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1.
Triadic communication in the primary care paediatric consultation: a review of the literature. 下载免费PDF全文
BACKGROUND: Children aged 6-12 years are usually seen in primary care with an adult carer. It is a government and professional priority for doctors to try and involve these children in their medical consultations. AIM: To ascertain the evidence available on the amount and type of involvement that children in the 6-12 year age group have in their primary care consultations when the consultation was held with a child, a GP, and an adult. DESIGN OF THE STUDY: Literature review. METHOD: Data sources included MEDLINE, CINAHL, EMBASE, and ERIC, The Cochrane library, PsychINFO, Web of Science and Wilson's Social Science abstracts, hand searching for references, and contact with authors. RESULTS: Twenty-one studies were selected for inclusion in the study. Children were found to have little quantitative involvement in their own consultations. They may take part during information gathering but are unlikely to participate in the treatment planning and discussion parts of the consultation. CONCLUSION: Children in the 6-12 year age group have little meaningful involvement in their consultations. 相似文献
2.
Paul Little Peter White Joanne Kelly Hazel Everitt Shkelzen Gashi Annemieke Bikker Stewart Mercer 《The British journal of general practice》2015,65(635):e357-e365
Background
Few studies have assessed the importance of a broad range of verbal and non-verbal consultation behaviours.Aim
To explore the relationship of observer ratings of behaviours of videotaped consultations with patients’ perceptions.Design and setting
Observational study in general practices close to Southampton, Southern England.Method
Verbal and non-verbal behaviour was rated by independent observers blind to outcome. Patients competed the Medical Interview Satisfaction Scale (MISS; primary outcome) and questionnaires addressing other communication domains.Results
In total, 275/360 consultations from 25 GPs had useable videotapes. Higher MISS scores were associated with slight forward lean (an 0.02 increase for each degree of lean, 95% confidence interval [CI] = 0.002 to 0.03), the number of gestures (0.08, 95% CI = 0.01 to 0.15), ‘back-channelling’ (for example, saying ‘mmm’) (0.11, 95% CI = 0.02 to 0.2), and social talk (0.29, 95% CI = 0.4 to 0.54). Starting the consultation with professional coolness (‘aloof’) was helpful and optimism unhelpful. Finishing with non-verbal ‘cut-offs’ (for example, looking away), being professionally cool (‘aloof’), or patronising, (‘infantilising’) resulted in poorer ratings. Physical contact was also important, but not traditional verbal communication.Conclusion
These exploratory results require confirmation, but suggest that patients may be responding to several non-verbal behaviours and non-specific verbal behaviours, such as social talk and back-channelling, more than traditional verbal behaviours. A changing consultation dynamic may also help, from professional ‘coolness’ at the beginning of the consultation to becoming warmer and avoiding non-verbal cut-offs at the end. 相似文献3.
Paul Little Peter White Joanne Kelly Hazel Everitt Stewart Mercer 《The British journal of general practice》2015,65(635):e351-e356
Background
The impact of changing non-verbal consultation behaviours is unknown.Aim
To assess brief physician training on improving predominantly non-verbal communication.Design and setting
Cluster randomised parallel group trial among adults aged ≥16 years attending general practices close to the study coordinating centres in Southampton.Method
Sixteen GPs were randomised to no training, or training consisting of a brief presentation of behaviours identified from a prior study (acronym KEPe Warm: demonstrating Knowledge of the patient; Encouraging [back-channelling by saying ‘hmm’, for example]; Physically engaging [touch, gestures, slight lean]; Warm-up: cool/professional initially, warming up, avoiding distancing or non-verbal cut-offs at the end of the consultation); and encouragement to reflect on videos of their consultation. Outcomes were the Medical Interview Satisfaction Scale (MISS) mean item score (1–7) and patients’ perceptions of other domains of communication.Results
Intervention participants scored higher MISS overall (0.23, 95% confidence interval [CI] = 0.06 to 0.41), with the largest changes in the distress–relief and perceived relationship subscales. Significant improvement occurred in perceived communication/partnership (0.29, 95% CI = 0.09 to 0.49) and health promotion (0.26, 95% CI = 0.05 to 0.46). Non-significant improvements occurred in perceptions of a personal relationship, a positive approach, and understanding the effects of the illness on life.Conclusion
Brief training of GPs in predominantly non-verbal communication in the consultation and reflection on consultation videotapes improves patients’ perceptions of satisfaction, distress, a partnership approach, and health promotion. 相似文献4.
