The effects of patient's frequency of attendance and etiology of symptoms,on the General Practitioners wellbeing |
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Affiliation: | 1. Department of Psychology, Rey Juan Carlos University, Alcorcón, Spain;2. Behavioral Sciences Methodology Department, Complutense of Madrid University, Madrid, Spain;1. Department of General Psychology, University of Padua, Padua, Italy;2. Department of Psychology, California State University, Los Angeles, USA;3. FISPPA Department, University of Padua, Padua, Italy;1. Université de Toulouse, Toulouse, France;2. École Pratique des Hautes Études, 31830 Paris, France;1. Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal;2. Laboratory for Applied Health Research (LabinSaúde), Coimbra, Portugal;3. University of Coimbra, Faculty of Psychology and Education Sciences, Coimbra, Portugal;1. CERPPS, Université de Toulouse, Toulouse, France;2. University of Québec – TELUQ, 5800, rue Saint-Denis, Bureau 1105, Montréal, Québec H2S 3L5, Canada;3. Albany Medical College, Albany Medical Center Internal Medicine and Pediatrics, 1019 New Loudon Road, Cohoes, NY 12047, USA;4. Institute of Advanced Studies (EPHE), Paris, France;5. CLLE, Université de Toulouse, CNRS, Toulouse, France |
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Abstract: | IntroductionThe presence of Medically Unexplained Symptoms and a high Frequency of Attendance negatively affects the General Practitioners’ (GP) wellbeing. Although, overlapping between both phenomena is partial, with a number of frequent attenders reporting medically unexplained symptoms during consultation, there is no evidence on how GP's well-being it is affected by the specific main effects of these factors and their interaction. Evidence is also scant on the psychological processes explaining the negative impact of attendance and the etiology of symptoms on GP's wellbeing.ObjectiveDrawing on the Job Demand-Control and the Conservation of Resource stress models, this paper tests the moderating effects of the GP’ perception of patient's attendance and etiology of symptoms on the relationship between patient's demands and feedback on the GP's wellbeing.MethodA total of 105 volunteer GPs self-reported on the study variables through an experience sampling methodology after 898 patients’ consultation. Patients attendance and etiology of symptoms were categorized according to the physician self-perception and an external criterion (organizational records).ResultsPerception of Patients Frequent Attendance and Medically Unexplained Symptoms were positively related to physician's Emotional Exhaustion. Contrary to expected the test of the moderation effects of patients characteristics on the relation between patient's demands and feedback and the GP's emotional exhaustion were stronger for normal attenders compared with frequent attenders. An ad hoc study shows this unexplained result is related to the GP's expectations on Frequent vs. normal attenders’ behaviors. No significant results were found when the external criterion of classification was used.ConclusionCombined analysis of Frequency of Attendance and Etiology of Symptoms lead to a better understanding of the GP's decreased wellbeing. Also, the perception of the strain level (demands/positive feedback levels) associated to the consultation with different types of patients contribute to explain the consequences for the GP's wellbeing, especially when GP's expectations on patient's behaviors are violated. |
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Keywords: | Medically unexplained symptoms Frequent attendance Primary care Doctor–patient relationship Emotional exhaustion Job-demands Patient feedback Symptômes médicalement inexpliqués Fréquence de visites Soins primaires Relation médecin–patient Épuisement émotionnel Demandes d’emploi Commentaires des patients FA" },{" #name" :" keyword" ," $" :{" id" :" kw0080" }," $$" :[{" #name" :" text" ," _" :" Frequent attenders MES" },{" #name" :" keyword" ," $" :{" id" :" kw0090" }," $$" :[{" #name" :" text" ," _" :" Medically Explained Symptoms MUS" },{" #name" :" keyword" ," $" :{" id" :" kw0100" }," $$" :[{" #name" :" text" ," _" :" Medically Unexplained Symptoms NA" },{" #name" :" keyword" ," $" :{" id" :" kw0110" }," $$" :[{" #name" :" text" ," _" :" Normal Attenders. |
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