Is perceived social distance between the patient and the general practitioner related to their disagreement on patient's health status?

Schieber, Anne-Cécile; Kelly-Irving, Michelle; Delpierre, Cyrille; Lepage, Benoît; Bensafi, Amel; Afrité, Anissa; Pascal, Jean; Cases, Chantal; Lang, Thierry

doi:10.1016/j.pec.2012.11.012

Cited by 15 publications

(20 citation statements)

References 41 publications

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“…Empirical studies support these assumptions: women, older patients, patients with perceived better health status and patients with lower education tend to be more satisfied (Hall and Dornan, 1990; Jackson et al, 2001; Rahmqvist and Bara, 2010). Among relational factors, we find communication style (Hall et al, 2014; Weisman and Teitelbaum, 1985; Willems et al, 2005), continuity of care (Beach et al, 2013; Hall and Roter, 2002; Salmon et al, 2005; Schieber et al, 2013; Whear et al, 2013), experiences of partnership and shared decision making (Ommen et al, 2011; Street et al, 2005), congruence in doctor–patient beliefs (Krupat et al, 2001; Serber et al, 2003) and reciprocated trust (Croker et al, 2013). Greater satisfaction generally occurs ‘when the patient has the perception of being listened to, of being treated with respect, humanely and as fairly as others’ (Sans-Corrales et al, 2006: 309).…”

Section: Patient Satisfaction: Theory and Previous Researchmentioning

confidence: 94%

Factors facilitating patient satisfaction among women with medically unexplained long-term fatigue: A relational perspective

Lian

Hansen

2015

Health (London)

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Bodily conditions that are difficult to identify, explain and treat with the aid of medical knowledge and technology appear to be particularly challenging to medical encounters.Patients are often dissatisfied with the help they receive, and they often experience that their medical needs are not met. To explore factors facilitating patient satisfaction among patients with a medically unexplained condition we ask: what is the importance of individual versus relational factors in facilitating patient satisfaction in clinical encounters between general practitioners (GPs) and women with medically unexplained long-term fatigue? We approach this question through a statistical analysis of survey data collected from a net sample of 431 women recruited through a patient organisation for people suffering from myalgic encephalomyelitis (ME) in 2013. Participants were asked about their experiences with general practitioners in the Norwegian national health system in two different phases: shortly after illness onset, and current regular GP last 12 months. The questions evolved around themes concerning shared understanding and decision-making, being taken seriously, being paid due respect, and being treated as an equal partner. Through descriptive statistics and multivariable logistic regression analyses, we explored how their experiences were related to individual and relational factors, respectively. Free-text comments from the questionnaires were used while interpreting the results. The analysis illuminates that relational aspects in medical encounters between GPs and ME-patients, especially continuity, congruence in doctor-patient views and being seen by a specialist, are important catalysts of patient satisfaction. The probability of being satisfied with the initial investigation was more than six times higher in women who were referred to specialists, compared to those who were not. We conclude that continuity of care and experiences of being in a partnership that operates on a common ground -a shared understanding of the patient's illness -foster patient satisfaction among women with medically unexplained long-term fatigue.3

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Section: Patient Satisfaction: Theory and Previous Researchmentioning

confidence: 94%

Factors facilitating patient satisfaction among women with medically unexplained long-term fatigue: A relational perspective

Lian

Hansen

2015

Health (London)

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“…This (perceived) social distance could lead to BMJ Global Health poor doctor-patient relationships, unmet expectations and resentment. 42 To mitigate these feelings of inferiority, patients often seek assistance from a companion when visiting hospitals, which often multiplies the costs to be borne by the patient. By seeking care in drug shops, patients can avoid the feelings of inferiority, apprehension and the cost of taking care of the companion associated with attending a hospital.…”

