Patients' ideas, fears and expectations of their coronary risk: barriers for primary prevention.
The application of cardiovascular guidelines and risk tables may be impeded by many barriers. In the present paper, we explored the role of patients in the feasibility of cardiovascular preventive care in general practice. Patient-related barriers were examined by means of a qualitative study. Fifteen GPs audio-taped one or two consultations on primary cardiovascular preventive care. The tapes were used to guide the subsequent semi-structured in-depth interviews with patients. Twenty-two patients were interviewed. Patients' understanding of prevention of cardiovascular disease (CVD) was often insufficient. The risk table and the multi-factorial approach were difficult to understand. Risk perception was often unrealistic and dichotomous, and mainly based on personal experiences. There was a demand for more information and cholesterol tests. At the patient level, many barriers impede effective prevention of cardiovascular diseases. In particular, the highly individualized high-risk approach needs to be explained to patients. Educational patient materials, intended to support both the GP and the patient, should take into account the ideas, fears and expectations of patients.
van Steenkiste
Ben
B
Department of General Practice, Centre for Quality of Care Research, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. ben.vansteenkiste@hag.unimaas.nl
van der Weijden
Trudy
T
Timmermans
Daniëlle
D
Vaes
Jaqueline
J
Stoffers
Jelle
J
Grol
Richard
R
D000328:Adult; D003142:Communication; D003299:Cooperative Behavior; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D003657:Decision Making; D005194:Family Practice / Q000379:methods; D005239:Fear; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D010353:Patient Education as Topic / Q000592:standards; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D010817:Physician-Patient Relations; D011322:Primary Prevention / Q000379:methods / Q000592:standards; D036301:Qualitative Research; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires