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Encounters between medical specialists and patients with medically unexplained physical symptoms; influences of communication on patient outcomes and use of health care: a literature overview Cover

Encounters between medical specialists and patients with medically unexplained physical symptoms; influences of communication on patient outcomes and use of health care: a literature overview

Open Access
|Sep 2012

Figures & Tables

Table 1

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#1

(unexplain* OR (un NEXT/1 explain*) OR (‘not’ NEXT/3 explain*)):de,ab,ti

#2

(nonspecific* OR (non NEXT/1 specific*) OR (‘not’ NEXT/3 specific*)):de,ab,ti

#3

((subjective OR Somatoform OR functional) NEXT/5 (symptom* OR disorder* OR complaint*)):de,ab,ti

#4

((frequent NEXT/1 attend*) OR (high NEXT/1 utili*) OR hypochondri*):de,ab,ti

#5

((Headache OR ‘chest pain’ OR ‘neck pain’ OR ‘pelvic pain’ OR ‘benign pain’ OR ‘back pain’ OR trauma OR ‘chemical sensitivity’ OR gastrointest* OR dyspepsia OR seizure* OR Fatigue OR dizziness OR hysteri* OR premenstrual OR ‘irritable bowel’ OR fibromyalgia) NEAR/3 (psycholog* OR psychogen* OR Psychosom* OR Psychophysiol* OR functional* OR chronic OR syndrome OR non-cardiac OR noncardiac OR Tension OR cumulative OR multiple)):de,ab,ti

#6

#1 OR #2 OR #3 OR #4 OR #5

#7

(specialis* OR specialization OR physician* OR (vocational NEXT/1 trainee*) OR intern OR interns OR resident* OR ‘secondary care’ OR hospital*):de,ab,ti

#8

((professional* OR doctor* OR physician* OR provider*) NEAR/3 patient):de,ab,ti

#9

#6 AND #7 AND #8

Table 2

Overview of included studies

Author, yearRef #

Study design

Study group

Number of patients

Outcome

Intervention/study subject

Effect

Bieber 2008 [30]

RCT

Fibromyalgia syndrome patients

83

Patient satisfaction

A shared decision-making training programme for specialists combined with an information leaflet for patients versus information leaflet only

No difference in patient satisfaction was found in the shared decision making group and the information only group

Bieber 2006 [31]

RCT

Fibromyalgia syndrome patients

67

Functioning

A shared decision-making training programme for specialists combined with an information leaflet for patients versus information leaflet only or standard care as usual

Functional capacity did not differ across the study groups. The patients of the share decision making study group improved coping with pain and being more positive

Collins 2009 [28]

Cohort study

Patients with functional gastrointestinal disorders

13

Health anxiety

Use of health care

Concordance between specialists’ understanding of patients reported symptoms and their actual needs

Underestimating patients’ expectations and symptoms maintained health anxiety and was likely to lead to more use of health care

Van Dulmen 1995 [27]

Cohort study

Patients with functional abdominal pain

110

Patient satisfaction

Health anxiety

Correct perceptions of patients’ attributions and having the same doctor

Reduced health anxiety (p = 0.01) and improved satisfaction by consulting the same doctor (p = 0.02)

Hall-Patch 2010 [25]

Cohort study

Patients with pseudo neurological epileptic seizures

50

Course of symptoms

A patient information leaflet and a communication protocol for neurologists to explain the psychological nature of the seizures

Reduced frequency of seizures

Owens 1995 [32]

Cohort study

Patients with irritable bowel syndrome

112

Use of health care

Physician-patient relationship on use of health care

Reduced number of return visits for IBS-related symptoms

Petrie 2007 [26]

RCT

Patients with nonspecific chest pain

92

Health anxiety

Course of symptoms

Providing information about normal test results before testing

The number of patients still reporting chest pain after 1 month decreased significantly (p < 0.001). Addressing patients’ attributions by information about normal test results prior to testing diminished health anxiety

Stones 2006 [29]

Cohort study

Women with chronic pelvic pain

100

Patient satisfaction

Doctors affect, appropriateness of information and ability to meet patients expectations

Initial consultation influenced further care experiences. Doctors affect, appropriate information and meeting patients’ expectations enhanced patient satisfaction

Fig. 1

Flow chart

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Language: English
Published on: Sep 27, 2012
Published by: Bohn Stafleu van Loghum
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2012 Anne Weiland, Rianne E. Van de Kraats, Annette H. Blankenstein, Jan L. C. M. Van Saase, Henk T. Van der Molen, Wichor M. Bramer, Alexandra M. Van Dulmen, published by Bohn Stafleu van Loghum
This work is licensed under the Creative Commons Attribution 4.0 License.