Family Practice, Vol 15, 172-181, Copyright © 1998 by World Organization of Family Doctors
E Laerum, S Steine, A Finset and S Lundevall
BACKGROUND AND OBJECTIVES: Many patients in general practice present with
complex health problems. It is argued that the GP who is in a prime
position to counsel patients with such problems, will, however, often
perceive a lack of tools to manage them. The aim of the present study was
to develop a novel instrument in terms of a patient- administered
questionnaire, the Patient Perspective Survey (PPS), designed to enhance
the quality of clinical communication in the consultation. It is based on a
biopsychosocial patient perspective, patient centredness, patient
resources, involvement and coping, and quality of life orientation.
METHODS: Development of the PPS has included comprehensive literature
research, discussions and advice, during several phases, from groups of
GPs, patients, broad panels of experts and testing in pilot studies. After
many revisions, a 102-item version, consisting of a main somatic, mental
and social domain axis, was evaluated by GPs and patients in 213
consultations. RESULTS: The basic idea, theoretical elements and purpose of
the PPS appeared in general to be well accepted. Seventy-five to
eighty-five per cent of the patients found the questions relevant and easy
to understand and there were high positive scorings regarding influence on
the doctor- patient relationship, communication, resource and coping
aspects, occurrence of new information and general satisfaction with the
consultation. Similar scorings were obtained from the GPs' evaluation. Both
parties agreed that there is a need for a shorter and more specific PPS
version, and that the resource and coping dimension should be even more
extended. CONCLUSIONS: We consider it well documented that there is a need
for this new instrument to deal with complex health problems in general
practice, and that it has promising potentials for consultation
improvement.
ORIGINAL CLINICAL RESEARCH
Complex health problems in general practice: do we need an instrument for consultation improvement and patient involvement? Theoretical foundation, development and user evaluation of the Patient Perspective Survey (PPS)
Department of General Practice and Community Medicine, University of Oslo, Blindern, Norway.
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