Patient requests in family practice: a focal point for clinical negotiations

A growing body of literature has stressed the importance of eliciting the patient's views on the management of health and illness. In particular, it is recognized that patients frequently enter into clinical encounters with specific requests for services, that is ideas about how they hope to be helped. The present investigation examined the following two questions: what kinds of requests do adult patients coming to a family practice center have prior to seeing the doctor; and will factor analysis of a 25-item patient request questionnaire provide evidence of the basic or most common dimensions of patient requests in this population? Two newly-developed instruments were administered to a sample of 144 adult patients before their visit to the doctor. Factor analysis yielded five major request factors--'medical information', 'psychosocial assistance', 'therapeutic listening', 'general health advice', and 'biomedical treatment'--partially replicating the findings of an earlier pilot study. The clinical implications of eliciting patient requests in the light of current behavioural and social science research into the doctor-patient relationship are discussed. Future research directions are also outlined.