Patients' ideas, concerns, expectations and satisfaction in primary health care – a questionnaire study of patients and health care professionals' perspectives.

Objective: Explore the perceptions of patients and health care professionals about patients' ideas, concerns, expectations (ICE), and satisfaction in consultations with general practitioners (GPs), district nurses (DNs) and physiotherapists (PTs). Design: Cross-sectional questionnaire study of participants in planned consultations. Setting: Five primary health care centers and two rehabilitation centers in Stockholm, Sweden. Subjects: Pairs of patients and GPs (n = 156), patients and DNs (n = 73), and patients and PTs (n = 69). Main outcome measures: Multiple-choice questions about patients' ICE and satisfaction. Results: Approximately 75% of patients and GPs reported that patients' thoughts and explanations about their symptoms emerged during the consultation. For patient-DN pairs, the figure was 60%, and for patient-PT pairs, 80%. A majority of patients reported not having concerns and anxiety about the investigation/treatment, whereas health care professionals thought patients were more concerned. One-third of patients consulting GPs and PTs expected to receive a reason/explanation for their symptoms. Figures were lower for the DNs. About 70% of patients were satisfied with the consultation. Conclusions: Most patients expressed their ideas, a minority had concerns, and a minority expected an explanation of their illness. Patients and health care professionals rated patient satisfaction high, but health care professionals tended to believe patients were less satisfied than patients reported they were. Patient surveys show that important aspects of patient-centeredness remain weak in Swedish primary health care; for example, shared decision-making. In this study of planned consultations, few patients expected to receive an explanation of their symptoms, but most were satisfied with the consultation. Health care professionals thought patients' experiences were more negative than they were. This discrepancy was observed in responses to questions about patients' concerns, expectations and satisfaction. [ABSTRACT FROM AUTHOR]

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