title: Patient and physician explanatory models for acute bronchitis.
abstract: OBJECTIVE
  Our goals were to develop explanatory models to better understand how physicians diagnose and treat acute bronchitis; to describe patient expectations and needs when experiencing an episode of acute bronchitis; and to enhance communication between physician and patient.
  
  
  METHODS
  We used qualitative, semi-structured, in-depth interviews to generate patient and physician explanatory models.
  
  
  METHODS
  We had a purposeful, homogeneous sample of 30 family physicians and 30 adult patients.
  
  
  METHODS
  Our multidisciplinary team of investigators used an editing style of analysis to develop patient and physician explanatory models based on the following topics: (1) what caused my illness/etiology, (2) what symptoms I had/onset of symptoms, (3) what my sickness did to me/pathophysiology, (4) how severe is my sickness/course of illness, and (5) what kind of treatment should I receive/treatment.
  
  
  RESULTS
  We found that patient and physician models were congruous for symptoms of acute bronchitis and incongruous for etiology and course of illness. Models were congruous for treatment, although for different reasons.
  
  
  CONCLUSIONS
  Patients may have a very vague understanding of the process of infection and the difference between bacteria and viruses. Compounding this confusion is frequent miscommunication from physicians regarding the clinical course of untreated illness. These factors and non-communicated expectations from patients and fear of missing something on the part of physicians contribute to the decision to treat with antibiotics.
authors.affiliation: Department of Family Practice and Community Medicine, University of Texas Southwestern Medical Center at Dallas, 75390-9067, USA. laura.snell@usouthwestern.edu
authors.forename: Laura M
authors.initials: LM
authors.lastname: Snell
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Wilson
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.forename: Carolyn
authors.initials: C
authors.lastname: Sargent
authors.forename: Olive
authors.initials: O
authors.lastname: Chen
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Corey
mesh_terms: D000208:Acute Disease; D000328:Adult; D001991:Bronchitis / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'