Psychosocial problem disclosure by primary care patients.
The vast majority of psychologically distressed primary care patients present exclusively somatic concerns at the outsets of their visits.
However, it is not known how often such patients subsequently disclose psychosocial problems to their primary care physicians (PCPs) and what variables predict such disclosures.
Our objectives were to measure, among psychologically distressed primary care patients, the frequency of disclosure of psychosocial problems (disclosure), the effects of prior psychosocial inquiry (prior inquiry) by PCPs and various patient variables on disclosure, and the effect of disclosure on mental health problem recognition (recognition) by PCPs, The study was based in the practices of 69 community-based PCPs and involved 308 adult patients with 28-item General Health Questionnaire scores of 5 or greater, indicating significant psychological distress.
Disclosure occurred during 51% of visits overall and 67% of visits with prior inquiry.
The odds of disclosure were increased by prior inquiry (p<0.001), greater physician-patient familiarity (p<0.001) and greater severity of patient psychological distress (p<0.001).
Prior inquiry and physician-patient familiarity had a negative interaction (p<0.05) of smaller size than either variable's main effect, so that their combined effect on disclosure exceeded the effect of either variable alone but was less than multiplicative.
The estimated odds ratio for recognition given disclosure was 24. (...)
Mots-clés Pascal : Difficulté psychologique, Aspect social, Médecin, Relation médecin malade, Epidémiologie, Connaissance, Reconnaissance, Homme, Personnel sanitaire
Mots-clés Pascal anglais : Psychological difficulty, Social aspect, Physician, Physician patient relation, Epidemiology, Knowledge, Recognition, Human, Health staff
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0254984
Code Inist : 002B18I12. Création : 16/11/1999.