Patients' descriptions of the relation between physical symptoms and negative emotions: a qualitative analysis of primary care consultationsBekhuis, E., Gol, J., Burton, C. & Rosmalen, J., Feb-2020, In : British Journal of General Practice. 70, 691, p. E78-E85 8 p.
Research output: Contribution to journal › Article › Academic › peer-review
Primary care guidelines for the management of persistent, often 'medically unexplained', physical symptoms encourage GPs to discuss with patients how these symptoms relate to negative emotions. However, many GPs experience difficulties in reaching a shared understanding with patients.
To explore how patients with persistent symptoms describe their negative emotions in relation to their physical symptoms in primary care consultations, in order to help GPs recognise the patients starting points in such discussions.
Design and setting
A qualitative analysis of 47 audiorecorded extended primary care consultations with 15 patients with persistent physical symptoms.
The types of relationships patients described between their physical symptoms and their negative emotions were categorised using content analysis. In a secondary analysis, the study explored whether patients made transitions between the types of rotations they described through the course of the consultations.
All patients talked spontaneously about their negative emotions. Three main categories of relations between these emotions and physical symptoms were identified: separated (negation of a link between the two); connected (symptom and emotion are distinct entities that are connected); and inseparable (symptom and emotion are combined within a single entity). Some patients showed a transition between categories of relations during the intervention.
Patients describe different types of relations between physical symptoms and negative emotions in consultations. Physical symptoms can be attributed to emotions when patients introduce this link themselves. but this link tends to be denied when introduced by the GP. Awareness of the ways patients discuss these relations could help GPs to better understand the patient's view and, in this way, collaboratively move towards constrictive explanations and symptom management strategies.
|Number of pages||8|
|Journal||British Journal of General Practice|
|Early online date||17-Dec-2019|
|Publication status||Published - Feb-2020|
- communication, consultation, emotions, medically unexplained symptoms, relation, MEDICALLY UNEXPLAINED SYMPTOMS, GENERAL-PRACTITIONERS, REATTRIBUTION, CUES, INTERVENTION, SOMATIZATION, PREVALENCE, MANAGEMENT, DISORDERS, DOCTORS