Patient and physician explanatory models for acute bronchitis.
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.
Snell
Laura M
LM
Department of Family Practice and Community Medicine, University of Texas Southwestern Medical Center at Dallas, 75390-9067, USA. laura.snell@usouthwestern.edu
Wilson
Ruth P
RP
Oeffinger
Kevin C
KC
Sargent
Carolyn
C
Chen
Olive
O
Corey
Kristen M
KM
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'