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General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study

Dowrick, Christopher; Gask, Linda; Hughes, John G.; Charles-Jones, Huw; Hogg, Judith A.; Peters, Sarah; Salmon, Peter; Rogers, Anne R. and Morriss, Richard K. (2008) General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study. BMC Family Practice, 9 . Article Number: 46. ISSN 1471-2296

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Abstract

Background: The successful introduction of new methods for managing medically unexplained symptoms in primary care is dependent to a large degree on the attitudes, experiences and expectations of practitioners. As part of an exploratory randomised controlled trial of reattribution training, we sought the views of participating practitioners on patients with medically unexplained symptoms, and on the value of and barriers to the implementation of reattribution in practice. Methods: A nested attitudinal survey and qualitative study in sixteen primary care teams in northwest England. All practitioners participating in the trial (n = 74) were invited to complete a structured survey. Semi-structured interviews were undertaken with a purposive sub-sample of survey respondents, using a structured topic guide. Interview transcripts were used to identify key issues, concepts and themes, which were grouped to construct a conceptual framework: this framework was applied systematically to the data. Results: Seventy (95%) of study participants responded to the survey. Survey respondents often found it stressful to work with patients with medically unexplained symptoms, though those who had received reattribution training were more optimistic about their ability to help them. Interview participants trained in reattribution (n = 12) reported that reattribution increased their confidence to practice in a difficult area, with heightened awareness, altered perceptions of these patients, improved opportunities for team-building and transferable skills. However general practitioners also reported potential barriers to the implementation of reattribution in routine clinical practice, at the level of the patient, the doctor, the consultation, diagnosis and the healthcare context.

Item Type:Article
Additional Information:10 pages (page numbers not for citation purposes). Published: 19 August 2008.
Uncontrolled Keywords:primary care; unexplained symptoms; reattribution
Subjects:R Medicine > R Medicine (General)
Departments, Research Centres and Related Units:Academic Faculties, Institutes and Research Centres > Faculty of Medicine > School of Population, Community & Behavioural Sciences
DOI:10.1186/1471-2296-9-46
Publisher's Statement:© 2008 Dowrick et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Related URLs:
Refereed:Yes
Status:Published
ID Code:893
Deposited On:05 Nov 2008 16:37
Last Modified:28 Feb 2012 11:51

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