title: Patients with mental health needs are engaged in asking questions, but physicians' responses vary.
abstract: Increased patient engagement is of particular interest regarding patients with mental health needs, given the high burden of mental illness in the United States and the potential for greater patient engagement to improve health outcomes. Little is known about the extent to which these patients ask questions of their physicians; how physicians respond; and what the relationship is between patients' questions and visit outcomes. We conducted in-depth mixed-method analyses of 322 audio recordings of primary care visits by people with mental health needs. We found that patients asked many questions-a median of fifteen per visit-but that they were more likely to ask about biomedical topics, such as diabetes, than about mental health topics. Patients received highly varied responses from physicians. Our findings suggest that efforts aimed at improving patient engagement should move beyond simply encouraging patients to ask questions. The goal should also be to support physicians in recognizing patients' concerns and providing the most responsive answers, as well as promoting strong relationships to undergird communication among all members of the care team.
authors: Department of Health Policy Research, Palo Alto Medical Foundation Research Institute, California, USA. tai-sealem@pamfri.org
authors: Ming
authors: M
authors: Tai-Seale
authors: Patricia K
authors: PK
authors: Foo
authors: Cheryl D
authors: CD
authors: Stults
mesh_terms: D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D011787:Quality of Health Care
references: Health Serv Res. 2007 Oct;42(5):1871-94
references: 17850524
references: Patient Educ Couns. 2006 Jul;62(1):38-45
references: 15964736
references: Ann Fam Med. 2010 Mar-Apr;8(2):151-9
references: 20212302
references: Patient Educ Couns. 2011 Jan;82(1):63-8
references: 20430566
references: JAMA. 2000 Aug 23-30;284(8):1021-7
references: 10944650
references: J Health Soc Behav. 1985 Jun;26(2):81-101
references: 4031436
references: Patient Educ Couns. 2000 Sep;41(2):209-22
references: 12024545
references: Patient Educ Couns. 2010 Mar;78(3):350-6
references: 20202780
references: J Gen Intern Med. 1992 Jan-Feb;7(1):26-31
references: 1548545
references: Expert Opin Drug Saf. 2005 Nov;4(6):1111-24
references: 16255668
references: Psychiatr Serv. 2006 Jan;57(1):37-47
references: 16399961
references: J Gen Intern Med. 2007 Jun;22(6):782-6
references: 17431697
references: J Ambul Care Manage. 2012 Apr-Jun;35(2):129-32
references: 22415286
references: Med Care. 2008 Mar;46(3):247-56
references: 18388839
references: Popul Health Manag. 2010 Dec;13(6):331-7
references: 21090989
references: Soc Sci Med. 1991;32(5):541-8
references: 2017721
references: Ann Intern Med. 2009 Oct 6;151(7):456-63
references: 19805769
references: Health Aff (Millwood). 2012 May;31(5):1030-8
references: 22566443
references: Med Care. 1998 Jul;36(7):1047-56
references: 9674622
references: J Am Geriatr Soc. 2007 Dec;55(12):1903-11
references: 18081668
references: Ann Behav Med. 2005 Dec;30(3):225-42
references: 16336074
references: Patient Educ Couns. 2010 Sep;80(3):358-63
references: 20667678
references: Soc Sci Med. 1994 Oct;39(7):955-65
references: 7992128
references: Med Care. 2003 Nov;41(11):1284-92
references: 14583691
references: J Clin Oncol. 2007 Feb 20;25(6):715-23
references: 17308275
references: J Ambul Care Manage. 2012 Apr-Jun;35(2):78-9
references: 22415280