PubMed · 14763883
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Pierre Bobin. 2003. Incomprehension.. https://doi.org/10.1489/1544-581x(2003)071%3C0355%3Ae%3E2.0.co%3B2
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Cancer patients vary in their preferred level of involvement in medical decision making, and responding to patients' desired level of involvement is a key element of good medical care. While the literature has clearly demonstrated heterogeneity among cancer patients' preferences, less is known about how the preferences of any given patient may change over time. This longitudinal study compared cancer patients' preferences for involvement in medical decision making from the time of diagnosis to the time of completion of therapy. Data from 729 cancer patients with mixed diagnoses were analyzed. Most patients reported a change in preferred level of involvement over time, and multivariate analysis demonstrated that patients tend to prefer a decreasing level of involvement over time (p<0.0001). Stability of patients' preferences was also associated with type of cancer, but not with other sociodemographic characteristics. The results from this study highlight the importance of reevaluating patients' preferences for involvement in medical decision making throughout the course of cancer therapy, as such preferences are likely to change.
INTRODUCTION: High utilization of medical services has been described for patients with fibromyalgia syndrome (FMS). There are no studies available that assess whether the patients' subjective illness beliefs influence their behavior in utilizing healthcare. METHODS: Examinations were performed by taking the history of pain treatment in 100 FMS patients evaluated by experts for the social court and 25 patients attending an outpatient pain center. The subjective illness theories were drawn from the patients' responses to the German Pain Questionnaire (GPQ). The statements made on the GPQ regarding utilization of healthcare services were compared with the records and the answers given in the interview on pain therapy. RESULTS: Of the patients, 44% specified a somatic, 2% a psychogenic, 9% none, and 45% a psychosomatic illness belief. The patients were classified as high utilizers of specialized medical services in 25% of the cases and of psychiatric-psychotherapeutic services in 14%. No significant correlations between the type of subjective illness theory and utilization of specialized medical or psychiatric-psychotherapeutic services were observed. CONCLUSION: From the psychosomatic viewpoint, only part of the FMS patients exhibited an inordinately one-sided somatic illness belief. The utilization of healthcare services cannot be explained by the subjective perception of the illness.
This study aimed to conduct quantitative and qualitative analyses of anonymous data from an immunisation hotline call centre over equal periods in 1999 and 2003. Transcripts for all telephone calls in two periods were analysed using thematic and descriptive statistical analyses and significance testing of comparisons made between data from the two periods. Caller numbers increased from 1010 in 1999 to 3413 in 2003. There was a significant increase in service utilisation by both the public (mostly parents) and health professionals, especially by general practice nurses. The nature of the enquiries shifted according to schedule changes and media stories. Findings are discussed in the context of prominent issues at that time, and suggestions are made for improving communication to meet the needs of both the public and health professionals.