The workload of GPs: patients with psychological and somatic problems compared

Zantinge, E.M.; Verhaak, Peter; Bensing, J.M.

doi:10.1093/fampra/cmh732

Cited by 72 publications

(84 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with medically unexplained symptoms (MUS) have as poor a quality of life as those with comparable symptoms caused by disease 6,7 . Many doctors find these patients challenging [8][9][10][11][12] and provide disproportionate levels of health care, which is often ineffective and might sometimes increase patients' dependence 7,[13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

et al. 2009

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

et al. 2009

View full text Add to dashboard Cite

“…It has been shown that patients with mental health problems contact their general practice more often than patients with physical problems [3]. Moreover, it has been demonstrated that consultations with patients who suffer from mental health problems take more time [4][5][6][7][8][9] and leave the GPs more often with the subjective experience of a lack of time [7].…”

Section: Introductionmentioning

confidence: 99%

The workload of general practitioners does not affect their awareness of patients’ psychological problems

Zantinge

Verhaak

Bakker

et al. 2007

Patient Education and Counseling

View full text Add to dashboard Cite

Objective: To investigate if general practitioners (GPs) with a higher workload are less inclined to encourage their patients to disclose psychological problems, and are less aware of their patients' psychological problems. Methods: Data from 2095 videotaped consultations from a representative selection of 142 Dutch GPs were used. Multilevel regression analyses were performed with the GPs' awareness of the patient's psychological problems and their communication as outcome measures, the GPs' workload as a predictor, and GP and patient characteristics as confounders. Results: GPs' workload is not related to their awareness of psychological problems and hardly related to their communication, except for the finding that a GP with a subjective experience of a lack of time is less patient-centred. Showing eye contact or empathy and asking questions about psychological or social topics are associated with more awareness of patients' psychological problems. Conclusion: Patients' feelings of distress are more important for GPs' communication and their awareness of patients' psychological problems than a long patient list or busy moment of the day. GPs who encourage the patient to disclose their psychological problems are more aware of psychological problems. Practice implications: We recommend that attention is given to all the communication skills required to discuss psychological problems, both in the consulting room and in GPs' training. Additionally, attention for gender differences and stress management is recommended in GPs' training. #

show abstract

“…Both stressors and depression or anxiety are also associated with greater use of primary care services (Zantinge, Verhaak, and Bensing, 2005;Brantley et al, 2005).…”

mentioning

confidence: 99%

Prevalence and Correlates of Substance Use Among South African Primary Care Clinic Patients

Ward

Mertens

Flisher

et al. 2008

Substance Use & Misuse

View full text Add to dashboard Cite

We aimed to assess prevalence and correlates of hazardous use of tobacco, alcohol and other drugs in a primary care population in Cape Town, South Africa. Stratified random sampling was used to select 14 of the 49 clinics in the public health sector in Cape Town, and every "nth" patient, with those ages 18-25 oversampled (N = 2,618). Data were collected from December 2003 through 2004, using the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test. Hazardous use of tobacco was most common, followed by alcohol and then other drugs. Hazardous tobacco use was associated with the 18-25 years age group, no religious involvement, high school completion, and higher stress. Hazardous alcohol use was associated with male gender, younger men, no religious involvement, employment, some high school education, and higher stress. Hazardous use of other drugs was associated with Colored (mixed) race (particularly among men), no religious involvement, employment, and stress. For all substances, women, particularly Black women, had the lowest rates of hazardous use. Although the study is cross-sectional, it does identify groups that may be at high risk of substance misuse and for whom intervention is urgent. Because prevalence of substance use is high in this population, routine screening should be introduced in primary care clinics. (Parry, 2005;Sitas et al., 2004). Cannabis and methaqualone are the most frequently identified illicit drugs in drugrelated arrests, psychiatric diagnoses, and trauma patients (Parry et al., 2002), but treatment demand for cocaine, heroin, and methamphetamine use is increasing Parry, Myers, and Plüddemann, 2004).Primary health care services provide an advantageous location for intervening in substance use (Whitlock, Polen, Green, Orleans, and Klein, 2004;Fleming et al., 2002). In South Africa, the public health sector is the main provider of primary care (Health Systems Trust, 2004), yet no data are available on prevalence of substance misuse among South African patients.Risk factors are those associated with increased likelihood of negative health behaviors or outcomes, whereas protective factors are those that are associated with increased likelihood of positive health behaviors or outcomes, or with decreased likelihood of negative health behaviors or outcomes (Kirby, 2001). Although the association with disease occurrence may not be causal, such correlates are useful for identifying high-risk groups or factors that may be usefully targeted in intervention strategies. Risk and protective factors influencing substance use have not been much studied in the developing world (De Lima, Dunn, Novo, Tomasi, and Reisser, 2003).Personal characteristics identified as risk factors may include age, race, and gender. In South Africa, the racial categories defined under apartheid-Black, Colored (mixed race), Indian, and White-have a long association in South Africa with access both to alcohol and to treatment (Mager, 2004). Different race groups may demonstrate differen...

show abstract

The workload of GPs: patients with psychological and somatic problems compared

Abstract: Patients with psychological or social problems make heavy demands on the GP's workload, for the greater part due to the increase in somatic problems presented.

Cited by 72 publications

References 18 publications

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want?

The workload of general practitioners does not affect their awareness of patients’ psychological problems

Prevalence and Correlates of Substance Use Among South African Primary Care Clinic Patients

Contact Info

Product

Resources

About