Chris Salisbury Sunita Procter Kate Stewart Leah Bowen Sarah Purdy Matthew Ridd Jose Valderas Tom Blakeman David Reeves 《The British journal of general practice》2013,63(616):e751-e759
Background
Demographic and policy changes appear to be increasing the complexity of consultations in general practice.Aim
To describe the number and types of problems discussed in general practice consultations, differences between problems raised by patients or doctors, and between problems discussed and recorded in medical records.Design and setting
Cross-sectional study based on video recordings of consultations in 22 general practices in Bristol and North Somerset.Method
Consultations were examined between 30 representative GPs and adults making a pre-booked day-time appointment. The main outcome measures were number and types of problems and issues discussed; who raised each problem/issue; consultation duration; whether problems were recorded and coded.Results
Of 318 eligible patients, 229 (72.0%) participated. On average, 2.5 (95% CI = 2.3 to 2.6) problems were discussed in each consultation, with 41% of consultations involving at least three problems. Seventy-two per cent (165/229) of consultations included problems in multiple disease areas. Mean consultation duration was 11.9 minutes (95% CI = 11.2 to 12.6). Most problems discussed were raised by patients, but 43% (99/229) of consultations included problems raised by doctors. Consultation duration increased by 2 minutes per additional problem. Of 562 problems discussed, 81% (n = 455) were recorded in notes, but only 37% (n = 206) were Read Coded.Conclusion
Consultations in general practice are complex encounters, dealing with multiple problems across a wide range of disease areas in a short time. Additional problems are dealt with very briefly. GPs, like patients, bring an agenda to consultations. There is systematic bias in the types of problems coded in electronic medical records databases. 相似文献5.
《Patient education and counseling》2021,104(10):2490-2497
ObjectiveProviding a second opinion (SO) in oncology is complex, and communication during SOs remains poorly understood. This study aimed to systematically observe how patients and oncologists communicate about SO-specific topics (i.e., patient motivation, the referring oncologist, treatment transfer/back-referral), and how such communication affects patient satisfaction.MethodsA prospective mixed-methods study of cancer patients seeking a SO (N = 69) and consulting oncologists was conducted. Before the SO, patients reported their expected place of future treatment. Following the SO, patients’ and oncologists’ satisfaction was assessed. All SOs were audio-recorded. Absolute and relative duration of SO-specific talk were calculated and specific events (e.g., questions/utterances) were coded (incl. valence, explicitness).ResultsSOs lasted 19–73 min, of which 3.7% was spent discussing motivations. Oncologists rarely explored patients’ motivations. Talk about referring oncologists (12.5% of consultation) was mostly critical by patients (M = 43.0%), but positive/confirming by consulting oncologists (M = 73.5%). Although 22.2% of patients expected a treatment transfer, this topic (3.3% of consultation time) was rarely explicitly discussed. Patients who were referred back were significantly less satisfied (d = 0.85).ConclusionPatient-provider communication in oncological SOs appears insufficiently aligned.Practice ImplicationsPatients and oncologists need support to explicitly and productively communicate about SO-specific topics and to better manage expectations. Recommendations are provided. 相似文献
6.
Zebiene E Svab I Sapoka V Kairys J Dotsenko M Radić S Miholic M 《Patient education and counseling》2008,73(2):246-250
Objective
Efficient patient–physician collaboration is proven to have a direct benefit on health care outcomes through improved compliance, appointment keeping and use of preventive services. The aim of this study was to evaluate the patient–physician agreement on communication during primary care consultations and consider possible discrepancies.Methods
A cross-sectional survey using self-administered questionnaires was performed in primary care in four European countries (Lithuania, Slovenia, Serbia and Russia). Post-consultation evaluations of doctor–patient communication were made by patients and physicians and were compared with pre-consultation expectations of the patient. Discrepancies in these evaluations were determined for the entire database, and within groups of expectations, using factor analysis.Results
One thousand three hundred and thirty-two sets of questionnaires were collected by the study team. In this sample, in more than 90% of consultations physicians and patients agreed about meeting patient expectations. Discrepancies were more likely to be identified when the patients were consulting the physician for the first time or had not seen that physician for more than 12 months (up to 26.1%). There is a significantly lower correlation between the physician recognising patient's unmet expectations for all factors if the physician had been working in Primary Care for between 6 and 10 years (8.6%). The results demonstrate that physicians working more than 16 years in practice are less likely to recognise that they have failed to meet the expectations of patients who are seeking reassurance (9%).Conclusion
Personal continuity of care is associated with a lower discrepancy between the opinions of patients and physicians regarding meeting patient expectations during consultations in primary care. The highest agreement is within first 6 years in practice, which may reflect long-term effects of training.Practice implications
Primary care physicians should put more emphasis on identifying and addressing patient expectations in primary care consultation, including agreement with patient. Existing discrepancies may be considered to be indicators of potential opportunities to improve physician's performance and overall quality of care. 相似文献7.
