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Titolo:
Unsaid but not forgotten - Patients' unvoiced desires in office visits
Autore:
Bell, RA; Kravitz, RL; Thom, D; Krupat, E; Azari, R;
Indirizzi:
Univ Calif Davis, Dept Commun, Davis, CA 95616 USA Univ Calif Davis DavisCA USA 95616 vis, Dept Commun, Davis, CA 95616 USA Univ Calif Davis, Dept Stat, Davis, CA 95616 USA Univ Calif Davis Davis CA USA 95616 Davis, Dept Stat, Davis, CA 95616 USA Univ Calif Davis, Ctr Hlth Serv Res Primary Care, Davis, CA 95616 USA UnivCalif Davis Davis CA USA 95616 Res Primary Care, Davis, CA 95616 USA Univ Calif Davis, Med Ctr, Davis, CA 95616 USA Univ Calif Davis Davis CA USA 95616 f Davis, Med Ctr, Davis, CA 95616 USA Stanford Univ, Sch Med, Div Family & Community Med, Stanford, CA USA Stanford Univ Stanford CA USA v Family & Community Med, Stanford, CA USA Massachusetts Coll Pharm & Allied Hlth Serv, Boston, MA USA Massachusetts Coll Pharm & Allied Hlth Serv Boston MA USA Boston, MA USA
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 16, volume: 161, anno: 2001,
pagine: 1977 - 1984
SICI:
0003-9926(20010910)161:16<1977:UBNF-P>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
SHARED DECISION-MAKING; PATIENTS EXPECTATIONS; PRIMARY-CARE; SATISFACTION; REQUESTS; PERCEPTIONS; BEHAVIOR; QUALITY; AGENDA; TRUST;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Bell, RA Univ Calif Davis, Dept Commun, Davis, CA 95616 USA Univ Calif Davis Davis CA USA 95616 Commun, Davis, CA 95616 USA
Citazione:
R.A. Bell et al., "Unsaid but not forgotten - Patients' unvoiced desires in office visits", ARCH IN MED, 161(16), 2001, pp. 1977-1984

Abstract

Objectives: To examine patient, physician, and health care system characteristics associated with unvoiced desires for action, as well as the consequences of these unspoken requests. Patients and Methods: Patient surveys were administered before, immediately after, and 2 weeks after outpatient visits in the practices of 45 family practice, internal medicine, and cardiology physicians working in a multispecialty group practice or group model health maintenance organization. Datawere collected at the index visit from 909 patients, of whom 97.6% were surveyed 2 weeks after the outpatient visit. Before the visit, patients ratedtheir trust in the physician, health concerns, and health status. After the visit, patients reported on various types of unexpressed desires and rated their visit satisfaction. At follow-up, patients rated their satisfaction, health concerns, and health status, and also described their postvisit health care use. Evaluations of the visit were also obtained from physicians. Results: Approximately 9% of the patients had I or more unvoiced desire(s). Desires for referrals (16.5% of desiring patients) and physical therapy (8.2%) were least likely to be communicated. Patients with unexpressed desires tended to be young, undereducated, and unmarried and were less likely totrust their physician. Patients with unvoiced desires evaluated the physician and visit less positively;, these encounters were evaluated by physicians as requiring more effort. Holding an unvoiced desire was associated withless symptom improvement, but did not affect postvisit health care use. Conclusions: Patients' unvoiced needs affect patients' and physicians' visit evaluations and patients' subjective perceptions of improvement. Implications of these findings for clinical practice are examined.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/09/20 alle ore 23:37:41