title: How to deal with a crying patient? A study from a primary care setting in Croatia, using the 'critical incident technique'.
abstract: BACKGROUND
  Expression of strong emotions by patients is not a rare event in medical practice, however, there are few studies describing general practitioner (GP) communication with a crying patient.
  
  
  OBJECTIVE
  The aim of this study was to describe GP behaviour with a patient who cries in a family practice setting.
  
  
  METHODS
  A semi-qualitative study was conducted on 127 Croatian GP trainees, 83.5% female, and 16.5% male. The study method used was the 'critical incident technique.' GP trainees described their recent experience with patients who cried in front of them. Textual data were explored inductively using content analysis to generate categories and explanations.
  
  
  RESULTS
  All 127 (100.0%) GP trainees initially let patients cry, giving them verbal (81.9%) and/or nonverbal support (25.9%). GP trainees (69.3%) encouraged their patients to verbalize and to describe the problem. Most GP trainees (87.4%) tried to establish mutual problem understanding. Approximately half of the GP trainees (55.1%) made a joint management plan. A minor group (14.2%) tried to maintain contact with the patient by arranging follow-up appointments. The vast majority of GP trainees shared their patient's emotion of sadness (92.9%). Some GP trainees were caught unaware or unprepared for patient's crying and reacted awkwardly (4.7%), some were indifferent (3.9%) or even felt guilty (3.1%).
  
  
  CONCLUSIONS
  GP trainees' patterns of communication with crying patients can be described in five steps: (a) let the patient cry; (b) verbalization of emotions and facilitation to express the problem; (c) mutual understanding and solution finding; (d) evaluation--maintaining contact; and (e) personal experience of great emotional effort.
authors.affiliation: Department of Family Medicine, Andrija Štampar School of Public Health, School of Medicine University of Zagreb, Zagreb, Croatia. gpetrice@snz.hr
authors.forename: Goranka
authors.initials: G
authors.lastname: Petriček
authors.forename: Mladenka
authors.initials: M
authors.lastname: Vrcić-Keglević
authors.forename: Djurdjica
authors.initials: D
authors.lastname: Lazić
authors.forename: Lucija
authors.initials: L
authors.lastname: Murgić
mesh_terms: D017523:Croatia; D003448:Crying / Q000523:psychology; D004503:Education, Medical, Graduate; D004644:Emotions; D005260:Female; D058006:General Practice / Q000193:education; D058005:General Practitioners / Q000193:education / Q000523:psychology*; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011340:Problem Solving; D036301:Qualitative Research; D013647:Task Performance and Analysis; D014705:Verbal Behavior