Blakeman T Chew-Graham C Reeves D Rogers A Bower P 《The British journal of general practice》2011,61(591):e666-e673
Background
Two key elements to improve the quality of care for people with long-term conditions in primary care are improved clinical information systems to support delivery of evidence-based care, and enhanced self-management support. Although both elements are viewed as necessary, their interaction is not well understood.Aim
To explore the use of computer-based ‘disease management’ templates and their relevance to self-management dialogue within clinical encounters.Design and setting
Qualitative study of general practices located in three primary care trusts in the north of England.Method
A qualitative mixed methods study was conducted that included comparative analysis of (1) observations of general practice consultations (n = 86); and (2) interviews with health professionals in general practice (n = 17).Results
The analysis suggested that use of the computer templates reinforced a checklist approach to consultations, which included professionals working through several self-management topics framed as discrete behaviours. As a consequence, conversation tended to become focused on the maintenance of the professional-patient relationship at the expense of expansion in self-management dialogue. The computer templates also shaped how patient-initiated self-management dialogue was managed when it arose, with a shift towards discussion around medical agendas.Conclusion
In order to enhance the management of long-term conditions in primary care, the design and implementation of clinical information systems to improve evidence-based care need to take into account their potential impact on supporting self-management. 相似文献8.
Jodie T Allen Simon R Cohn Amy L Ahern 《The British journal of general practice》2015,65(633):e248-e255
BackgroundReferral to a commercial weight-loss programme is a cost-effective intervention that is already used within the NHS. Qualitative research suggests this community-based, non-medical intervention accords with participants’ view of weight management as a lifestyle issue.AimTo examine the ways in which participants’ attitudes and beliefs about accessing a commercial weight management programme via their doctor relate to their weight-loss experience, and to understand how these contextual factors influence motivation and adherence to the intervention.MethodTwenty-nine participants (body mass index [BMI] ≥28 kg/m2; age ≥18 years), who took part in the WRAP (Weight Loss Referrals for Adults in Primary Care) trial, were recruited at their 3-month assessment appointment to participate in a semi-structured interview about their experience of the intervention and weight management more generally. Interviews were audiorecorded, transcribed verbatim, and analysed inductively using a narrative approach.ResultsAlthough participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management, the referral from the GP and subsequent clinical assessments frame their experience of the intervention as medically pertinent with clear health benefits.ConclusionReferral by the GP and follow-up assessment appointments were integral to participant experiences of the intervention, and could be adapted for use in general practice potentially to augment treatment effects. 相似文献
9.
'Talking of Sex': developing and piloting a sexual health communication tool for use in primary care
Macdowall W Parker R Nanchahal K Ford C Lowbury R Robinson A Sherrard J Martins H Fasey N Wellings K 《Patient education and counseling》2010,81(3):332-337
Objective
To develop and pilot a communication aid aimed at increasing the frequency with which sexual health issues are raised proactively with young people in primary care.Methods
Group interviews among primary health care professionals to guide development of the tool, simulated consultations to pre-test it, and a pilot study to assess effectiveness.Results
We developed an electronic consultation aid: Talking of Sex and piloted it in eight general practices across the UK. 188 patients and 58 practitioners completed questionnaires pre-intervention, and 92 patients and 45 practitioners post-intervention. There was a modest increase in the proportion of consultations in which sexual health was raised, from 28.1% pre-intervention to 32.6% post-intervention. In consultations with nurses the rise was more marked. More patients reported discussing preventive practices such as condom use post-intervention. Patients unanimously welcomed the opportunity to discuss sexual health matters with their practitioner.Conclusion
The tool has capacity to increase the frequency with which sexual health is raised in primary care, particularly by nurses, to influence the topics discussed, and to improve patient satisfaction.Practice implications
The tool has potential in increasing the proportion of young people whose sexual health needs are addressed in general practice. 相似文献10.
