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What happened? GPs' perceptions of consultation outcomes and a comparison with the experiences of their patients
Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
Centre for Clinical Research, Falun.
Kalmar County Council, Esplananden Health Care Centre, Västervik.
2010 (English)In: European Journal of General Practice, ISSN 1381-4788, E-ISSN 1751-1402, Vol. 16, no 2, 80-84 p.Article in journal (Other academic) Published
Abstract [en]

Objective: To investigate GPs’ perceptions of consultation outcomes and to investigate the associations between these and outcomes perceived by the patients. Design: 25 GPs and 10 patients for each GP filled in a questionnaire about the outcome of the same consultation. The questions in the questionnaires were formulated from concepts found in preceding qualitative studies. Their answers were analysed and compared. Setting: GPs and patients from 16 group practices in Norrbotten, Sweden. Results: The GPs had the apprehension that their consultations would lead to cure/symptom relief in half of their consultations. They believed that their patients were satisfied up to 90% and that up to 75% had been reassured, understood more or could cope better. The GPs were satisfied themselves with up to 95% of the consultations, they enhanced their relationship to their patient up to 70%. Their affirmative concordance with their patients was high regarding satisfaction, intermediate regarding patient reassurance and patient understanding and lowest regarding cure/symptom relief.

Conclusion: The GPs’ were lacking in their ability to assess the patients’ increased understanding and the concordance between their own and the patients’ expectation of cure/symptom relief was low.

Place, publisher, year, edition, pages
2010. Vol. 16, no 2, 80-84 p.
Keyword [en]
Family Practice, Outcome, Outcome Assessment, Consultation, General Practitioner
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-18480DOI: 10.3109/13814780903528587PubMedID: 20100110OAI: diva2:219781
Available from: 2009-05-28 Created: 2009-05-28 Last updated: 2010-06-03Bibliographically approved
In thesis
1. Outcomes from GPs' Consultations
Open this publication in new window or tab >>Outcomes from GPs' Consultations
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Resultat av konsultationer hos allmänläkare
Abstract [en]

Background and aims. Patients’ consultations with GPs can deal with a wide range of conditions and problems. Generally, consultation outcomes have been considered in evaluations but outcome has a meaning for elaboration of care beyond the graduating role of quality and other evaluation instruments. Knowledge about outcomes is needed for understanding and development. The aim of this thesis was to investigate outcomes of GPs’ consultations as directly experienced by patients and GPs and to investigate connections between clinical strategies and presumed patient outcomes.

Methods. First, concepts describing outcomes from patients’ and GPs’ viewpoints were developed from interviews in groups and individually. Secondly, based on this, questionnaires about the consultation outcomes were formulated. Then, patients and GPs answered questionnaires regarding the same recent consultation. The numbers of the different outcomes were counted and the experiences of outcomes from the same consultations were compared. Finally, another questionnaire including both the GP outcome questions and questions about the clinical situation and decisions made was answered by GPs.

Results. Concepts describing consultation outcomes were brought forward. Cure/symptom relief, reassurance, patient understanding and satisfaction were used by both patients and GPs to describe outcome of consultations. Only patients described as outcomes a confirmation of their ideas and a change in self-perception. GPs, but not patients, described the patient outcomes in terms of check-up and coping. Besides this, GPs also described other outcomes that concerned relationship-building, a change of surgery routines and self-evaluation. Selfevaluation was related to a perceived collegial consensus about right and wrong. The concordance between GPs and patients assessing the same consultations was high for satisfaction, intermediate for patient understanding and low for belief in cure/symptom relief. Clinical strategies were linked to outcomes. Immediate problem solving was registered in about half the consultations. When immediate problem solving was registered the patients were supposed to be more reassured, satisfied and coped better than after gradual problem solving. With increasing psychosocial content of the consultation the GPs registered more dissatisfaction both for themselves and their patients.

Conclusions. Change in self- perception was a prominent patient outcome. GPs’ self-evaluations ought to have the inherent possibility to serve as a basis for development of general practice.

The entire map of the encountered outcome concepts can serve as a basis for further research and development. The mapping of concepts can be of help when prioritising. Knowledge about the total picture of consultation outcomes can help the GP to understand the patients’ worlds better. It can also contribute to a realistic picture of possible consultation outcomes. The GPs seemed to adjust their problem solving (immediate or gradual) to the registered problem and furthermore adjust the immediate problem solving, focusing either on the problem or on the patient as a person.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 91 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1047
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-18483 (URN)978‐91‐7393‐968‐3 (ISBN)
Public defence
2009-06-04, Aulan, Hälsans Hus, ingång 16, Campus US, Linköpings Universitet , Linköping, 13:00 (English)
Available from: 2009-05-28 Created: 2009-05-28 Last updated: 2009-06-10Bibliographically approved

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