Detection of patient psychological distress and longitudinal patient–doctor relationships: a cross-sectional study

Abstract

METHOD Recruitment and data collectionGPs were recruited from practices in and around Bristol, England. As the majority of practices were members of a local research collaborative, selection was non-random. During study surgeries those patients who were eligible (aged ≥16 years and able to self-complete a questionnaire) and study GPs were asked to complete questionnaires. With consent, patients' electronic medical records were reviewed for data on consultation length, longitudinal care, and mental health. Patient psychological statusPatient-reported psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12).12 The General Health Questionnaire is a self-completed measure of psychiatric disturbance that has been widely used in primary care studies. GHQ-12 scores were calculated using the '0011' method, which gives a score of between zero and 12.12 At a given threshold, patients are usually dichotomised into groups of psychiatric and non-psychiatric cases. For the purposes of the main Psychological distress in patients who attend their GP is thought to be under-recognised. However, it is likely that both disclosure and detection are influenced by how well the patient and doctor know each another.

Patient–doctor continuity and diagnosis of cancer: electronic medical records study in general practice

“…Previous work has highlighted the potential problems of ‘over-familiarity’ and the potential benefit of having a ‘fresh set of eyes’. 5 , 38 However, that is not to negate the psychological benefits that some patients may derive from ‘following through’ a cancer diagnosis with the same GP. Until further work is carried out, it would seem sensible to recommend that practices encourage patients to follow new problems up with the same doctor, especially for patients whose symptoms or signs at the initial consultation may represent an underlying cancer but do not in themselves warrant immediate investigation or referral.…”

General practitioners' ‘lived experience’ of assessing psychological distress in cancer patients: an exploratory qualitative study

“…Although countering this, a recent study in the general population revealed that depth of the doctor–patient relationship and the detection of emotional distress are weak (Ridd et al . ). While perceived delay in diagnosis as a threat to the doctor–patient relationship is well described (McWilliam et al .…”

“…The assertion of GPs that the doctor-patient relationship is a powerful facilitator to the assessment of distress is supported by studies which revealed that the doctorpatient relationship was associated with: prior knowledge which facilitated the assessment of psychological problems (Hjortdhal 1992;Warmenhoven et al 2012); positive patient communication practices (McWilliam et al 2000) and holistic proactive cancer care (Kendall et al 2013). Although countering this, a recent study in the general population revealed that depth of the doctor-patient relationship and the detection of emotional distress are weak (Ridd et al 2012). While perceived delay in diagnosis as a threat to the doctor-patient relationship is well described (McWilliam et al 2000;Sisler 2003;Kelly et al 2008;Browne et al 2011), only two GPs described this.…”

The Association between Patient-Reported Pain and Doctors’ Language Proficiency in Clinical Practice

“…Greater depth of patient-physician relationship in primary care has been suggested to increase the GPs' detection of patients' emotional distress [ 23 ]. Altogether 41% of our respondents reported having earlier visited an assigned GP.…”