title: When do patients feel wronged? Empirical study of sick-listed patients' experiences with healthcare encounters.
abstract: BACKGROUND
  The way in which patients experience encounters with healthcare professionals seems to affect care outcome, but very little is known about reactions evoked by experiences of negative encounters.
  
  
  OBJECTIVE
  To examine how patients perceive healthcare encounters, with a special focus on negative encounters and feeling wronged.
  
  
  METHODS
  A questionnaire was sent to 10,042 long-term sickness absentees (response rate 58%). Attributable risk (AR) with 95% confidence intervals (CIs) was calculated regarding relations between experiences of different types of negative encounters with healthcare staff and of feeling wronged. To test the consistency of our results, we also analysed the AR for positive experiences and feeling respected.
  
  
  RESULTS
  Of 5802 participants, 1628 reported having experienced negative encounters, and 1036 of them also reported having felt wronged. The types of negative encounters with the highest AR for feeling wronged were 'nonchalant behaviour': AR 71.1 (95% CI 66.3-75.8) and 'treated me with disrespect': AR 54.8 (95% CI 49.8-59.8). Males in general tended to have higher ARs for feeling wronged than females, as had respondents with psychiatric diagnoses in comparison to other patients.
  
  
  CONCLUSIONS
  The present study indicates high ARs of feeling wronged among long-term sickness absentees if exposed to negative encounters in healthcare. Nonchalance and disrespect were the most important factors in this regard, but the different types of negative encounters were very much intertwined. Feeling wronged seems to be an outcome based on several experiences of negative encounters, either in a series of events or bundled together in a single event.
authors.affiliation: Department of Learning, Informatics, Management and Ethics, Stockholm Centre for Healthcare Ethics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Maja
authors.initials: M
authors.lastname: Wessel
authors.forename: Gert
authors.initials: G
authors.lastname: Helgesson
authors.forename: Daniel
authors.initials: D
authors.lastname: Olsson
authors.forename: Niklas
authors.initials: N
authors.lastname: Juth
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.forename: Niels
authors.initials: N
authors.lastname: Lynöe
mesh_terms: D000041:Absenteeism; D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D018582:Sick Leave / Q000706:statistics & numerical data*; D012943:Social Security; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors