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General practitioners' attributions of fatigue
A E de Rijk1, K M Schreurs, J M Bensing
1Department of Clinical and Health Psychology, Utrecht University, The Netherlands.
Social Science & Medicine (1982)
|July 29, 1998
Summary
General practitioners (GPs) attribute fatigue based on patient complaints and underlying conditions, not social factors. These attributions influence consultation styles, shifting towards counseling for psychosocial fatigue.
Area of Science:
- Primary Health Care
- General Practice
- Medical Sociology
Background:
- Fatigue is a common presenting complaint in general practice.
- Understanding how general practitioners (GPs) attribute the causes of fatigue (somatic vs. psychosocial) is crucial for effective patient management.
- Previous research has not fully elucidated the factors influencing these attributions and their impact on consultation dynamics.
Purpose of the Study:
- To examine the somatic-psychosocial attributions of fatigue made by general practitioners.
- To investigate the relationship between patient characteristics, consultation characteristics, and GPs' attributions of fatigue.
- To determine how GPs' attributions of fatigue influence their clinical decision-making during consultations.
Main Methods:
- Analysis of 2097 contact registrations from the Dutch National Study of Morbidity and Intervention in General Practice.
- Multiple regression analysis to explain GPs' attributions using patient-related characteristics (sociodemographic, other complaints, underlying disease/problem).
- Correlation analysis between GPs' attributions and consultation characteristics (examination, procedures, counseling, treatment, prescription, duration).
Main Results:
- Patient-related characteristics explained 26.0% of the variance in GPs' fatigue attributions, with psychosocial complaints being highly influential.
- GPs' attributions were not influenced by sociodemographic characteristics, indicating no discrimination between social groups.
- Psychosocially attributed fatigue correlated with consultations involving less physical examination, more reassurance-seeking procedures, more counseling, less medical treatment, and longer duration.
Conclusions:
- GPs' attributions of fatigue are primarily influenced by the nature of other complaints and underlying diseases/problems, not patient social groups.
- The way GPs attribute fatigue significantly shapes the subsequent management and characteristics of the medical consultation.
- These findings highlight the importance of considering both biomedical and psychosocial factors in understanding fatigue presentations in primary care.