Do multimorbidity and deprivation influence patients’ emotional expressions and doctors’ responses in primary care consultations? – An exploratory study using multilevel analysis

Abstract

Objective: To explore whether and how patient multimorbidity and socioeconomic deprivation conditions might influence patients' emotional expression and doctors' responses in the general practice (GP) consultations. Results: GPs were less likely to provide space as the consultation proceeded, controlling for multimorbidity and deprivation variables. Patients with multimorbidity were less likely to express emotional distress in an explicit form. GPs were more likely to provide acknowledgement to emotions expressed by patients from more deprived areas. Methods Conclusion:Multimorbidity and deprivation may influence the dynamics of the GP consultations in specific ways. Rigorous methodologies using larger samples are required to explore further how these two variables relate to each other and influence cue expression, provider response and subsequent patient outcomes.Practice implications: Understanding how multimorbidity and deprivation impact on GP consultations may help inform future service improvement programmes.

Emotional Communication in HIV Care: An Observational Study of Patients’ Expressed Emotions and Clinician Response

“…On the other hand, while most other studies found that cue B (i.e. implications of concern through emphasis, including metaphors and uncommon wordings) was the most common emotional expression (35)(36)(37)(60)(61)(62)(63)(64), cue D (i.e. mentioning of stressful life circumstances without verbal emphasis) was the most common in our study.…”

Pharmacists’ responses to cues and concerns of polypharmacy patients during clinical medication reviews—A video observation study

“…[41] The explicitness of responses was assessed in studies with other primary healthcare providers. Nurses interacting with older patients or patients with mild mental health problems and general practitioners mainly responded in a non-explicit providing space way to patients' negative emotions, with brief verbal encouragements as the most common response [21,23,27]. These studies -as well as our study -are in line with the ambitions in healthcare to make consultations more patient-centred instead of provider-centred [12].…”

“…This is comparable to the responses of nursing staff to patients' emotional cues during private consultations [20][21][22][23][24][25]. Whereas physicians are less likely to further explore patients' emotional cues, their positive responses vary from 33 to 80% [19,22,24,[26][27][28]. Responding to cues and concerns was perceived challenging for pharmacy staff during consultations at the counter in Dutch pharmacies.…”

“…Patients presenting negative emotions mainly as cues is also common among consultations with other primary healthcare providers. [20,27,42] Nurses' and physicians' explicit responses to patients' cues and concerns vary from 12 to 82% [21,23,24,27]. This is the first study in community pharmacy to examine patients' negative emotions during a pharmacist-patient discussion about medication therapy.…”

Predictors of weight discussion in primary care consultations: A multilevel modeling approach

“…Previous research has attributed differences in healthcare communication to variability in patient and healthcare practitioner demographic, psychological and cultural characteristics [25][26][27]. Multilevel modelling approaches have previously been employed to examine patient-practitioner communication in a variety of clinical settings, including oncology [28], dentistry [29], and primary care [22,30,31].…”