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The general practitioner's workload and the detection of their patients' psychological problems.
Zantinge, E.M., Verhaak, P.F., Bakker, D.H. de, Meer, K. van der, Bensing, J.M. The general practitioner's workload and the detection of their patients' psychological problems. Occhio Clinico: 2006(suppl. 6) 22. Abstract. 12th Regional Conference of the European Society of General Practice/Family Medicine: "Towards medical renaissance bridging the gap between biology and humanities", Florence, Italy on 27-30 August 2006.
Many mental problems are not detected by the General Practitioner (GP). Recognition of these problems is important because it is one of the critical stages in finding appropriate care for the patient. Mental health care requires extra time investments from the side of the GP and this might be a problem because GPs complain about their increasing workload. We therefore investigated if GP's workload affect the detection of their patients' psychological problems and secondly, if GP's detection is partly determined by their consultation lengths and communication. Data were derived from the Second Dutch National Survey of General Practice, a cross-sectional study conducted in the Netherlands in 2000-2002. 2784 videotaped consultations of a representative selection of 142 GPs were used. The GP's communication was rated by observers according to the Roter Interaction Analysis System. GPs recorded after each consultation if psychological problems were detected. Results showed that GPs are not led by their workload in detecting patients' mental problems. GP's workload does neither affect the length of their consultations nor the communication shown in the consultations. Detection correspond! with longer consultations, showing eye contact and asking questions about psychological topics. Empathy and patidpt centeredness alone are not enough to detect patients' mental problems. A patient with a psychological main reason for encounter is often detected, in contrast to patients with somatic main reasons for encounter with psychological complaints present on the background. Concluding, attention for specific skills needed to discuss mental problems in GP's (vocational) training are recommended.(aut. ref.)
Many mental problems are not detected by the General Practitioner (GP). Recognition of these problems is important because it is one of the critical stages in finding appropriate care for the patient. Mental health care requires extra time investments from the side of the GP and this might be a problem because GPs complain about their increasing workload. We therefore investigated if GP's workload affect the detection of their patients' psychological problems and secondly, if GP's detection is partly determined by their consultation lengths and communication. Data were derived from the Second Dutch National Survey of General Practice, a cross-sectional study conducted in the Netherlands in 2000-2002. 2784 videotaped consultations of a representative selection of 142 GPs were used. The GP's communication was rated by observers according to the Roter Interaction Analysis System. GPs recorded after each consultation if psychological problems were detected. Results showed that GPs are not led by their workload in detecting patients' mental problems. GP's workload does neither affect the length of their consultations nor the communication shown in the consultations. Detection correspond! with longer consultations, showing eye contact and asking questions about psychological topics. Empathy and patidpt centeredness alone are not enough to detect patients' mental problems. A patient with a psychological main reason for encounter is often detected, in contrast to patients with somatic main reasons for encounter with psychological complaints present on the background. Concluding, attention for specific skills needed to discuss mental problems in GP's (vocational) training are recommended.(aut. ref.)
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