TY - JOUR
T1 - Sub-optimal patient and physician communication in primary care consultations
T2 - its relation to severe and difficult asthma
AU - Moffat, Mandy
AU - Cleland, Jennifer
AU - van der Molen, Thys
AU - Price, David
PY - 2006/6/1
Y1 - 2006/6/1
N2 - Introduction: Asthma control can be influenced by a range of non-medical issues, including psychosocial factors. Little is known about the views of patients, particularly those with severe and/or difficult asthma, towards their asthma control and their asthma-related primary care consultations. Aims and objectives: To explore patients' experiences of their asthma and primary care asthma consultations in order to identify target areas for intervention. Methods: This was a qualitative study of 14 asthma patients based in grounded theory. Questions were asked about: asthma understanding; control issues; and interactions with primary care health professionals. Data were analysed using the constant comparative method and framework approach. Results: Participants with severe and/or difficult asthma normalised control issues, were reluctant to discuss non-medical factors with healthcare professionals (HCPs), reported poorer communication with HCPs, and were reluctant to raise relevant but non-medical factors in the consultation. Conclusions: Our data identifies that patients, particularly those with severe and/or difficult asthma and poor control, underplay symptoms and do not discuss non-medical factors which may impact on asthma control in primary care consultations. This poor communication is associated with patients underestimating disease severity and/or what could be achieved in terms of disease control. Training HCPs in the use of patient-centred communication skills may optimise asthma management in primary care.
AB - Introduction: Asthma control can be influenced by a range of non-medical issues, including psychosocial factors. Little is known about the views of patients, particularly those with severe and/or difficult asthma, towards their asthma control and their asthma-related primary care consultations. Aims and objectives: To explore patients' experiences of their asthma and primary care asthma consultations in order to identify target areas for intervention. Methods: This was a qualitative study of 14 asthma patients based in grounded theory. Questions were asked about: asthma understanding; control issues; and interactions with primary care health professionals. Data were analysed using the constant comparative method and framework approach. Results: Participants with severe and/or difficult asthma normalised control issues, were reluctant to discuss non-medical factors with healthcare professionals (HCPs), reported poorer communication with HCPs, and were reluctant to raise relevant but non-medical factors in the consultation. Conclusions: Our data identifies that patients, particularly those with severe and/or difficult asthma and poor control, underplay symptoms and do not discuss non-medical factors which may impact on asthma control in primary care consultations. This poor communication is associated with patients underestimating disease severity and/or what could be achieved in terms of disease control. Training HCPs in the use of patient-centred communication skills may optimise asthma management in primary care.
KW - Asthma
KW - Patient experiences
KW - Professional-patient communication
KW - Qualitative study
KW - Symptom control
UR - http://www.scopus.com/inward/record.url?scp=33744506255&partnerID=8YFLogxK
U2 - 10.1016/j.pcrj.2006.02.006
DO - 10.1016/j.pcrj.2006.02.006
M3 - Article
C2 - 16757396
AN - SCOPUS:33744506255
SN - 1471-4418
VL - 15
SP - 159
EP - 165
JO - Primary Care Respiratory Journal
JF - Primary Care Respiratory Journal
IS - 3
ER -