Abstract:
OBJECTIVE:To identify differences between patients viewed as frustrating by their physicians and those considered typical and satisfying. DESIGN:This cross-sectional observational study focused on psychologically distressed high users of medical services. Frustrating patients were compared with typical and satisfying patients, using data from patient questionnaires, physician assessments, structured psychiatric interviews, and computerized utilization records. SETTING:Group Health Cooperative of Puget Sound, a large health maintenance organization. PATIENTS/PARTICIPANTS:Study patients were in the top decile for ambulatory visits, and bad elevated scores for anxiety, depression, and somatization. Among the 339 patients invited to participate in the study, 251 agreed, and 228 were rated by their physicians. MAIN RESULTS:A substantial proportion (37%) of the high users were viewed as frustrating by their physicians. Physicians' ratings of physical disease severity did not differ among the groups, but frustrating patients rated their own health status less favorably and reported more somatic symptoms and disabilities. The frustrating group utilized more medical services than did other distressed high utilizers. All three groups had a high prevalence of mental disorders. However, frustrating patients had higher rates of somatization and generalized anxiety disorder. CONCLUSIONS:Physicians and their frustrating patients had contrasting views of the patients' illnesses. The best predictors of physician frustration were somatization and increased medical service utilization. There is need for further research and clinical attention concerning optimal clinical management for patients with somatization.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Lin EH,Katon W,Von Korff M,Bush T,Lipscomb P,Russo J,Wagner Edoi
10.1007/BF02598969subject
Has Abstractpub_date
1991-05-01 00:00:00pages
241-6issue
3eissn
0884-8734issn
1525-1497journal_volume
6pub_type
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
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更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Sexual dysfunction is an important issue that affects many cancer survivors who are increasingly being cared for by internists. OBJECTIVE:To examine the attitudes and reported practices of internists regarding survivorship care as it pertains to sexual dysfunction. DESIGN:Surveys were sent to 406 physician...
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更新日期:2014-03-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
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更新日期:2005-10-01 00:00:00
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更新日期:2006-10-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2000-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2014-02-01 00:00:00
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更新日期:2019-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00624.x
更新日期:2006-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-07-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:1986-11-01 00:00:00
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更新日期:1995-03-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:2014-01-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:2007-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2008-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1046/j.1525-1497.2002.10405.x
更新日期:2002-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s11606-011-1788-4
更新日期:2011-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05982-0
更新日期:2020-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-04-01 00:00:00