication in primary care MUS consultations: a focus group study.Scandinavian journal of primary health care · 2021Article
- ICD-10-Coding of Medically Unexplained Physical Symptoms and Somatoform Disorders-A Survey With German GPs.Frontiers in medicine · 2021Article
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany general practitioners (GPs) struggle with the communication with patients with medically unexplained symptoms (MUS). This study aims to identify GPs' difficulties in communication during MUS consultations.
methodsWe video-recorded consultations and asked GPs immediately after the consultation whether MUS were presented. GPs and patients were then asked to reflect separately on the consultation in a semi-structured interview while watching the consultation. We selected the comments where GPs experienced difficulties or indicated they should have done something else and analysed these qualitatively according to the principles of constant comparative analysis. Next, we selected those video-recorded transcripts in which the patient also experienced difficulties; we analysed these to identify problems in the physician-patient communication.
resultsTwenty GPs participated, of whom two did not identify any MUS consultations. Eighteen GPs commented on 39 MUS consultations. In 11 consultations, GPs did not experience any difficulties. In the remaining 28 consultations, GPs provided 84 comments on 60 fragments where they experienced difficulties. We identified three issues for improvement in the GPs' communication: psychosocial exploration, structure of the consultation (more attention to summaries, shared agenda setting) and person-centredness (more attention to the reason for the appointment, the patient's story, the quality of the contact and sharing decisions). Analysis of the patients' views on the fragments where the GP experienced difficulties showed that in the majority of these fragments (n = 42) the patients' comments were positive. The video-recorded transcripts (n = 9) where the patient experienced problems too were characterised by the absence of a dialogue (the GP being engaged in exploring his/her own concepts, asking closed questions and interrupting the patient).
conclusionGPs were aware of the importance of good communication. According to them, they could improve their communication further by paying more attention to psychosocial exploration, the structure of the consultation and communicating in a more person-centred way. The transcripts where the patient experienced problems too, were characterised by an absence of dialogue (focussing on his/her own concept, asking closed questions and frequently interrupting the patient).
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