Perceived Family Criticism and Primary Care Utilization: Psychosocial and Biomedical Pathways |
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| Authors: | KEVIN FISCELLA M.D. M.P.H. PETER FRANKS M.D. CLEVELAND G. SHIELDS Ph.D. |
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| Affiliation: | Assistant Professor of Family Medicine, Primary Care Institute, Highland Hospital, Departments of Family Medicine and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester NY.;Professor of Family Medicine, Primary Care Institute, Highland Hospital, Departments of Family Medicine and Psychiatry, University of Rochester School of Medicine and Dentistry. Send correspondence to Dr. Franks at the Family Medicine Center, 885 South Avenue, Rochester NY 14618.;Associate Professor of Family Medicine and Psychiatry, Director of the Wynne Center for Family Research, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester NY. |
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| Abstract: | We explored the relationship of perceived family criticism to subsequent healthcare utilization in patients attending a family medicine center. We examined: a) the relationship of perceived criticism to subsequent utilization for biomedical and psychosocial/somatic problems; b) the mediating effects of self-rated mental health and physical function; and c) the mediating effects of social support. The analyses were adjusted for age, sex, race, education, health insurance, and marital status. Higher perceived criticism predicted more psychosocial/somatic and biomedical visits. The relationship of perceived criticism with psychosocial/somatic visits was entirely mediated through self-rated mental health. The relationship of perceived criticism with biomedical visits was partly mediated through self-rated physical function and, in part, independent. Social support played no role in explaining these relationships. Further research is needed to determine whether lowering perceived family criticism lowers primary care utilization. |
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