Harry PA Wagemakers Pim AJ Luijsterburg Edith M Heintjes Marjolein Y Berger Jan AN Verhaar Bart W Koes Sita MA Bierma-Zeinstra 《The British journal of general practice》2012,62(601):e561-e566
Background
Prognosis of persistent complaints after knee injury is based on secondary care populations. In a primary care setting, however, no studies have addressed this issue.Aim
To identify possible predictors of persistent complaints 1 year after a knee injury. These predictors are important for guiding the GP’s therapeutic management, and giving advice to patients about work and/or sports-related activities.Design and setting
Primary care prospective cohort study with a 1-year follow-up period in five municipalities in the southwest region of the Netherlands.Method
Patients who were eligible were recruited to the study by a GP research network with around 84 000 patients and 40 participating GPs. A total of 134 patients (aged 18–65 years) who consulted their GP within 5 weeks after a knee injury entered the study. Follow-up after 1 year was conducted in 122 patients. The main outcome was persistent complaints 1 year after injury; possible predictors for these complaints were obtained with a questionnaire, a physical examination, and magnetic resonance imaging (MRI), according to a standardised protocol.Results
After 1 year, of the 122 available patients, 21 (17%) reported persistent complaints and 101 (83%) reported full recovery or major improvement. In this study being aged >40 years had a significant association (P<0.05) with persistent complaints (odds ratio 8.0, 95% confidence interval 2.1 to 30.5). Physical examination and MRI findings revealed no predictors that were associated with these complaints.Conclusion
Being aged >40 years was the only determinant with a significant association with persistent complaints. As physical examination and MRI had no predictive value, they are not recommended for prognosis of persistent complaints. 相似文献11.
P Kinnersley N Stott T J Peters I Harvey 《The British journal of general practice》1999,49(446):711-716
BACKGROUND: There is general support for general practitioners (GPs) using patient-centred styles. However, there is limited British evidence of beneficial outcomes for patients from such styles. AIM: To explore whether, for patients presenting for new episodes of care, the GP's consulting style, specifically the patient-centredness of the consultation, is related to five generic outcomes. METHOD: General practitioners in South Wales were recruited, and one surgery consulting session was audiotape recorded for each participating clinician. Questionnaires were given to consenting patients before their consultations, immediately afterwards, and, by post, at two weeks to measure the following outcomes: doctor-patient agreement (on the nature of the problem and management), patient satisfaction, resolution of symptoms, resolution of concerns, and functional health status. From the patients consulting for a new episode of care and completing all three questionnaires, one patient was selected at random for each GP and the audiotape of their consultation rated for patient-centredness. Statistical analysis employed correlation coefficients and t-tests, followed by multiple regression and logistic regression to control for potential confounders. RESULTS: In total, 143 patients consulting 143 GPs were studied. The patient-centred score was positively and statistically significantly associated with patient satisfaction (Pearson correlation = 0.28; P = 0.002). No other associations were found with the other outcomes measured. CONCLUSION: The study presents evidence that patient-centred styles of consulting produce benefits in terms of increased patient satisfaction for patients consulting for new episodes of care in Britain. 相似文献
12.
13.
SL Lavela G Schectman J Gering SM Locatelli A Gawron FM Weaver 《Patient education and counseling》2012,88(3):420-426
Objective
To assess veterans’ health communication preferences (in-person, telephone, or electronic) for primary care needs and the impact of computer use on preferences.Methods
Structured patient interviews (n = 448). Bivariate analyses examined preferences for primary care by ‘infrequent’ vs. ‘regular’ computer users.Results
Only 54% were regular computer users, nearly all of whom had ever used the internet. ‘Telephone’ was preferred for 6 of 10 reasons (general medical questions, medication questions and refills, preventive care reminders, scheduling, and test results); although telephone was preferred by markedly fewer regular computer users. ‘In-person’ was preferred for new/ongoing conditions/symptoms, treatment instructions, and next care steps; these preferences were unaffected by computer use frequency. Among regular computer users, 1/3 preferred ‘electronic’ for preventive reminders (37%), test results (34%), and refills (32%).Conclusion
For most primary care needs, telephone communication was preferred, although by a greater proportion of infrequent vs. regular computer users. In-person communication was preferred for reasons that may require an exam or visual instructions. About 1/3 of regular computer users prefer electronic communication for routine needs, e.g., preventive reminders, test results, and refills.Practice implications
These findings can be used to plan patient-centered care that is aligned with veterans’ preferred health communication methods. 相似文献14.