Section: Otc Dispensing and Its Implicationsmentioning

confidence: 99%

Why do people purchase antibiotics over-the-counter? A qualitative study with patients, clinicians and dispensers in central, eastern and western Nepal

et al. 2021

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IntroductionOver-the-counter (OTC) use of antibiotics contributes to the burgeoning rise in antimicrobial resistance (AMR). Drawing on qualitative research methods, this article explores the characteristics of OTC sales of antibiotic in Nepal, its drivers and implications for policy.MethodsData were collected in and around three tertiary hospitals in eastern, western and central Nepal. Using pre-defined guides, a mix of semi-structured interviews and focus group discussions were conducted with dispensers at drug stores, patients attending a hospital and clinicians. Interviews were audio-recorded, translated and transcribed into English and coded using a combination of an inductive and deductive approach.ResultsDrug shops were the primary location where patients engaged with health services. Interactions were brief and transactional: symptoms were described or explicit requests for specific medicine made, and money was exchanged. There were economic incentives for clients and drug stores: patients were able to save money by bypassing the formal healthcare services. Clinicians described antibiotics as easily available OTC at drug shops. Dispensing included the empirical use of broad-spectrum antibiotics, often combining multiple antibiotics, without laboratory diagnostic and drug susceptibility testing. Inappropriately short regimens (2–3 days) were also offered without follow-up. Respondents viewed OTC antibiotic as a convenient alternative to formal healthcare, the access to which was influenced by distance, time and money. Respondents also described the complexities of navigating various departments in hospitals and little confidence in the quality of formal healthcare. Clinicians and a few dispensers expressed concerns about AMR and referred to evadable policies around antibiotics use and poor enforcement of regulation.ConclusionsThe findings point to the need for clear policy guidance and rigorous implementation of prescription-only antibiotics.

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“…Vulnerable patients seem to be doubly penalized: patients from lower social class communicate less actively and express fewer information needs, while concurrently, physicians seem to display more patient-centered communication with patients who are perceived as better communicators, and who expressed positive affect [ 3 ]. Moreover, several authors demonstrated that positive physician-patient interaction and communication seem to be facilitated when physicians see themselves as close to their patients in terms of socioeconomic identities and values [ 3 , 7 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…First, physicians’ beliefs about their patients can lead to disparities in treatment [ 10 ]. Second, the interactions between physicians and patients seem to vary according to their perceived social distance [ 11 – 14 ]. Several studies showed that patients from lower social classes receive significantly less information and are significantly less involved in shared decision-making [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Inpatient satisfaction with medical information received from caregivers: an observational study on the effect of social deprivation

Moret

Anthoine

Pourreau

et al. 2017

BMC Health Serv Res

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BackgroundThe main objective of this study was to explore the relationships between inpatients’ social differentiation and satisfaction with the medical information delivered by caregivers.MethodsIn four departments of a teaching hospital, patients were enrolled as well as their attending physician and one of the nurses assigned to them. Structured survey questionnaires were administered face-to-face to patients and caregivers. Patients were asked to rate their satisfaction with the medical information received, the quality and duration of the interactions with the caregivers, and their experience regarding their involvement in medical decision-making. Caregivers were asked to rate their perception of the patients’ social position and involvement in medical decision-making. Social deprivation was assessed using the EPICES score in particular. The statistical analysis was mainly descriptive and completed by a structural equation model.ResultsA sample of 255 patients, 221 pairs of patient-physician and 235 pairs of patient-nurse were considered. One third of the patients (32.7%) were identified as socially deprived. They were significantly less satisfied with the information they received on their health status or their treatment; 56.7% of patients thought that they received sufficient explanations without having to ask. This proportion was significantly lower in socially deprived patients (42.3%) compared to not deprived patients (63.6%, p < 0.01). Patients’ reported involvement in medical decision-making was significantly lower for socially deprived patients (75.0% vs 89.0%, p < 0.001). The structural equation model showed that the main determinant of patients’ satisfaction regarding medical information was their perceived involvement in informed medical decision-making (CFI = 0.998, RMSEA = 0.022).ConclusionsThese findings suggest that physicians and nurses need training on communication targeted towards vulnerable patients, in order to improve the accessibility of medical information, and thus to reduce health inequalities.

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Is perceived social distance between the patient and the general practitioner related to their disagreement on patient's health status?

Cited by 15 publications

References 41 publications

Factors facilitating patient satisfaction among women with medically unexplained long-term fatigue: A relational perspective

Factors facilitating patient satisfaction among women with medically unexplained long-term fatigue: A relational perspective

Why do people purchase antibiotics over-the-counter? A qualitative study with patients, clinicians and dispensers in central, eastern and western Nepal

Inpatient satisfaction with medical information received from caregivers: an observational study on the effect of social deprivation

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