Differences between out-patients with physical disease and those with medically unexplained symptoms with respect to patient satisfaction, emotional distress and illness perception.
OBJECTIVE
This study aimed to assess whether patients with medically unexplained symptoms (MUS) attending cardiology and neurology out-patient clinics were less satisfied with their consultation than patients whose presenting symptoms were explained by an organic diagnosis. The multidimensional nature of satisfaction and its relationships with emotional distress and illness perception were also assessed within the two groups.


METHODS
A prospective cohort study was carried out at a large inner city teaching hospital.


METHODS
New attenders at cardiology and neurology out-patient clinics participated in the study.


METHODS
The Satisfaction Questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Health Anxiety Questionnaire (HAQ) and the Illness Perception Questionnaire (IPQ) were used in the study.


RESULTS
There were no overall significant differences in satisfaction between organic and MUS patients. Factor analysis yielded four factors: satisfaction with information, satisfaction with style of doctor-patient interaction, satisfaction with clinic environment, and satisfaction with patient's health. Levels of internal consistency were good, with Cronbach's alphas between .74 and .95 for the four subscales.


CONCLUSIONS
When considering patients with MUS, these findings emphasize the need to examine healthcare satisfaction from a detailed and multidimensional perspective. Relationships between satisfaction dimensions, clinic specialties and measures of psychological well-being and of illness perception show interesting patterns. These findings raise both theoretical and service delivery questions concerning communication strategies.
Jackson
Judy
J
Psychological Medicine Research Group, Manchester Royal Infirmary, UK. Judy.Jackson@man.ac.uk
Kincey
John
J
Fiddler
Magdalen
M
Creed
Francis
F
Tomenson
Barbara
B
D000328:Adult; D000553:Ambulatory Care; D001294:Attitude to Health; D002309:Cardiology / Q000706:statistics & numerical data; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000706:statistics & numerical data; D010549:Personal Satisfaction; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires