GENERAL-PRACTICE PATIENTS BELIEFS ABOUT THEIR SYMPTOMS

Background. Patients' beliefs about symptoms are major influences on c onsultation and its consequences. However, little information is avail able about the beliefs of patients when they consult their general pra ctitioner (GP). Aim. To describe and quantify the range of beliefs of patients about their symptoms before consultation, and to test the hyp othesis that patients who attribute symptoms to stress or lifestyle wo uld expect less benefit than others from physical medicine but more fr om lifestyle change and emotional support. Method. Interviews with 100 patients attending one of two general practices were used to form a q uestionnaire, which was completed by 406 patients attending one of thr ee general practices in contrasting areas of Greater London. This meas ured the frequency of specific beliefs about the causes of their sympt oms and about effective forms of help. Patients were seen before their consultation. Results. The most common aetiological beliefs concerned stress and lifestyle. In general, the mechanisms underlying symptoms were thought to be disturbances in bodily functioning rather than path ological processes. The most valued form of help was explanation and d iscussion of symptoms. Nevertheless, about half the patients expected benefit from medication and only slightly fewer from hospital investig ation or treatment. Patients who attributed symptoms to stress or life style were no less likely to expect help from medication or specialist referral, but they were more likely to see benefit in explanation and counselling or lifestyle change. Conclusions. These finding's suggest hypotheses for future research into the effects that patients' attrib utions sf their symptoms to stress and lifestyle have on their health care demands, emphasize the importance of routinely assessing patients ' beliefs on consulting the GP, and provide information that can help to direct this assessment in the individual case.