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Observational study of patient-centeredness and 'positive' approach on outcomes of general practice consultations.

Research output: Contribution to journalJournal articlepeer-review

  • Paul Little
  • Hazel Everitt
  • Ian Williamson
  • Greg Warner
  • Michael Moore
  • Clare Gould
  • Kate Ferrier
  • Sheila Payne
<mark>Journal publication date</mark>20/10/2001
Issue number7318
Number of pages4
Pages (from-to)908-911
Publication StatusPublished
<mark>Original language</mark>English


Objective: To measure patients' perceptions of patient centredness and the relation of these perceptions to outcomes. Design: Observational study using questionnaires. Setting: Three general practices. Participants: 865 consecutive patients attending the practices. Main outcome measures: Patients' enablement, satisfaction, and burden of symptoms. Results: Factor analysis identified five components. These were communication and partnership (a sympathetic doctor interested in patients' worries and expectations and who discusses and agrees the problem and treatment, Cronbach's =0.96); personal relationship (a doctor who knows the patient and their emotional needs, =0.89); health promotion (=0.87); positive approach (being definite about the problem and when it would settle, =0.84); and interest in effect on patient's life (=0.89). Satisfaction was related to communication and partnership (adjusted =19.1; 95% confidence interval 17.7 to 20.7) and a positive approach (4.28; 2.96 to 5.60). Enablement was greater with interest in the effect on life (0.55; 0.25 to 0.86), health promotion (0.57; 0.30 to 0.85), and a positive approach (0.82; 0.52 to 1.11). A positive approach was also associated with reduced symptom burden at one month (=0.25; 0.41 to 0.10). Referrals were fewer if patients felt they had a personal relationship with their doctor (odds ratio 0.70; 0.54 to 0.90). Conclusions: Components of patients' perceptions can be measured reliably and predict different outcomes. If doctors don't provide a positive, patient centred approach patients will be less satisfied, less enabled, and may have greater symptom burden and higher rates of referral.