General practice patients' beliefs about their symptoms.
BACKGROUND
Patients' beliefs about symptoms are major influences on consultation and its consequences. However, little information is available about the beliefs of patients when they consult their general practitioner (GP).


OBJECTIVE
To describe and quantify the range of beliefs of patients about their symptoms before consultation, and to test the hypothesis that patients who attribute symptoms to stress or lifestyle would expect less benefit than others from physical medicine but more from lifestyle change and emotional support.


METHODS
Interviews with 100 patients attending one of two general practices were used to form a questionnaire, which was completed by 406 patients attending one of three general practices in contrasting areas of Greater London. This measured the frequency of specific beliefs about the causes of their symptoms and about effective forms of help. Patients were seen before their consultation.


RESULTS
The most common aetiological beliefs concerned stress and lifestyle. In general, the mechanisms underlying symptoms were thought to be disturbances in bodily functioning rather than pathological processes. The most valued form of help was explanation and discussion of symptoms. Nevertheless, about half the patients expected benefit from medication and only slightly fewer from hospital investigation or treatment. Patients who attributed symptoms to stress or lifestyle were no less likely to expect help from medication or specialist referral, but they were more likely to see benefit in explanation and counselling or lifestyle change.


CONCLUSIONS
These findings suggest hypotheses for future research into the effects that patients' attributions of their symptoms to stress and lifestyle have on their health care demands, emphasize the importance of routinely assessing patients' beliefs on consulting the GP, and provide information that can help to direct this assessment in the individual case.
Woloshynowych
M
M
Department of Psychology, University College London.
Valori
R
R
Salmon
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005194:Family Practice; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D013312:Stress, Physiological; D011795:Surveys and Questionnaires