Dataset Information

Recognition of anxiety disorders in children: a cross-sectional vignette-based survey among general practitioners.

ABSTRACT: OBJECTIVE:To quantify general practitioners' (GPs) sensitivity to anxiety disorders (ADs) when confronted with the range of symptoms common to children with ADs. Also, to explore GPs' conscious preferences and implicit tendencies for referral of children with ADs to mental healthcare. DESIGN AND SETTING:In a cross-sectional vignette-based survey, all attendees of a Dutch continuing medical education conference for primary care physicians were presented with subtitled audio fragments of five vignettes that we constructed to mimic symptom presentation of children with ADs in general practice. We asked attendees to select per vignette the most plausible diagnoses and most adequate referral option, and for their general referral preferences when they suspect each of the most common mental health problems. PARTICIPANTS:A sample of 229 GPs, resulting in a total of 1128 vignette evaluations. MAIN OUTCOME MEASURE:GPs' selection rate of ADs in the five vignettes compared with a benchmark provided by mental health professionals (MHPs). RESULTS:Overall, recognition of ADs was less likely in GPs compared with MHPs (OR=0.26, 95%?CI 0.15 to 0.46). GPs varied in their recognition of anxiety, with 44.1% not once selecting anxiety as the probable presenting problem. When asked explicitly, 63.9% of the GPs reported that they would refer a child to mental healthcare when they suspect probable ADs. By contrast, only 12.0% of the GPs who recognised anxiety in the vignettes actually selected that referral option. CONCLUSION:A significant fraction of GPs did not notice the depicted symptoms as anxiety. Despite the widespread prevalence of ADs, GPs seem to overlook anxiety already in their early diagnostic opinion. Improving GPs' familiarity with initial symptom presentation, ADs' base-rate, relevance and impact yields potential for timely recognition.

SUBMITTER: Aydin S

PROVIDER: S-EPMC7200042 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Recognition of anxiety disorders in children: a cross-sectional vignette-based survey among general practitioners.

Aydin Semiha S Crone Mathilde R MR Siebelink Bart M BM Vermeiren Robert R J M RRJM Numans Mattijs E ME Westenberg P Michiel PM

BMJ open 20200415 4

<h4>Objective</h4>To quantify general practitioners' (GPs) sensitivity to anxiety disorders (ADs) when confronted with the range of symptoms common to children with ADs. Also, to explore GPs' conscious preferences and implicit tendencies for referral of children with ADs to mental healthcare.<h4>Design and setting</h4>In a cross-sectional vignette-based survey, all attendees of a Dutch continuing medical education conference for primary care physicians were presented with subtitled audio fragmen ...[more]

PMID: 32300000

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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.

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Project description:BackgroundIdentifying essential competencies in end-of-life care, as well as general practitioners' (GPs) confidence in these competencies, is essential to guide training and quality improvement efforts in this domain.AimTo determine which competencies in end-of-life care are considered important by GPs, to assess GPs' confidence in these competencies in a European context and their reasons to refer terminally ill patients to a specialist.Design and settingCross-sectional postal survey involving a stratified random sample of 2000 GPs in Switzerland in 2014.MethodSurvey development was informed by a previous qualitative exploration of relevant end-of-life GP competencies. Main outcome measures were GPs' assessment of the importance of and confidence in 18 attributes of end-of-life care competencies, and reasons for transferring care of terminally-ill patients to a specialist. GP characteristics associated with main outcome measures were tested using multivariate regression models.ResultsThe response rate was 31%. Ninety-nine percent of GPs considered the recognition and treatment of pain as important, 86% felt confident about it. Few GPs felt confident in cultural (16%), spiritual (38%) and legal end-of-life competencies such as responding to patients seeking assisted suicide (35%) although more than half of the respondents regarded these competencies as important. Most frequent reasons to refer terminally ill patients to a specialist were lack of time (30%), better training of specialists (23%) and end-of-life care being incompatible with other duties (19%). In multiple regression analyses, confidence in end-of-life care was positively associated with GPs' age, practice size, home visits and palliative training.ConclusionsGPs considered non-somatic competencies (such as spiritual, cultural, ethical and legal aspects) nearly as important as pain and symptom control. Yet, few GPs felt confident in these non-somatic competencies. These findings should inform training and quality improvement efforts in this domain, in particular for younger, less experienced GPs.

Dataset Information

Recognition of anxiety disorders in children: a cross-sectional vignette-based survey among general practitioners.

Publications

Recognition of anxiety disorders in children: a cross-sectional vignette-based survey among general practitioners.

Similar Datasets

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