Difficult patient-doctor encounters in a Swiss university outpatient clinic: cross-sectional study
| العنوان: | Difficult patient-doctor encounters in a Swiss university outpatient clinic: cross-sectional study |
|---|---|
| المؤلفون: | Régis Marion-Veyron, Konstantinos Tzartzas, Alexandre Gouveia, Kevin Selby, Philippe Staeger, Pau Mota, Patrick Bodenmann |
| المصدر: | BMJ open, vol. 9, no. 1, pp. e025569 BMJ Open |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Universities, Attitude of Health Personnel, Cross-sectional study, Vulnerability, Ambulatory Care Facilities, 03 medical and health sciences, 0302 clinical medicine, Outcome variable, Ambulatory care, Surveys and Questionnaires, Health care, Ambulatory Care, Humans, Medicine, Outpatient clinic, 030212 general & internal medicine, Physician-Patient Relations, business.industry, Communication, 030503 health policy & services, Research, Internship and Residency, vulnerable patients, General Medicine, medicine.disease, Comorbidity, Social situation, difficult doctor-patient encounter, Cross-Sectional Studies, Family medicine, Female, Clinical Competence, 0305 other medical science, business, General practice / Family practice, Switzerland, general practice medicine |
| الوصف: | IntroductionPrevious research has shown that multiple factors contribute to healthcare providers perceiving encounters as difficult, and are related to both medical and non-medical demands.AimTo measure the prevalence and to identify predictors of encounters perceived as difficult by medical residents.Design and settingCross-sectional study at the Department of Ambulatory Care and Community Medicine (DACCM), a university outpatient clinic with a long tradition of caring for vulnerable patients.MethodWe identified difficult doctor–patient encounters using the validated Difficult Doctor–Patient Relationship Questionnaire (DDPRQ-10), and characterised patients using the patient’s vulnerability grid, a validated questionnaire measuring five domains of vulnerability, both completed by medical residents after each encounter. We used a multiple linear regression model with the outcome variable as the DDPRQ-10 score, controlling for resident characteristics.ParticipantsWe analysed 527 patient encounters performed by all 27 DACCM residents (17 women and 10 men). We asked each medical resident to evaluate 20 consecutive consultations starting on the same date.OutcomeOne hundred and fifty-seven encounters (29.8%) were perceived as difficult.ResultsAfter adjusting for differences among residents, all five domains of the patient vulnerability grid were independently associated with a difficult encounter: frequent healthcare user; psychological comorbidity; health comorbidity; risky behaviours and a precarious social situation.ConclusionNearly a third of encounters were perceived as difficult by medical residents in our university outpatient clinic that cares for a high proportion of vulnerable patients. This represents twice the average ratio of difficult encounters in general practice. All five domains of patient vulnerability appear to have partial explanatory power on medical residents’ perception of difficult patient encounters. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::469d607fcdf43fc73b447e336b39864c https://serval.unil.ch/resource/serval:BIB_B8ED9CC35C34.P001/REF.pdf |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....469d607fcdf43fc73b447e336b39864c |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |