Patients’ ideas, concerns, expectations and satisfaction in primary health care – a questionnaire study of patients and health care professionals’ perspectives

Joel Freilich,Eivor Wiking,Gunnar H Nilsson,Christina Olsson

doi:10.1080/02813432.2019.1684430

Joel Freilich, Eivor Wiking + Show 2 more

Open Access

https://doi.org/10.1080/02813432.2019.1684430

Copy DOI

Abstract

Objective: Explore the perceptions of patients and health care professionals about patients’ ideas, concerns, expectations (ICE), and satisfaction in consultations with general practitioners (GPs), district nurses (DNs) and physiotherapists (PTs).Design: Cross-sectional questionnaire study of participants in planned consultations.Setting: Five primary health care centers and two rehabilitation centers in Stockholm, Sweden.Subjects: Pairs of patients and GPs (n = 156), patients and DNs (n = 73), and patients and PTs (n = 69).Main outcome measures: Multiple-choice questions about patients’ ICE and satisfaction.Results: Approximately 75% of patients and GPs reported that patients’ thoughts and explanations about their symptoms emerged during the consultation. For patient-DN pairs, the figure was 60%, and for patient-PT pairs, 80%. A majority of patients reported not having concerns and anxiety about the investigation/treatment, whereas health care professionals thought patients were more concerned. One-third of patients consulting GPs and PTs expected to receive a reason/explanation for their symptoms. Figures were lower for the DNs. About 70% of patients were satisfied with the consultation.Conclusions: Most patients expressed their ideas, a minority had concerns, and a minority expected an explanation of their illness. Patients and health care professionals rated patient satisfaction high, but health care professionals tended to believe patients were less satisfied than patients reported they were.Key pointsPatient surveys show that important aspects of patient-centeredness remain weak in Swedish primary health care; for example, shared decision-making.In this study of planned consultations, few patients expected to receive an explanation of their symptoms, but most were satisfied with the consultation.Health care professionals thought patients’ experiences were more negative than they were.This discrepancy was observed in responses to questions about patients’ concerns, expectations and satisfaction.

Highlights

IntroductionMost patients have a particular agenda, which often includes ideas about the cause of the consultation [1]
A patient-centered consultation starts with eliciting the patient’s perspective
The research group was familiar with the centers in the area, and the 10 Primary health care (PHC) centers were chosen because their staff situation was stable and they had shown previous interest in research

Summary

Introduction

Most patients have a particular agenda, which often includes ideas about the cause of the consultation [1]. In many cases, they have an explanation of why they do not feel well [1,2]. Earlier studies have shown that patients do not always express their entire agenda in consultations, which can lead to misunderstandings and poor outcomes, such as unwanted prescriptions and nonadherence to treatment [3]. In patient-centered consultations, health care professionals aim to share understanding and decisionmaking with patients [6]. This involves empathy with and respect for the patient. Patient-centeredness may lead to increased patient satisfaction [7,8], better adherence to treatment [9,10], less need for investigations and fewer prescriptions [11,12], fewer referrals [13], better health outcomes [10,14] and less health care utilization [13,15]

Methods

Results

Discussion

Conclusion