title: Association of physicians' illness perception of fibromyalgia with frustration and resistance to accepting patients: a cross-sectional study.
abstract: The aim of this study was to elucidate whether physicians' illness perceptions correlate with their frustration or resistance to accepting patients with fibromyalgia (FM). In this cross-sectional postal survey, questionnaires were sent to member physicians of the Japan College of Rheumatology and Japan Rheumatism Foundation. Measures collected included the Brief Illness Perception Questionnaire with Causal Attribution, the Illness Invalidation Inventory, and the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10). Multiple logistic regression was performed to examine associations between the DDPRQ-10 and resistance to accepting patients with FM for treatment. We analyzed data from 233 physicians who had experience in consulting with patients with FM. Only 44.2 % answered that they wanted to accept additional patients with FM. Physicians' frustration was associated with difficulty controlling symptoms, patients' emotional responses, and causal attribution of FM to patient internal factors. Conversely, lower levels of frustration were associated with causal attributions to biological factors and uncontrollable external factors. However, the "difficult patient" perception did not correlate with resistance to accepting patients with FM. Difficulty controlling symptoms with treatment was the one factor common to both physicians' frustration and resistance to accepting patients with FM. Physicians may hesitate to accept patients with FM not because of the stigmatic image of the "difficult patient," but instead because of the difficulty in controlling the symptoms of FM. Thus, to improve the quality of consultation, physicians must continuously receive new information about the treatments and causes of FM.
authors.affiliation: Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. miekosph-tky@umin.ac.jp.
authors.forename: Mieko
authors.initials: M
authors.lastname: Homma
authors.affiliation: Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Hirono
authors.initials: H
authors.lastname: Ishikawa
authors.affiliation: Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kiuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis* / Q000523:psychology*; D005639:Frustration; D006297:Health Services Accessibility; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians; D016079:Refusal to Treat; D012044:Regression Analysis; D012219:Rheumatology / Q000379:methods; D012938:Social Perception; D012955:Societies, Medical; D011795:Surveys and Questionnaires
keywords: Difficult patients; Fibromyalgia; Illness perceptions; Japan; Physician–patient relationship
references.citation: Gen Hosp Psychiatry. 1997 Sep;19(5):315-23
references.pmid: 9328776
references.citation: J Gen Intern Med. 1996 Jan;11(1):1-8
references.pmid: 8691281
references.citation: Ann Rheum Dis. 2010 Nov;69(11):1990-5
references.pmid: 20498203
references.citation: Soc Sci Med. 2008 Jan;66(1):182-8
references.pmid: 17850944
references.citation: Psychol Health. 2011 May;26 Suppl 1:101-17
references.pmid: 21337260
references.citation: J Psychosom Res. 2006 Jun;60(6):631-7
references.pmid: 16731240
references.citation: Fam Pract. 1997 Jun;14(3):238-41
references.pmid: 9201499
references.citation: J Clin Rheumatol. 2007 Apr;13(2):59-62
references.pmid: 17414529
references.citation: J Psychosom Res. 2004 Oct;57(4):373-8
references.pmid: 15518673
references.citation: Arthritis Care Res (Hoboken). 2010 May;62(5):600-10
references.pmid: 20461783
references.citation: Psychosom Med. 2005 Nov-Dec;67(6):997-1005
references.pmid: 16314606
references.citation: Soc Sci Med. 2003 Aug;57(4):711-20
references.pmid: 12821018
references.citation: Psychosomatics. 2011 Mar-Apr;52(2):154-9
references.pmid: 21397108
references.citation: Psychosom Med. 2005 Nov-Dec;67(6):897-905
references.pmid: 16314594
references.citation: J Clin Epidemiol. 1996 Dec;49(12):1373-9
references.pmid: 8970487
references.citation: Patient Educ Couns. 2009 Jan;74(1):53-60
references.pmid: 18815004
references.citation: J Rheumatol. 2003 Aug;30(8):1671-2
references.pmid: 12913920
references.citation: Arthritis Care Res (Hoboken). 2013 Nov;65(11):1835-43
references.pmid: 23861259
references.citation: Arthritis Rheum. 1990 Feb;33(2):160-72
references.pmid: 2306288
references.citation: Value Health. 2005 Mar-Apr;8(2):94-104
references.pmid: 15804318
references.citation: Ann Intern Med. 2001 May 1;134(9 Pt  2):897-904
references.pmid: 11346326
references.citation: Arthritis Rheum. 2009 Dec 15;61(12):1650-6
references.pmid: 19950317
references.citation: Occup Med (Lond). 2009 Dec;59(8):550-5
references.pmid: 19704030
references.citation: J Gen Intern Med. 2011 Jun;26(6):588-94
references.pmid: 21264521
references.citation: J Clin Epidemiol. 1994 Jun;47(6):647-57
references.pmid: 7722577
references.citation: N Engl J Med. 1978 Apr 20;298(16):883-7
references.pmid: 634331