Somatizing frequent attenders in primary health care

Jyväsjärvi, Simo; Joukamaa, Matti; Väisänen, Erkki; Larivaara, Pekka; Kivelä, Sirkka‐Liisa; Keinänen‐Kiukaanniemi, Sirkka

doi:10.1016/s0022-3999(00)00217-8

Cited by 65 publications

(69 citation statements)

References 41 publications

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“…The frequently attending patient and the doctor Á/patient relationship The medical problems of frequent attenders are complex, with somatization, chronic diseases and psychological distress often in combination (1,3,5,6). Even injuries and infectious diseases have been shown to be usual, probably reflecting an increased vulnerability (7).…”

Section: Is Frequent Attendance a Persistent Trait?mentioning

confidence: 99%

Is frequent attendance a persistent characteristic of a patient?Repeat studies of attendance pattern at the family practitioner

Andersson

Lynøe

Hallgren

et al. 2004

Scandinavian Journal of Primary Health Care

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Section: Is Frequent Attendance a Persistent Trait?mentioning

confidence: 99%

Is frequent attendance a persistent characteristic of a patient?Repeat studies of attendance pattern at the family practitioner

Andersson

Lynøe

Hallgren

et al. 2004

Scandinavian Journal of Primary Health Care

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“…According to previous Finnish studies, patients who made at least eight outpatient visits per year to a general practitioner (GP) in the local health center were defined as FAs of medical services. [6][7][8]10] Patients were also defined as FAs if they had made at least four outpatient visits per year to the university hospital. [32] Because the aim was to examine the use of health services as a whole in order to develop health care services, specialized care was selected for inclusion.…”

Section: Settings and Samplementioning

confidence: 99%

“…They need more information and support, and they have a lower quality of life compared with non-frequent attenders. [1,7,10] The main reason for health care use is illness, and therefore the roles of psychological, social, and demographical factors are secondary. FAs is the group that might be expected to benefit from community matrons, [11] who are experienced nurses with advanced practice skills using case management techniques with patients who have chronic diseases and who use of health care services intensively.…”

Section: Introductionmentioning

confidence: 99%

The effects of intervention on frequent attenders' adherence to health regimens, depression, somatization and hypochondriasis

Hirsikangas

Kanste²,

Korpelainen³

et al. 2017

JNEP

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Background and objective: Frequent attender is the largest group to whom health care resources are allocated. Therefore potential interventions should be targeted at this group. Nurse-based case management considers frequent attenders' (FAs') needs for care as a whole and thus may reduce the use of other health services operators' resources. The objective of this study is to evaluate the effects of nurse-led case management on adherence to health regimens, depression, somatization and hypochondriasis in FAs. Methods: The study is a quasi-experimental intervention trial, carried out as a prospective 2-year follow-up design with an intervention group (n = 285) and a control group (n = 435). The hypothesis was that nurse-led case management based intervention would have a positive impact on FAs' adherence to health regimens, somatization, hypochondriasis, and depression. The intervention patients received nurse-led case management which included an evaluation of patient needs and resources, an individualized care plan, the coordination of multidisciplinary services, and support for self-management. The control patients received the usual care, which means patient support and education during visits to the health center. The data were collected from at least 18 years of age frequent attenders by self-reported instruments: the Adherence of Chronic Disease Inventory, the Whiteley Index, the Symptom Checklist-90-R and Beck Depression Inventory, and one-and two-year follow-ups between October 2008 and May 2011. Results: The intervention had an uplifting effect on the FAs' mood, and there was a statistically significant difference between the intervention patients and the control patients (p = .03). Intervention reduced somatization with FAs, and it improved FAs' adherence to health regimens, but there was not a statistically significant difference between groups. Hypochondriasis increased in the intervention group compared to the control group after intervention (p = .01). Conclusions: Nurse-led case management has a positive effect on FAs' depression symptoms, somatization, and adherence to health regimens. The results will be useful in developing effective nurse-led interventions and support methods for FAs with complex long-term health conditions. Hypochondriasis increased in the intervention group although the purpose was for the community matron to discuss with FAs and reduce their concerns.

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“…First, because medical overutilization in primary care may be a function of illness preoccupation (Jyvasjarvi et al, 2001), the MHP-H includes four items dealing with hypochondriacal beliefs. Although the overall prevalence rate for hypochondriasis/ somatization is relatively low (0.2%), its prevalence among medical outpatients ranges between 4 and 8% (Kirmayer & Robbins, 1991).…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

The Assessment of Adult Health Care Orientations: Development and Preliminary Validation of the Multidimensional Health Profile?Health Functioning Index (MHP-H) in a National Sample

Karoly

Ruehlman

Lanyon

2005

J Clin Psychol Med Settings

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This paper describes the development and preliminary validation of the Multidimensional Health Profile-Health Functioning Index (MHP-H), a 69-item self-report instrument designed to assess a variety of behaviors, perceptions, attitudes, and beliefs presumed to influence health status and the pursuit of lay and professional health care. The MHP-H briefly measures adult health history, health habits, health care utilization, health beliefs and attitudes, and response to illness (help-seeking behaviors). A national sample of adults (N = 673) was assessed, comprising 3 age groupings (18-32, 33-50, and 51-89) crossed with gender and then further subdivided into several subsamples for purposes of reliability and validity assessment. In addition, a group of spouse "key informants" was also recruited. Preliminary validation of single-item indicators as well as confirmatory factor analyses of multi-item scales was achieved. The present findings support the psychometric and practical utility of the MHP-H and warrant its use by health psychologists in a variety of research and applied settings. Keywordshealth behaviors; health attitudes; help seeking; national sampling; self-regulation In the domain of contemporary managed health care, psychological assessment and screening for possible future health risks, for potential over-or underutilization of services, or for attitudinal problems that could presage patient noncompliance is a widely acknowledged need that is seldom systematically addressed (Institute of Medicine, 1997; USDHHS, 2000). Largely neglected also are patients' pro-health psychological characteristics, such as attributions of self-efficacy for illness management, that are likely to contribute to responsible self-care (health self-regulation; cf., Anderson, 1979;Karoly, 1991;Levin, Katz, & Holst, 1976). Therefore, despite a growing recognition among health care providers of the benefits of early detection of health-compromising practices and self-defeating attitudes, many medical professionals continue to adopt a passive, problem-awaiting stance rather than taking advantage of relatively inexpensive paper-and-pencil or computer-based assessment devices that could enable them to anticipate and possibly prevent future threats to patient health and quality of life (cf., Curry, Ludman, Grothaus, Donovan, & Kim, 2003;Friedman, Sobel, Myers, Caudill, & Benson, 1995;Neumark-Sztainer, Wall, Story, & Perry, 2003). Fortunately, the unavailability of psychometrically sound and nationally normed instruments that assess patients' proclivities toward health-protective and health-compromising actions and attitudes may be one obstacle to progress in health screening that can be effectively addressed. The NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript purpose of the present research was the development of a comparatively brief self-report instrument to assist health care professionals in the cost-effective appraisal of clients' positive and negative health care orientations.The instrument d...

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Somatizing frequent attenders in primary health care

Cited by 65 publications

References 41 publications

Is frequent attendance a persistent characteristic of a patient?Repeat studies of attendance pattern at the family practitioner

Is frequent attendance a persistent characteristic of a patient?Repeat studies of attendance pattern at the family practitioner

The effects of intervention on frequent attenders' adherence to health regimens, depression, somatization and hypochondriasis

The Assessment of Adult Health Care Orientations: Development and Preliminary Validation of the Multidimensional Health Profile?Health Functioning Index (MHP-H) in a National Sample

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