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

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Final_accepted_author_version.pdf (386.6Kb)
Date
09/2015
Author
Zhou, Yuefang
Lundy, Jenna-Marie
Humphris, Gerald Michael
Mercer, Stewart W
Keywords
The VR-CoDES
Multimorbidity
Deprivation
Emotional distress
General practice
R Medicine (General)
NDAS
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Abstract
Objective: To explore whether and how patient multimorbidity and socioeconomic deprivation conditions might influence patients’ emotional expression and doctors’ responses in the general practice (GP) consultations. 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. 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. 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. Practice implications: Understanding how multimorbidity and deprivation impact on GP consultations may help inform future service improvement programmes.
Citation
Zhou , Y , Lundy , J-M , Humphris , G M & 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 , vol. 98 , no. 9 , pp. 1063–1070 . https://doi.org/10.1016/j.pec.2015.05.026
Publication
Patient Education and Counseling
Status
Peer reviewed
DOI
https://doi.org/10.1016/j.pec.2015.05.026
ISSN
0738-3991
Type
Journal article
Rights
© 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (http://creativecommons.org/licenses/by-nc-nd/4.0/)
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  • University of St Andrews Research
URL
http://www.sciencedirect.com/science/article/pii/S0738399115002712#appd002
URI
http://hdl.handle.net/10023/8995

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