Gary McLean Bruce Guthrie Stewart W Mercer Graham CM Watt 《The British journal of general practice》2015,65(641):e799-e805
Background
Universal access to health care, as provided in the NHS, does not ensure that patients’ needs are met.Aim
To explore the relationships between multimorbidity, general practice funding, and workload by deprivation in a national healthcare system.Design and setting
Cross-sectional study using routine data from 956 general practices in Scotland.Method
Estimated numbers of patients with multimorbidity, estimated numbers of consultations per 1000 patients, and payments to practices per patient are presented and analysed by deprivation decile at practice level.Results
Levels of multimorbidity rose with practice deprivation. Practices in the most deprived decile had 38% more patients with multimorbidity compared with the least deprived (222.8 per 1000 patients versus 161.1; P<0.001) and over 120% more patients with combined mental–physical multimorbidity (113.0 per 1000 patients versus 51.5; P<0.001). Practices in the most deprived decile had 20% more consultations per annum compared with the least deprived (4616 versus 3846, P<0.001). There was no association between total practice funding and deprivation (Spearman ρ −0.09; P = 0.03). Although consultation rates increased with deprivation, the social gradients in multimorbidity were much steeper. There was no association between consultation rates and levels of funding.Conclusion
No evidence was found that general practice funding matches clinical need, as estimated by different definitions of multimorbidity. Consultation rates provide only a partial estimate of the work involved in addressing clinical needs and are poorly related to the prevalence of multimorbidity. In these circumstances, general practice is unlikely to mitigate health inequalities and may increase them. 相似文献15.
Objective
To explore the potential agreement between two different methods to investigate emotional communication of native and non-native patients in medical consultations.Methods
The data consisted of 12 videotaped hospital consultations with six native and six non-native patients. The consultations were coded according to coding rules of the Verona Coding definitions of Emotional Sequences (VR-CoDES) and afterwards analyzed by discourse analysis (DA) by two co-workers who were blind to the results from VR-CoDES.Results
The agreement between VR-CoDES and DA was high in consultations with many cues and concerns, both with native and non-native patients. In consultations with no (or one cue) according to VR-CoDES criteria the DA still indicated the presence of emotionally salient expressions and themes.Conclusion
In some consultations cues to underlying emotions are communicated so vaguely or veiled by language barriers that standard VR-CoDES coding may miss subtle cues. Many of these sub-threshold cues could potentially be coded as cues according to VR-CoDES main coding categories, if criteria for coding vague or ambiguous cues had been better specified.Practice implications
Combining different analytical frameworks on the same dataset provide us new insights on emotional communication. 相似文献16.
Calum T McHale Joanne E Cecil Anita H Laidlaw 《Patient education and counseling》2019,102(12):2214-2222
ObjectiveTo analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations.MethodsConsultations between 14 PCPs and 218 overweight patients (BMI ≥ 25 kg/m2) were video recorded. Weight communication was coded using the Roter Interaction Analysis System (RIAS) and the novel St Andrews Issue Response Analysis System (SAIRAS). Communication code frequencies were analysed.ResultsWeight discussion occurred in 25% of consultations with overweight patients; 26% of these had weight-related consultation outcomes (e.g. weight-related counselling and referrals, stated weight-related intention from patients). Weight discussions were more likely to occur if PCPs provided space to patient attempts to discuss weight (p = 0.013). Longer weight discussions (p < 0.001) and contextualising weight as problematic when PCP/patient-initiated weight discussion (p < 0.001) were associated with weight-related consultation outcomes.ConclusionWeight was rarely discussed with overweight patients, however PCP space provision to patient weight-discussion initiation attempts increased weight discussion. When weight was discussed, increased time and/or contextualising weight as a problem increased the likelihood of weight-related consultation outcomes.Practical implicationPCP use of specific communication approaches when discussing, contextualising and responding to patient weight may facilitate weight-related discussion and consultation outcomes and could lead to more effective patient weight management. 相似文献
17.
