Linköping University Post Print Satisfaction is not all : patients ' perceptions of outcome of general practice consultations , a qualitative study

Background: Evaluation of outcome in general practice can be seen from different viewpoints. In this study we focus on the concepts patients use to describe the outcome of a consultation with a GP. Method: Patients were interviewed within a week after a consultation with a GP. The interviews were made with 20 patients in 5 focus groups and 8 individually. They were analysed with a phenomenographic research approach. Results: From the patient's perspective, the outcome of a consultation is about cure or symptom relief, understanding, confirmation, reassurance, change in self-perception and satisfaction. Conclusion: General practice consultations are often more important for patients than generally supposed. Understanding is the most basic concept. Background Evaluation of outcome in general practice can be seen from different viewpoints. Together, the patients' and the professionals' viewpoints make up the clinical perspective on outcome in medicine. Even when limited to those two, evaluation of general practice is a complex matter. Donabedian pointed out the difficulties in defining outcomes in general practice sufficiently to make them measurable [1]. To respond to the diversity and complexity of practice and its consequences, outcome research in general practice must take on many shapes. On the whole, and according to the literature in the field, the professional perspective has dominated. Here, the measurable, bodily effects of treatment or prevention are studied and the methods include epidemiology and various forms of intervention studies, some of them fulfilling the criteria of the RCT. One example of the former is the UKDPS in which development of complications in relation to the care of the diabetic patient is studied [2], while RCTs like "Famciklovir for the treatment of acute herpes zoster" describe the effects of specific treatments [3]. If practising according to the evidence given, the GP has to rely on such research. In the individual case he does not know whether the patient is actually being treated or just taking the medicine. Outcome of treatment is here a forecast with reasonable accuracy. Intermediate outcomes, that are available in practice, such as the levels of blood pressure or HbA1c, may support the forecast, but should not be mistaken for factual outcomes. Published: 24 October 2005 BMC Family Practice 2005, 6:43 doi:10.1186/1471-2296-6-43 Received: 02 March 2005 Accepted: 24 October 2005 This article is available from: http://www.biomedcentral.com/1471-2296/6/43 © 2005 Andén et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.