The relationship between general practitioners and patients is privileged. The aim of this study was to assess the concordance between the health profile perceived by the patient and the one described by the doctor. We conducted a cross-sectional study between 2019–2020. Patients completed the 5d-5L (EQ-p) and clinicians completed it “from the patient’s perspective” (EQ-d), also consulting the clinical diary. Statistical analysis was performed using Stata 14 (Cohen’s kappa; Fisher’s exact test). The sample consisted of 423 patients. The mean age was 56.7 ± 19.2. There were significant differences by gender in usual activities, pain, and anxiety/depression (74.6% of men had no limitation in usual activities versus 64.5% of women (p < 0.01), 53.9% of men had no pain versus 38.5% of women (p < 0.01), and 60.3% of men had no anxiety/depression versus 38.5% of women (p < 0.01)). Physicians did not detect these differences. The concordance between EQ-p and EQ-d was substantial for mobility (k = 0.62; p < 0.01), moderate for self-care (k = 0.48; p < 0.01) and usual activities (k = 0.50; p < 0.01). Concordance was fair for pain/discomfort (k = 0.32; p < 0.01), anxiety/depression (k = 0.38; p < 0.01), and EQ Index (k = 0.21; p < 0.01). There was greater agreement for “objective “dimensions (mobility, self-care, and usual activities). A good doctor, to be considered as such, must try to put himself in the “patient’s pajamas” to feel his feelings and be on the same wavelength.
Introduction Thanks to the privileged relationship that the general practitioner establishes with patients, he well knows their personal background and assesses the disorders as a whole, without focusing only on unique pathology. The aim of the work were: I) to assess the level of concordance between the health profile (HP) of the patient measured by the doctor and that measured by the patient, and II) to and assess which variables influence the perception. Methods A cross-sectional study was conducted between Aug 2019-Jan 2020 in a primary care setting. To assess health-related quality of life we administered the EuroQol 5d-5L to patients (EQ-p). Simultaneously, we asked the doctors to fill in the questionnaire 'from the patient's point of view' (EQ-d), also based on data collected in the computerized clinical diary. Data was collected anonymously and the statistical analysis was carried out using Stata 14 (Cohen's kappa; Fisher test). Results The sample consisted of 223 patients (46% men). The mean age was 56.5±19.6 (min 18-max95). The mean BMI was 25.5±5 (28% overweight; 18% obese). Significant differences by gender were found in Pain and Anxiety/Depression dimensions (44% of men had not pain vs 33% of women (p = 0.03) and 56% of men had no Anxiety/Depression vs 36% of women (p < 0.01)). These differences were not detected by doctors; As regards the concordance between EQ-p and EQ-d, it was moderate for Mobility (k = 0.45; p < 0.01) and Self-Care (k = 0.46; p < 0.01). The agreement was fair for usual activities (k = 0.39; p < 0.01) and it was poor for Pain/Discomfort (k = 0.14; p < 0.01), Anxiety/Depression (K = 0.19; p < 0.01) and EQ Index (k = 0.11 p < 0.01). Conclusions Our analysis shows a greater concordance especially for the dimensions that appear more objective (Mobility and self-care) than the subjective ones (Pain, Anxiety). The physicians do not seem to take into account the differences in perception between men and women when they empathize with patients. Key messages The general practitioner knows the personal history of his patients and assesses the disorders as a whole, without focusing only on the specific pathology. In the exercise of the identification, he seems to understand mainly dimensions that appear more objective without grasping the differences in perception between men and women.
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