SABOTAGING ONES OWN MEDICAL-CARE - PREVALENCE IN A PRIMARY-CARE SETTING

This study determines the prevalence of medically self-sabotaging beha viors reported by patients in a primary care setting. A 19-item self-r eport survey was completed by patients on-site al the Family Medicine Clinic, University of Oklahoma College of Medicine-Tulsa. Four hundred eleven consecutive male and female patients were seen for nonemergent care. Each of the 19 items was endorsed by at least 1 respondent. The most commonly endorsed self-sabotaging behaviors were not seeking med ical care when needed (37.2%) and not taking a prescribed medication ( 25.1%). Significantly more women (26.4%) than men (17.5%) reported not taking a prescribed medication (P<.05). After excluding these 2 commo nly endorsed items, 27 (6.6%) of the respondents reported at least 1 o ther self-sabotaging behavior, with most indicating 1 (63.0%) or 2 (22 .2%); the remaining 4 individuals reported 4 to 12 behaviors. Signific antly more men (4.8%) than women (0.6%) reported not following instruc tions from a physician or nurse to prolong illness (P<.05). A few pati ents (6.6%) seen in a primary care university outpatient clinic acknow ledged the active and intentional sabotage of their medical care, beyo nd not taking a prescribed medication or seeking medical care when nee ded. This is probably a conservative estimate and indicates that medic al care is actively compromised by a few patients.