The influence of health beliefs on the presentation and consultation outcome in patients with chemical sensitivities.
OBJECTIVE
This study was carried out to investigate the impact of the physical effects of a chemical exposure, health and chemical beliefs, and chemical sensitivities treatment preferences on the consultation outcome at a tertiary liaison clinic.


METHODS
Eighty-five patients exposed to a range of chemicals were assessed at a joint medical toxicology and psychiatric clinic. Patient's beliefs about chemicals and health, chemical sensitivities and their treatment preferences were assessed using a 23-item questionnaire.


RESULTS
Fifty-seven patients (69%) had suffered from a range of initial or delayed symptoms that were probably a clear physical consequence of the exposure (Group A), whereas 26 patients (31%) had not (Group B). There were no significant differences found between groups A and B in terms of their diagnosis and their beliefs about health, food, chemicals and chemical sensitivities treatment preferences. However, patients in Group A were significantly more likely to report moderate to severe symptoms in comparison to Group B. Consultation outcome too did not differ between the two groups. The only predictors of consultation outcome were the patients' chemical sensitivities treatment preferences. Patients who at the outset thought that their treatment should comprise of complete avoidance to chemicals, regular monitoring and the use of alternative rather than conventional medicine were significantly less likely to achieve a favourable consultation outcome. Patients' chemical sensitivities treatment preferences were related to the more general beliefs on health, food and the harmful nature of chemicals and were not related to the chemical exposure variables.


CONCLUSIONS
These findings suggest that addressing patients' treatment preferences and the general beliefs on chemicals, food and health may enhance outcome and perhaps ought to be the target for intervention in context of such a liaison clinic.
Gupta
K
K
Medical Toxicology Clinic, Guy's and St. Thomas Hospital Trust, Atrium 2, St. Thomas Guy House, London Bridge, SE 1 9RT London, UK. kamal@publiconline.co.uk
Horne
R
R
D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D018777:Multiple Chemical Sensitivity / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology*; D006113:United Kingdom