The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultations

Abstract Background It is unknown whether patients with medically unexplained symptoms (MUS) differ from patients with medically explained symptoms (MES) regarding their expectations and experiences on task‐oriented communication (ie, communication in which the primary focus is on exchanging medical...

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Main Authors: Juul Houwen, Bas J. E. Moorthaemer, Peter L. B. J. Lucassen, Reinier P. Akkermans, Willem J. J. Assendelft, Tim C. olde Hartman, Sandra vanDulmen
Format: Article
Language:English
Published: Wiley 2019-06-01
Series:Health Expectations
Subjects:
Online Access:https://doi.org/10.1111/hex.12854
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author Juul Houwen
Bas J. E. Moorthaemer
Peter L. B. J. Lucassen
Reinier P. Akkermans
Willem J. J. Assendelft
Tim C. olde Hartman
Sandra vanDulmen
author_facet Juul Houwen
Bas J. E. Moorthaemer
Peter L. B. J. Lucassen
Reinier P. Akkermans
Willem J. J. Assendelft
Tim C. olde Hartman
Sandra vanDulmen
author_sort Juul Houwen
collection DOAJ
description Abstract Background It is unknown whether patients with medically unexplained symptoms (MUS) differ from patients with medically explained symptoms (MES) regarding their expectations and experiences on task‐oriented communication (ie, communication in which the primary focus is on exchanging medical content), affect‐oriented communication (ie, communication in which the primary focus is on the emotional aspects of the interaction) and therapy‐oriented communication (ie, communication in which the primary focus is on therapeutic aspects) of the consultation and the extent to which GPs meet their expectations. Objective This study aims to explore (a) differences in patients’ expectations and experiences in consultations with MUS patients and patients with MES and (b) the influence of patients’ experiences in these consultations on their post‐visit anxiety level. Study design Prospective cohort. Setting Eleven Dutch general practices. Measurements Patients completed the QUOTE‐COMM (Quality Of communication Through the patients’ Eyes) questionnaire before and after the consultation to assess their expectations and experiences and these were related to changes in patients’ state anxiety (abbreviated State‐Trait Anxiety Inventory; STAI). Results Expectations did not differ between patients with MUS and MES. Patients presenting with either MUS or MES rated their experiences for task‐related and affect‐oriented communication of their GP higher than their expectations. GPs met patients’ expectations less often on task‐oriented communication in MUS patients compared to MES patients (70.2% vs 80.9%; P = ˂0.001). Affect‐oriented communication seems to be most important in reducing the anxiety level of MUS patients (β −0.63, 95% Cl = −1.07 to −0.19). Discussion Although the expectations of MUS patients are less often met compared to those of MES patients, GPs often communicate according to patients’ expectations. Experiencing affect‐oriented communication is associated with a stronger reduction in anxiety in patients with MUS than in those with MES. Conclusion GPs communicate according to patients’ expectations. However, GPs met patients’ expectations on task‐oriented communication less often in patients with MUS compared to patients with MES. Experiencing affect‐oriented communication had a stronger association with the post‐consultation anxiety for patients with MUS than MES.
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spelling doaj.art-b3b5061374444fc5a8c34b93915ce2b32022-12-22T01:47:55ZengWileyHealth Expectations1369-65131369-76252019-06-0122333834710.1111/hex.12854The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultationsJuul Houwen0Bas J. E. Moorthaemer1Peter L. B. J. Lucassen2Reinier P. Akkermans3Willem J. J. Assendelft4Tim C. olde Hartman5Sandra vanDulmen6Department of Primary and Community Care Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The NetherlandsDepartment of Primary and Community Care Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The NetherlandsDepartment of Primary and Community Care Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The NetherlandsDepartment of Primary and Community Care Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The NetherlandsDepartment of Primary and Community Care Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The NetherlandsDepartment of Primary and Community Care Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The NetherlandsDepartment of Primary and Community Care Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The NetherlandsAbstract Background It is unknown whether patients with medically unexplained symptoms (MUS) differ from patients with medically explained symptoms (MES) regarding their expectations and experiences on task‐oriented communication (ie, communication in which the primary focus is on exchanging medical content), affect‐oriented communication (ie, communication in which the primary focus is on the emotional aspects of the interaction) and therapy‐oriented communication (ie, communication in which the primary focus is on therapeutic aspects) of the consultation and the extent to which GPs meet their expectations. Objective This study aims to explore (a) differences in patients’ expectations and experiences in consultations with MUS patients and patients with MES and (b) the influence of patients’ experiences in these consultations on their post‐visit anxiety level. Study design Prospective cohort. Setting Eleven Dutch general practices. Measurements Patients completed the QUOTE‐COMM (Quality Of communication Through the patients’ Eyes) questionnaire before and after the consultation to assess their expectations and experiences and these were related to changes in patients’ state anxiety (abbreviated State‐Trait Anxiety Inventory; STAI). Results Expectations did not differ between patients with MUS and MES. Patients presenting with either MUS or MES rated their experiences for task‐related and affect‐oriented communication of their GP higher than their expectations. GPs met patients’ expectations less often on task‐oriented communication in MUS patients compared to MES patients (70.2% vs 80.9%; P = ˂0.001). Affect‐oriented communication seems to be most important in reducing the anxiety level of MUS patients (β −0.63, 95% Cl = −1.07 to −0.19). Discussion Although the expectations of MUS patients are less often met compared to those of MES patients, GPs often communicate according to patients’ expectations. Experiencing affect‐oriented communication is associated with a stronger reduction in anxiety in patients with MUS than in those with MES. Conclusion GPs communicate according to patients’ expectations. However, GPs met patients’ expectations on task‐oriented communication less often in patients with MUS compared to patients with MES. Experiencing affect‐oriented communication had a stronger association with the post‐consultation anxiety for patients with MUS than MES.https://doi.org/10.1111/hex.12854anxietyconsultationdoctor‐patient communicationexpectationsgeneral practicemedically unexplained symptoms
spellingShingle Juul Houwen
Bas J. E. Moorthaemer
Peter L. B. J. Lucassen
Reinier P. Akkermans
Willem J. J. Assendelft
Tim C. olde Hartman
Sandra vanDulmen
The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultations
Health Expectations
anxiety
consultation
doctor‐patient communication
expectations
general practice
medically unexplained symptoms
title The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultations
title_full The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultations
title_fullStr The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultations
title_full_unstemmed The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultations
title_short The association between patients’ expectations and experiences of task‐, affect‐ and therapy‐oriented communication and their anxiety in medically unexplained symptoms consultations
title_sort association between patients expectations and experiences of task affect and therapy oriented communication and their anxiety in medically unexplained symptoms consultations
topic anxiety
consultation
doctor‐patient communication
expectations
general practice
medically unexplained symptoms
url https://doi.org/10.1111/hex.12854
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