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Biomedical subjects

Geoff Earnshaw

Publications and source records attributed to Geoff Earnshaw.

2 recordsLinked to original sources

A comparison of GPs and nurses in their approach to psychological disturbance in primary care consultations.

It has frequently been reported that GPs fail to diagnose many of the psychological problems that present to them. It also appears that practice nurses working in primary care also show similar diagnostic 'failings'. This study extends these observations by reporting the psychiatric diagnostic practices of GPs and nurses working in the same settings of six general practices. After each consultation the health professional involved assessed the degree of psychological morbidity and the amount of time they had spent attending to this problem. The health professionals' assessment was compared with the score from a General Health Questionnaire completed by the patient. Analysis of 1646 consultations revealed that GPs saw patients with more psychological problems than nurses. Nurses, however, spent significantly more time dealing with their psychological workload than their GP colleagues, after allowing for the fact that they saw fewer patients in this category. This observation raises the question of whether this use of scarce time resource in the consultation is appropriate.

Family Practice↗

What constructs do GPs use when diagnosing psychological problems?

BACKGROUND: The mismatch between general practice and psychiatric diagnosis of psychological problems has been frequently reported. AIMS: To identify which items from the 28-item general health questionnaire (GHQ-28) best predicted general practitioners' (GPs') own assessments of morbidity and the proportion of time spent in consultations on psychological problems. DESIGN OF STUDY: Cross-sectional survey. SETTING: General practice in southeast London. METHOD: Eight hundred and five consultations were carried out by 47 GPs, during which patients completed the 28-item GHQ, and doctors independently assessed the degree of psychological disturbance and the proportion of the consultation spent on psychological problems. Data from the consultations were entered into a stepwise multiple regression to determine the best GHQ-item predictors of GP judgements. RESULTS: GPs' assessments of the degree of psychological disturbance were best predicted using only seven GHQ items, and their perceptions of the proportion of time spent on psychological problems were predicted by only four items. Items were drawn predominantly from the 'anxiety and insomnia' and 'severe depression' sub-scales, ignoring the 'somatic' and 'social dysfunction' dimensions. CONCLUSION: In diagnosing psychological disturbance GPs ignore major symptom areas that psychiatrists judge important.

Adolescent↗