LIFE-STYLE INTERVENTION IN GENERAL-PRACTICE - EFFECTS ON PSYCHOLOGICAL WELL-BEING AND PATIENT SATISFACTION

The objectives of this study were to: (1) study if an opportunistic sc reening of coronary heart disease (CHD) risk factors among male attend ers in general practice (GP) influenced the overall subjective satisfa ction with life of persons labelled 'high risk' compared to other scre ened persons; (2) compare psychological well-being and patient satisfa ction in a patient centred and self-directive (PCSD) intervention with conventional care (CC); and (3) evaluate patient satisfaction and psy chological well-being among subjects with high CHD risk during a one y ear intervention study. Effects of 'labelling' were evaluated in 115 s ubjects with high CHD risk in comparison with a low risk reference pop ulation. The 22 participating GP centres were randomly allocated to fo llow either a PCSD intervention or a CC approach. An overall satisfact ion with life question was employed and psychological well-being were measured using the General Health Questionnaire (20 item version). Sat isfaction measures on health care aspects were also included. No diffe rence of change between the high risk and the reference population was found concerning satisfaction with life after screening. No significa nt difference of change was found within or between the PCSD and the C C group concerning emotional well-being or overall satisfaction with l ife during one year intervention. Satisfaction with the care received was significantly better in the CC group as compared with the PCSD gro up (p = 0.02). Satisfaction with own efforts for improving health was, however, more pronounced in the PCSD group (p = 0.01). A substantial number (n = 61) of the participants reported distaste of being reminde d of the risk of heart disease and no more than 60 of the participants were satisfied with their own efforts for improving health. Although no significant change of satisfaction with life and emotional well-bei ng due to screening or intervention could be detected, clinicians shou ld be aware that encouraging patients to change life style may lead to patients' annoyance of being reminded of the risk of disease and diss atisfaction with their own efforts. Increasing patient responsibility and self-determination may improve their satisfaction with their own e fforts, but reduce satisfaction with medical care.