Dataset Information

Patient-physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners.

ABSTRACT:

Objectives

To examine whether the quality of the patient-physician relationship, assessed by the general practitioner (GP) and the patient, associates with GPs' use of gut feeling (GF) in cancer diagnosis.

Design

Cross-sectional questionnaire survey of cancer patients and their GPs.

Setting

Danish primary care.

Participants

Newly diagnosed cancer patients and their GPs. Patients completed a questionnaire and provided the name of the GP to whom they have presented their symptoms. The named GP subsequently received a questionnaire.

Primary and secondary outcome measures

GPs' use of GF in the diagnostic process for the particular patient. GPs who answered that they used their GF 'to a high degree' or 'to a very high degree' were categorised as 'used their GF to a great extent'. GPs who answered that they used their GF 'to some degree', 'to a limited degree' or 'not at all' were categorised as 'limited or no use of GF'.

Results

GPs were less likely to use GF when they assessed relational aspects of the patient encounter as difficult compared with less difficult (OR=0.67; 95% CI 0.46 to 0.97). The physician-reported level of empathy was positively associated with use of GF (OR=2.60; 95% CI 1.60 to 4.22). The lower use of GF in difficult encounters was not modified by level of empathy.

Conclusions

Experiencing relational aspects of patient encounter as difficult acted as a barrier for the use of GF in cancer diagnosis. Although physician-rated empathy increased use of GF, high empathy did not dissolve the low use of GF in difficult encounters. As diagnosis of cancer is a key challenge in primary care, it is important that GPs are aware that the sensitivity of cancer-related GF is compromised by a difficult patient-physician relationship.

SUBMITTER: Pedersen AF

PROVIDER: S-EPMC6629394 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Patient-physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners.

Pedersen Anette Fischer AF Andersen Christina Maar CM Ingeman Mads Lind ML Vedsted Peter P

BMJ open 20190709 7

<h4>Objectives</h4>To examine whether the quality of the patient-physician relationship, assessed by the general practitioner (GP) and the patient, associates with GPs' use of gut feeling (GF) in cancer diagnosis.<h4>Design</h4>Cross-sectional questionnaire survey of cancer patients and their GPs.<h4>Setting</h4>Danish primary care.<h4>Participants</h4>Newly diagnosed cancer patients and their GPs. Patients completed a questionnaire and provided the name of the GP to whom they have presented the ...[more]

PMID: 31289073

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Project description:BackgroundJob satisfaction of general practitioners (GPs) is important because of the consequences of low satisfaction for GPs, their patients and the health system, such as higher turnover, health problems for the physicians themselves, less satisfied patients, poor clinical outcomes and suboptimal health care delivery. In this study, we aim to explain differences in the job satisfaction of GPs within and between countries.MethodsWe performed a secondary analysis of cross-sectional survey data, collected between 2010 and 2012 on 7379 GPs in 34 (mostly European) countries, as well as data on country and health system characteristics from public databases. Job satisfaction is measured through a composite score of six items about self-reported job experience. Operationalisation of the theoretical constructs includes variables, such as the range of services GPs provide, working hours, employment status, and feedback from colleagues. Data were analysed using linear multilevel regression analysis, with countries and GPs as levels. We developed hypotheses on the basis of the Social Production Function Theory, assuming that GPs 'produce' job satisfaction through stimulating work that provides a certain level of comfort, adds to their social status and provides behavioural confirmation.ResultsJob satisfaction varies between GPs and countries, with high satisfaction in Denmark and Canada (on average 2.97 and 2.77 on a scale from 1-4, respectively) and low job satisfaction in Spain (mean 2.15) and Hungary (mean 2.17). One-third of the total variance is situated on the country level, indicating large differences between countries, and countries with a higher GDP per capita have more satisfied GPs. Health system characteristics are not related to GP job satisfaction. At the GP and practice level, performing technical procedures and providing preventive care, feedback from colleagues, and patient satisfaction are positively related to GP job satisfaction and working more hours is negatively related GP job satisfaction.ConclusionOverall and in terms of our theoretical approach, we found that GPs are able to 'produce' work-related well-being through activities and resources related to stimulation, comfort and behavioural confirmation, but not to status.

Dataset Information

Patient-physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners.

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Patient-physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners.

Similar Datasets

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