The presence of certain risk factors increase the risk that the encounter between a physician and patient may be perceived as difficult by the physician.
Independent Predictor
Odds Ratio
95% CI
depressive or anxiety disorder
2.4
(1.5 - 3.9)
>= 5 physical symptoms
1.9
(1.1 - 3.1)
severity of symptoms > 6 on a 10 point scale (with 10 unbearable)
1.6
(1.0 - 2.4)
poorer physician psychosocial attitude score
3.9
(1.6 - 9.5)
where:
• The physician's psychosocial attitude is measured using the Physician Belief Scale.
Interpretation:
• The greater the mismatch between a patient with active psychosocial problems and the physician with poor tolerance of psychosocial problems, the more likely that the encounter will be viewed as difficult by the physician.
• The patients of "difficult" encounters tend to have reduced satisfaction, more unmet expectations, and make greater use of health care services.
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