Dataset Information

General practitioners can evaluate the material, social and health dimensions of patient social status.

ABSTRACT:

Objective

To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.

Design

Cross-sectional multicentric survey.

Setting

Fourty-seven primary care private offices in Western Switzerland.

Participants

Random sample of 2030 patients ? 16, who encountered a general practitioner (GP) between September 2010 and February 2011.

Main measures

Primary outcome

patient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP's evaluation and patient's own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients' deprivation and its influence on health and care.

Results

To evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (-0.7, p = 0.002). GP's evaluation of patient social status was 0.5 point higher than the patient's own estimate (p<0.0001).

Conclusions

GPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients' own evaluation, GPs overestimate patient social status.

SUBMITTER: Chatelard S

PROVIDER: S-EPMC3893170 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

General practitioners can evaluate the material, social and health dimensions of patient social status.

Chatelard Sophia S Bodenmann Patrick P Vaucher Paul P Herzig Lilli L Bischoff Thomas T Burnand Bernard B

PloS one 20140115 1

<h4>Objective</h4>To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.<h4>Design</h4>Cross-sectional multicentric survey.<h4>Setting</h4>Fourty-seven primary care private offices in Western Switzerland.<h4>Participants</h4>Random sample of 2030 patients ≥ 16, who encountered a general practitioner (GP) between September 2010 and February 2011.<h4>Main measures</h4><h4>Primary outcome</h4>patient social status perceived ...[more]

PMID: 24454752

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Project description:BACKGROUND: It has now for many years been recognised that patient evaluations should be undertaken as an integral part of the complex task of improving the quality of general practice care. Yet little is known about the general practitioners' (GPs') benefit from patient evaluations. Aim 1 was to study the impact on the GPs of a patient evaluation and subsequent feedback of results presented at a plenary session comprising a study guide for the results and group discussions. Aim 2 was to study possible facilitators and barriers to the implementations of the results raised by the patient evaluation process. METHODS: A patient evaluation survey of 597 voluntarily participating GPs was performed by means of the EUROPEP questionnaire. Evaluation results were fed back to the GPs as written reports at a single feedback meeting with group discussions of the results. Between 3 and 17 months after the feedback, the 597 GPs received a questionnaire with items addressing their experience with and perceived benefit from the evaluations. RESULTS: 79.4% of the GPs responded. 33% of the responding GPs reported that the patient evaluation had raised their attention to the patient perspective on the quality of general practice care. Job satisfaction had improved among 26%, and 21% had developed a more positive attitude to patient evaluations. 77% of the GPs reported having learnt from the evaluation. 54% had made changes to improve practice, 82% would recommend a patient evaluation to a colleague and 75% would do another patient evaluation if invited. 14% of the GPs had become less positive towards patient evaluations, and job satisfaction had decreased among 3%. CONCLUSIONS: We found a significant impact on the GPs regarding satisfaction with the process and attitude towards patient evaluations, GPs' attention to the patients' perspective on care quality and their job satisfaction. Being benchmarked against the average seemed to raise barriers to the concept of patient evaluations and difficulties interpreting the results may have formed a barrier to their implementation which was partly overcome by adding qualitative data to the quantitative results. The GPs' significant willingness to share and discuss the results with others may have served as a facilitator.

Project description:Aim Increasingly at GP practices, patients appear who are extremely worried as a result of health information researched online and consequently affected by doubts and concerns. The study highlights GP attitudes and experiences with regard to this patient group. Moreover, it identifies strategies adopted by GPs to respond appropriately to worried or scared patients. Subject and methods In the German federal states of Baden-Württemberg, Rhineland-Palatinate and Saarland, 2532 GPs were surveyed between June and August 2022. Owing to the explorative nature of the study, a descriptive analysis was conducted. Results Of the total respondents, 77% deemed the current problem of internet-related health concerns to be a major challenge in everyday practice. The implications affect patients’ mental stability and expectations towards the doctor (esp. demand for further instrumental diagnosis, 83%). One doctor in five (20%) has experienced the termination of patient contact because the relationship with the patient was no longer possible due to the patient’s uncontrolled online information behaviour. To respond to worried or scared patients, the respondents generally ask certain patient groups about online research (39%) and take this into account in the doctor–patient discussion (23%). Furthermore, the respondents use a detailed explanation of the diagnosis and/or treatment (65%) and recommend websites that they consider reputable (66%). Some of the doctors prefer a joint examination of the information researched by the patient (55%) as well as to explain the benefits and risks of online research (43%). Conclusion Many GPs demonstrate a high level of awareness and sensitivity with regard to extensive online research and potentially worried patients. It seems advisable to actively address the online search for information in the patient consultation to prevent possible negative effects on the doctor–patient relationship and to actively involve the patient. In this respect, it would also be worth considering expanding the medical history to include the dimension of online searching. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01909-1.

