Do multimorbidity and deprivation influence patients' emotional expressions and doctors' responses in primary care consultations? – An exploratory study using multilevel analysis

Zhou, Y., Lundy, J.-M. , Humphris, G. and Mercer, S. W. (2015) Do multimorbidity and deprivation influence patients' emotional expressions and doctors' responses in primary care consultations? – An exploratory study using multilevel analysis. Patient Education and Counseling, 98(9), pp. 1063-1070. (doi: 10.1016/j.pec.2015.05.026) (PMID:26111501)

Abstract

Objective: To explore whether and how patient multimorbidity and socioeconomic deprivation might influence patients’ emotional expression and doctors’ responses in the general practice (GP) consultations.<p></p> Methods: Video recordings of 107 consultations (eight GPs) were coded with the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Multilevel logistic regressions modelled the probability of GP providing space response, considering patient multimorbidity, deprivation conditions and other contextual factors. Further multinomial regressions explored the possible impact of multimorbidity and deprivation on expression of and specific responses to patients’ emotional distress.<p></p> Results: It was less likely for GPs to provide space as the consultation proceeded, controlling for multimorbidity and deprivation variables. Patients with multimorbidity were less likely to express emotional distress in an explicit form. GPs were more likely to provide acknowledgement to emotions expressed by patients from more deprived areas.<p></p> Conclusion: Multimorbidity and deprivation may influence the dynamics of the GP consultations in specific ways. Rigorous methodologies using larger samples are required to explore further how these two variables relate to each other and influence cue expression, provider response and subsequent patient outcomes.<p></p> Practice implications Understanding how multimorbidity and deprivation impact on GP consultations may help inform future service improvement programmes.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mercer, Professor Stewart and Lundy, Dr Jenna-Marie
• Authors: Zhou, Y., Lundy, J.-M., Humphris, G., and Mercer, S. W.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Patient Education and Counseling
• Publisher: Elsevier Ireland Ltd.
• ISSN: 0738-3991
• ISSN (Online): 1873-5134
• Published Online: 16 June 2015
• Copyright Holders: Copyright © 2015 Elsevier Ireland Ltd.
• First Published: First published in Patient Education and Counseling 98(9):1063-1070
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher