Rude or aggressive patient behaviour during out-of-hours GP care: challenges in communication with patients.
OBJECTIVE
GPs in out-of-hours care report that they feel at risk of rude or aggressive patient behaviour. We tried to get information about the incidence, types and patient characteristics of rude or aggressive behaviour.


METHODS
Retrospective, observational study involving the analysis of medical records of all patients who contacted a Dutch GP cooperative between June 2001 and June 2002.


RESULTS
Of the 36.259 patient records, 545 (1.5%) reported rude behaviour, 67 (0.2%) reported verbal aggression and physical aggression was not reported. Anxiety, sorrow, or pain was reported by patients in 49.7% of the cases with rude or aggressive behaviour. The conflict topic between patients and professional was mostly the request of a home visit (21.8%), or a centre consultation (17.3%). Patients with mental health problems (OR 2.3 CI 1.8-3.1) were more at risk for rude or aggressive behaviour.


CONCLUSIONS
Rude and aggressive behaviour on GP cooperatives occurs relative seldom and is associated with anxiety, sorrow, and pain. The wish to see a doctor instead getting a telephone advice is a frequent conflict topic between patient and professional.


CONCLUSIONS
The findings suggest that improved communication at the telephone, particularly exploring the expectation, needs and worries of patients, may reduce aggressive behaviour.
Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, KWAZO 114, PO Box 9101, 6500 HB Nijmegen, The Netherlands. p.giesen@voha.umcn.nl
Paul
P
Giesen
Henk
H
Mokkink
Mijke
M
Hensing
Wil
W
van den Bosch
Richard
R
Grol
D000293:Adolescent; D000328:Adult; D039602:After-Hours Care; D000374:Aggression; D002648:Child; D002675:Child, Preschool; D005194:Family Practice; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D013689:Telephone