Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners
Objectives To examine whether the quality of the patient–physician relationship, assessed by the general practitioner (GP) and the patient, associates with GPs’ use of gut feeling (GF) in cancer diagnosis.Design Cross-sectional questionnaire survey of cancer patients and their GPs.Setting Danish pri...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/7/e027288.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846151113369190400 |
|---|---|
| author | Peter Vedsted Anette Fischer Pedersen Christina Maar Andersen Mads Lind Ingeman |
| author_facet | Peter Vedsted Anette Fischer Pedersen Christina Maar Andersen Mads Lind Ingeman |
| author_sort | Peter Vedsted |
| collection | DOAJ |
| description | Objectives To examine whether the quality of the patient–physician relationship, assessed by the general practitioner (GP) and the patient, associates with GPs’ use of gut feeling (GF) in cancer diagnosis.Design Cross-sectional questionnaire survey of cancer patients and their GPs.Setting Danish primary care.Participants Newly diagnosed cancer patients and their GPs. Patients completed a questionnaire and provided the name of the GP to whom they have presented their symptoms. The named GP subsequently received a questionnaire.Primary and secondary outcome measures GPs’ use of GF in the diagnostic process for the particular patient. GPs who answered that they used their GF ‘to a high degree’ or ‘to a very high degree’ were categorised as ‘used their GF to a great extent’. GPs who answered that they used their GF ‘to some degree’, ‘to a limited degree’ or ‘not at all’ were categorised as ‘limited or no use of GF’.Results GPs were less likely to use GF when they assessed relational aspects of the patient encounter as difficult compared with less difficult (OR=0.67; 95% CI 0.46 to 0.97). The physician-reported level of empathy was positively associated with use of GF (OR=2.60; 95% CI 1.60 to 4.22). The lower use of GF in difficult encounters was not modified by level of empathy.Conclusions Experiencing relational aspects of patient encounter as difficult acted as a barrier for the use of GF in cancer diagnosis. Although physician-rated empathy increased use of GF, high empathy did not dissolve the low use of GF in difficult encounters. As diagnosis of cancer is a key challenge in primary care, it is important that GPs are aware that the sensitivity of cancer-related GF is compromised by a difficult patient–physician relationship. |
| format | Article |
| id | doaj-art-6fb5bf9c72ef49ff80e5e6fc3e0694ca |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-6fb5bf9c72ef49ff80e5e6fc3e0694ca2024-11-28T01:25:07ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2018-027288Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitionersPeter Vedsted0Anette Fischer Pedersen1Christina Maar Andersen2Mads Lind Ingeman3Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, DenmarkDepartment of Clinical Medicine, Aarhus University, Aarhus, DenmarkSteno Diabetes Center Odense, Odense University Hospital, Odense, Denmark3 Acute Medical Admission Unit, Aarhus Universitetshospital, Aarhus, DenmarkObjectives To examine whether the quality of the patient–physician relationship, assessed by the general practitioner (GP) and the patient, associates with GPs’ use of gut feeling (GF) in cancer diagnosis.Design Cross-sectional questionnaire survey of cancer patients and their GPs.Setting Danish primary care.Participants Newly diagnosed cancer patients and their GPs. Patients completed a questionnaire and provided the name of the GP to whom they have presented their symptoms. The named GP subsequently received a questionnaire.Primary and secondary outcome measures GPs’ use of GF in the diagnostic process for the particular patient. GPs who answered that they used their GF ‘to a high degree’ or ‘to a very high degree’ were categorised as ‘used their GF to a great extent’. GPs who answered that they used their GF ‘to some degree’, ‘to a limited degree’ or ‘not at all’ were categorised as ‘limited or no use of GF’.Results GPs were less likely to use GF when they assessed relational aspects of the patient encounter as difficult compared with less difficult (OR=0.67; 95% CI 0.46 to 0.97). The physician-reported level of empathy was positively associated with use of GF (OR=2.60; 95% CI 1.60 to 4.22). The lower use of GF in difficult encounters was not modified by level of empathy.Conclusions Experiencing relational aspects of patient encounter as difficult acted as a barrier for the use of GF in cancer diagnosis. Although physician-rated empathy increased use of GF, high empathy did not dissolve the low use of GF in difficult encounters. As diagnosis of cancer is a key challenge in primary care, it is important that GPs are aware that the sensitivity of cancer-related GF is compromised by a difficult patient–physician relationship.https://bmjopen.bmj.com/content/9/7/e027288.full |
| spellingShingle | Peter Vedsted Anette Fischer Pedersen Christina Maar Andersen Mads Lind Ingeman Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners BMJ Open |
| title | Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners |
| title_full | Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners |
| title_fullStr | Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners |
| title_full_unstemmed | Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners |
| title_short | Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners |
| title_sort | patient physician relationship and use of gut feeling in cancer diagnosis in primary care a cross sectional survey of patients and their general practitioners |
| url | https://bmjopen.bmj.com/content/9/7/e027288.full |
| work_keys_str_mv | AT petervedsted patientphysicianrelationshipanduseofgutfeelingincancerdiagnosisinprimarycareacrosssectionalsurveyofpatientsandtheirgeneralpractitioners AT anettefischerpedersen patientphysicianrelationshipanduseofgutfeelingincancerdiagnosisinprimarycareacrosssectionalsurveyofpatientsandtheirgeneralpractitioners AT christinamaarandersen patientphysicianrelationshipanduseofgutfeelingincancerdiagnosisinprimarycareacrosssectionalsurveyofpatientsandtheirgeneralpractitioners AT madslindingeman patientphysicianrelationshipanduseofgutfeelingincancerdiagnosisinprimarycareacrosssectionalsurveyofpatientsandtheirgeneralpractitioners |