Background
Over half a million people die in Britain each year and, on average, a GP will have 20 patients die annually. Bereavement is associated with significant morbidity and mortality, but the research evidence on which GPs and district nurses can base their practice is limited.Aim
To review the existing literature concerning how GPs and district nurses think they should care for patients who are bereaved and how they do care for them.Design
Systematic literature review.Method
Searches of AMED, BNI, CINAHL, EMBASE, Medline and PsychInfo databases were undertaken, with citation searches of key papers and hand searches of two journals. Inclusion criteria were studies containing empirical data relating to adult bereavement care provided by GPs and district nurses. Information from data extraction forms were analysed using NVivo software, with a narrative synthesis of emergent themes.Results
Eleven papers relating to GPs and two relating to district nurses were included. Both groups viewed bereavement care as an important and satisfying part of their work, for which they had received little training. They were anxious not to ‘medicalise’ normal grief. Home visits, telephone consultations, and condolence letters were all used in their support of bereaved people.Conclusion
A small number of studies were identified, most of which were >10 years old, from single GP practices, or small in size and of limited quality. Although GPs and district nurses stated a preference to care for those who were bereaved in a proactive fashion, little is known of the extent to which this takes place in current practice, or the content of such care. 相似文献18.
Christian D Mallen George Peat Elaine Thomas Kate M Dunn Peter R Croft 《The British journal of general practice》2007,57(541):655-661
BACKGROUND: Estimating the future course of musculoskeletal pain is an important consideration in the primary care consultation for patients and healthcare professionals. Studies of prognostic indicators tend to have been viewed in relation to each site separately, however, an alternative view is that some prognostic indicators may be common across different sites of musculoskeletal pain. AIM: To identify generic prognostic indicators for patients with musculoskeletal pain in primary care. DESIGN OF STUDY: Systematic review. SETTING: Observational cohort studies in primary care. METHOD: MEDLINE, EMBASE, PsychINFO and CINAHL electronic databases were searched from inception to April 2006. Inclusion criteria were that the study was a primary care-based cohort, published in English and contained information on prognostic indicators for musculoskeletal conditions. RESULTS: Forty-five studies were included. Eleven factors, assessed at baseline, were found to be associated with poor outcome at follow up for at least two different regional pain complaints: higher pain severity at baseline, longer pain duration, multiple-site pain, previous pain episodes, anxiety and/or depression, higher somatic perceptions and/or distress, adverse coping strategies, low social support, older age, higher baseline disability, and greater movement restriction. CONCLUSION: Despite substantial heterogeneity in the design and analysis of original studies, this review has identified potential generic prognostic indicators that may be useful when assessing any regional musculoskeletal pain complaint. However, Its unclear whether these indicators, used alone, or in combination, can correctly estimate the likely course of individual patients' problems. Further research is needed, particularly in peripheral joint pain and using assessment methods feasible for routine practice. 相似文献
19.
Background
Older patients presenting to GPs with musculoskeletal pain are at high risk of having concurrent depression.Aim
To investigate the performance of ultra-short (1–4 items tools) screening questions used during the consultation, and through a patient questionnaire to detect depressive symptoms among older adults presenting with musculoskeletal pain to general practice.Design of study
Cross-sectional survey, linked GP consultation data.Setting
General practices in central Cheshire, UK.Method
Consecutive patients aged ≥50 years presenting with non-inflammatory musculoskeletal pain were eligible to participate. GPs screened all patients in the consultation for the presence of depressive symptoms using two questions. All patients were sent a postal questionnaire within 1 week of consultation containing the Hospital Anxiety and Depression Scale and the written version of the depression screening questions.Results
The total number of patients included in the study was 428. In total, 35.5% of consulters had comorbid depressive symptoms, with 13.5% experiencing moderate or severe symptoms. Just over half of participants (n = 218/242; 51.4%) screened positive on self-administered screening at home compared with only 78 (20.8%) on GP-administered screening in the consultation. There was little difference between GPadministered and self-administered screening in the probability of depressive symptoms among those who screened positive with regard to exhibiting signs of having depressive symptoms.Conclusion
Older patients consulting their GP with musculoskeletal pain frequently have comorbid mental ill health. Ultrashort depression screening questions administered during the consultation miss a large number of those with depressive symptoms, including six out of eight patients with severe symptoms. An improvement in the performance of screening questions in this patient group or narrowing the definition of ‘high risk’ from all patients aged ≥50 years presenting with musculoskeletal pain could help to improve detection. 相似文献20.
Helene R Voogdt-Pruis George HMI Beusmans Anton PM Gorgels Arnold DM Kester Jan W Van Ree 《The British journal of general practice》2010,60(570):40-46