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

Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations
Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations
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.
0959-8138
908-911
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Everitt, Hazel
80b9452f-9632-45a8-b017-ceeeee6971ef
Williamson, Ian
12381296-edbf-4ac5-969b-dcb559c22f27
Warner, Greg
72005519-1aa0-42da-b370-7ebd99792539
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Gould, Clare
058d7307-9b42-4f85-b02e-7e3a37d9af67
Ferrier, Kate
fdc3705e-7bca-4580-bc3e-20f88e386a4b
Payne, Sheila
d7c97f41-ec69-4157-9339-ca07c521fbcc
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Everitt, Hazel
80b9452f-9632-45a8-b017-ceeeee6971ef
Williamson, Ian
12381296-edbf-4ac5-969b-dcb559c22f27
Warner, Greg
72005519-1aa0-42da-b370-7ebd99792539
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Gould, Clare
058d7307-9b42-4f85-b02e-7e3a37d9af67
Ferrier, Kate
fdc3705e-7bca-4580-bc3e-20f88e386a4b
Payne, Sheila
d7c97f41-ec69-4157-9339-ca07c521fbcc

Little, Paul, Everitt, Hazel, Williamson, Ian, Warner, Greg, Moore, Michael, Gould, Clare, Ferrier, Kate and Payne, Sheila (2001) Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. BMJ, 323 (7318), 908-911. (doi:10.1136/bmj.323.7318.908).

Record type: Article

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.

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More information

Published date: 20 October 2001

Identifiers

Local EPrints ID: 24389
URI: http://eprints.soton.ac.uk/id/eprint/24389
ISSN: 0959-8138
PURE UUID: ecf0b184-0528-43a6-94a3-629f7de7e64b
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

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Date deposited: 30 Mar 2006
Last modified: 11 Jul 2024 01:43

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Contributors

Author: Paul Little ORCID iD
Author: Hazel Everitt ORCID iD
Author: Ian Williamson
Author: Greg Warner
Author: Michael Moore ORCID iD
Author: Clare Gould
Author: Kate Ferrier
Author: Sheila Payne

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