Project description:ObjectiveGiven recent concerns regarding general practitioner (GP) workforce capacity, we aimed to describe GPs' career intentions, especially those which might impact on GP workforce availability over the next 5 years.DesignCensus survey, conducted between April and June 2016 using postal and online responses , of all GPs on the National Health Service performers list and eligible to practise in primary care. Two reminders were used as necessary.SettingSouth West England (population 3.5 ?million), a region with low overall socioeconomic deprivation.ParticipantsEligible GPs were 2248 out of 3370 (67 % response rate).Main outcome measuresReported likelihood of permanently leaving or reducing hours spent in direct patient care or of taking a career break within the next 5 years and present morale weighted for non-response.ResultsResponders included 217 7 GPs engaged in patient care. Of these, 863 (37% weighted, 95% ?CI 35 % to 39 %) reported a high likelihood of quitting direct patient care within the next 5 years. Overall, 1535 (70% weighted, 95% ?CI 68 % to 72 %) respondents reported a career intention that would negatively impact GP workforce capacity over the next 5 years, through permanently leaving or reducing hours spent in direct patient care, or through taking a career break. GP age was an important predictor of career intentions; sharp increases in the proportion of GPs intending to quit patient care were evident from 52 years. Only 305 (14% weighted, 95% ?CI 13 % to 16 %) reported high morale, while 1195 ( 54 % weighted, 95% ?CI 52 % to 56 %) reported low morale. Low morale was particularly common among GP partners. Current morale strongly predicted GPs' career intentions; those with very low morale were particularly likely to report intentions to quit patient care or to take a career break.ConclusionsA substantial majority of GPs in South West England report low morale. Many are considering career intentions which, if implemented, would adversely impact GP workforce capacity within a short time period.Study registrationNIHR HS&DR - 14/196/02, UKCRN ID 20700.

Project description:BackgroundThere is growing evidence for the use of social prescribing as a means to improve the mental health of patients. However, there are gaps in understanding the barriers and enablers faced by General Practitioners (GPs) when engaging in social prescribing for patients with mental health problems.MethodsThis study uses a qualitative approach involving one-to-one interviews with GPs from across the UK. The COM-B model was used to elucidate barriers and enablers, and the Theoretical Domains Framework (TDF) and a Behaviour Change Theory and Techniques tool was used to identify interventions that could address these.ResultsGPs recognised the utility of social prescribing in addressing the high levels of psychosocial need they saw in their patient population, and expressed the need to de-medicalise certain patient problems. GPs were driven by a desire to help patients, and so they benefited from regular positive feedback to reinforce the value of their social prescribing referrals. They also discussed the importance of developing more robust evidence on social prescribing, but acknowledged the challenges of conducting rigorous research in community settings. GPs lacked the capacity, and formal training, to effectively engage with community groups for patients with mental health problems. Link workers, when available to GPs, were of fundamental importance in bridging the gap between the GP and community. The formation of trusting relationships was crucial at different points of the social prescribing pathway, with patients needing to trust GPs in order for them to agree to see a link worker or attend a community activity, and GPs requiring a range of strong inter-personal skills in order to gain patients' trust and motivate them.ConclusionThis study elucidates the barriers and enablers to social prescribing for patients with mental health problems, from the perspectives of GPs. Recommended interventions include a more systematic feedback structure for GPs and more formal training around social prescribing and developing the relevant inter-personal skills. This study provides insight for GPs and other practice staff, commissioners, managers, providers and community groups, to help design and deliver future social prescribing services.

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Dataset Information

General practitioners can evaluate the material, social and health dimensions of patient social status.

Objective

Design

Setting

Participants

Main measures

Primary outcome

Results

Conclusions

Publications

General practitioners can evaluate the material, social and health dimensions of patient social status.

Similar Datasets

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