What general practitioners (do not) say during consultations with patients with medically unexplained symptoms: A quantitative multilevel analysis

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2016-10-03
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en
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Experts suggest that general practitioners (GPs) should communicative positively during consultations with patients with medically unexplained symptoms (MUS), but it remains unclear what positive communication entails. The current study aims quantify linguistic elements in doctor-patient communication on MUS versus MES (medically explained symptoms). Coders identified and categorised frames and negations in GPs’ judgmental expressions (N = 2604, 21% double-coded) of 82 transcribed doctor-patient consultations of 18 GPs. Anxiety was assessed with patient questionnaires. Multilevel models showed that, compared to MES patients, patients with MUS were more likely to receive negatively loaded messages, i.e., positive messages in a negated (“not bad”) rather than direct manner (“good”), or negative messages in a direct (“bad”) rather than negated way (“not good”). Negatively loaded messages predicted changes in patient anxiety. Findings show that GPs tend to use negative wordings to explain symptoms and give treatment advice for patients with MUS, but patients would benefit from hearing more positively loaded messages instead.
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