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Patient-physician interaction in general practice and health inequalities in a multidisciplinary study: design, methods and feasibility in the French INTERMEDE study.

Kelly-Irving M, Rolland C, Afrite A, Cases C, Dourgnon P, Lombrail P, Pascal J, Lang T - BMC Health Serv Res (2009)

Bottom Line: The design and methodology used in this study were both successfully implemented, and readily accepted by doctors and patients alike.This type of multidisciplinary study shows great potential in providing further knowledge into the role of patient/physician interaction and its influence on maintaining or producing health inequalities.The next challenge in this study will be implementing the multidisciplinary approach during the data analysis.

View Article: PubMed Central - HTML - PubMed

Affiliation: UMR INSERM 558 Epidémiologie et analyses en santé publique, Faculté de medicine, F-31073 Toulouse, France. kelly@cict.fr

ABSTRACT

Background: The way in which patients and their doctors interact is a potentially important factor in optimal communication during consultations as well as treatment, compliance and follow-up care. The aim of this multidisciplinary study is to use both qualitative and quantitative methods to explore the 'black box' that is the interaction between the two parties during a general practice consultation, and to identify factors therein that may contribute to producing health inequalities. This paper outlines the original multidisciplinary methodology used, and the feasibility of this type of study.

Methods and design: The study design combines methodologies on two separate samples in two phases. Firstly, a qualitative phase collected ethnographical and sociological data during consultation, followed by in-depth interviews with both patients and doctors independently. Secondly, a quantitative phase on a different sample of patients and physicians collected data via several questionnaires given to patients and doctors consisting of specific 'mirrored' questions asked post-consultation, as well as collecting information on patient and physician characteristics.

Discussion: The design and methodology used in this study were both successfully implemented, and readily accepted by doctors and patients alike. This type of multidisciplinary study shows great potential in providing further knowledge into the role of patient/physician interaction and its influence on maintaining or producing health inequalities. The next challenge in this study will be implementing the multidisciplinary approach during the data analysis.

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Diagram of quantitative sample.
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Figure 1: Diagram of quantitative sample.

Mentions: Overall the sample consisted of 27 GPs from three French regions (IF, MP and PL) who were recruited on a volunteer basis via GP networks: the Toulouse Department for general medicine and the French society for general medicine. Though variations on the age, sex, seniority and type of practice are present within the group of GPs, they by no means represent the full spectrum of practicing physicians in urban France. In total 1035 patients were approached by the researchers in the different GP waiting rooms at the three sites (see Table 2). Among these 710 (69%) fulfilled the eligibility criteria for inclusion. By the end of the data collection period 125 individuals had either refused to participate (n = 103) or abandoned the study (n = 22). The final overall sample for the quantitative phase is therefore 585 patients, which represents 82% of the sample of eligible patients (see Figure 1).


Patient-physician interaction in general practice and health inequalities in a multidisciplinary study: design, methods and feasibility in the French INTERMEDE study.

Kelly-Irving M, Rolland C, Afrite A, Cases C, Dourgnon P, Lombrail P, Pascal J, Lang T - BMC Health Serv Res (2009)

Diagram of quantitative sample.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2684738&req=5

Figure 1: Diagram of quantitative sample.
Mentions: Overall the sample consisted of 27 GPs from three French regions (IF, MP and PL) who were recruited on a volunteer basis via GP networks: the Toulouse Department for general medicine and the French society for general medicine. Though variations on the age, sex, seniority and type of practice are present within the group of GPs, they by no means represent the full spectrum of practicing physicians in urban France. In total 1035 patients were approached by the researchers in the different GP waiting rooms at the three sites (see Table 2). Among these 710 (69%) fulfilled the eligibility criteria for inclusion. By the end of the data collection period 125 individuals had either refused to participate (n = 103) or abandoned the study (n = 22). The final overall sample for the quantitative phase is therefore 585 patients, which represents 82% of the sample of eligible patients (see Figure 1).

Bottom Line: The design and methodology used in this study were both successfully implemented, and readily accepted by doctors and patients alike.This type of multidisciplinary study shows great potential in providing further knowledge into the role of patient/physician interaction and its influence on maintaining or producing health inequalities.The next challenge in this study will be implementing the multidisciplinary approach during the data analysis.

View Article: PubMed Central - HTML - PubMed

Affiliation: UMR INSERM 558 Epidémiologie et analyses en santé publique, Faculté de medicine, F-31073 Toulouse, France. kelly@cict.fr

ABSTRACT

Background: The way in which patients and their doctors interact is a potentially important factor in optimal communication during consultations as well as treatment, compliance and follow-up care. The aim of this multidisciplinary study is to use both qualitative and quantitative methods to explore the 'black box' that is the interaction between the two parties during a general practice consultation, and to identify factors therein that may contribute to producing health inequalities. This paper outlines the original multidisciplinary methodology used, and the feasibility of this type of study.

Methods and design: The study design combines methodologies on two separate samples in two phases. Firstly, a qualitative phase collected ethnographical and sociological data during consultation, followed by in-depth interviews with both patients and doctors independently. Secondly, a quantitative phase on a different sample of patients and physicians collected data via several questionnaires given to patients and doctors consisting of specific 'mirrored' questions asked post-consultation, as well as collecting information on patient and physician characteristics.

Discussion: The design and methodology used in this study were both successfully implemented, and readily accepted by doctors and patients alike. This type of multidisciplinary study shows great potential in providing further knowledge into the role of patient/physician interaction and its influence on maintaining or producing health inequalities. The next challenge in this study will be implementing the multidisciplinary approach during the data analysis.

Show MeSH