GPs asking patients to self-rate their health: a qualitative study.
BACKGROUND
In epidemiological research, self-rated health is an independent predictor of mortality, cardiovascular diseases, and other critical outcomes. It is recommended for clinical use, but research is lacking.


OBJECTIVE
To investigate what happens in consultations when the question 'How would you assess your general health compared with others your own age?' is posed.


METHODS
Authentic consultations with GPs at health centres in Sweden.


METHODS
Thirty-three planned visits concerning diabetes, pain, or undiagnosed symptoms were voice-recorded. Dialogue regarding self-rated health was transcribed verbatim and analysed using a systematic text condensation method. Speaking time of patients and doctors was measured and the doctors' assessment of the value of the question was documented in a short questionnaire.


RESULTS
Two overarching themes are used to describe patients' responses to the question. First, there was an immediate reaction, often expressing strong emotions, setting the tone of the dialogue and influencing the continued conversation. This was followed by reflection regarding their functional ability, management of illnesses and risks, and/or situation in life. The GPs maintained an attitude of active listening. They sometimes reported a slight increase in consultation time or feeling disturbed by the question, but mostly judged it as valuable, shedding additional light on the patients' situation and making it easier to discuss difficulties and resources. The patients' speaking time increased noticeably during this part of the consultation.


CONCLUSIONS
Asking patients to comparatively self-rate their health is an effective tool in general practice.
Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden.
Göran
G
Waller
Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden.
Katarina
K
Hamberg
Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden.
Annika
A
Forssén
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D059026:Diagnostic Self Evaluation; D005260:Female; D058006:General Practice / Q000379:methods; D058005:General Practitioners / Q000523:psychology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012017:Referral and Consultation; D018434:Sickness Impact Profile; D013548:Sweden / Q000453:epidemiology
GP; comparative self-rated health; consultations; family medicine; qualitative analysis