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Journal of Health Psychology
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What do General Practitioners Discuss with their Patients?

Exploring the Relationship between Content of Medical Consultations and Treatment Decisions

Antonietta Di Caccavo

Department of Psychology, School of Humanities and Social Sciences, University of Glamorgan, Mid Glamorgan CF37 1DL, UK [Tel. (01443) 482066 direct line, (01443) 482551 dept. office; Fax (01443) 482138; tdicacca{at}glam.ac.uk]

Ann Ley

Department of Clinical Psychology, South Devon Health Care NHS Trust, UK

Fraser Reid

Department of Psychology, University of Plymouth, Devon, UK

Thirty audiotaped and transcribed general practice consultations were used to develop a classification scheme to code the content of doctor–patient communication in primary care. Open coding was used to identify subject matter discussed by general practitioners in consultations featuring commonly presented problems such as respiratory, psychological and musculoskeletal complaints. The classification scheme was found to have an adequate inter-rater reliability (0.72) and was used in a pilot study to code a further 75 consultations featuring psychological problems as the main presenting complaints. Multivariate analysis of variance showed significant relationships between what was discussed by general practitioners and the type of treatment decisions made (F(16, 51) 2.12, p .01). Consultations in which general practitioners talked to their patients about mental coping strategies, social support and treatment options were less likely to end with decisions to prescribe drugs than consultations in which general practitioners did not discuss these subjects.

Key Words: communication content • general practice • psychological complaints • treatment decisions

Journal of Health Psychology, Vol. 5, No. 1, 87-97 (2000)
DOI: 10.1177/135910530000500101
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