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Journals / KONURALP TIP DERGİSİ / 2026 / Volume: 15 Issue: 1

Difficult Encounters Experienced by Family Physicians and the Coping Methods They Employ: A Cross-sectional Study

Aile Hekimlerinin Karşılaştığı Zor Durumlar ve Başa Çıkma Yöntemleri: Kesitsel Bir Çalışma

Servet Aker(ondokuz mayıs üniversitesi tıp fakültesi)0000-0002-1395-5944
Mustafa Kürşat Şahin(ONDOKUZ MAYIS ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-3490-6009
Pages
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Publication Date
2023-03-15
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Although empathy was the most frequently employed coping method, a lack of training on the subject was also identified.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The purpose of this study was to determine difficult encounters and the practice of medicine among family physicians (FPs).
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Key Findings & Data:Methods: The research was conducted as a cross-sectional study using a questionnaire between 15 June and 15 July, 2019.
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Conclusion & Impact:Although empathy was the most frequently employed coping method, a lack of training on the subject was also identified.
🔬Design:Survey & Empirical Study
📍Scope:2019 Verileri
⚙️Variables:Delivery of Health Care · Difficult Encounter · Family Practice

Abstract

Objective: The purpose of this study was to determine difficult encounters and the practice of medicine among family physicians (FPs). Methods: The research was conducted as a cross-sectional study using a questionnaire between 15 June and 15 July, 2019. The questionnaire included sociodemographic characteristics, difficult situations that may be encountered, and methods of coping with such situations. Three hundred twenty-five FPs took part in the study. Results: The FPs reported being most frequently troubled by “requests for unnecessary reports” and “patients requesting unindicated tests”. FPs described male gender, age 31-40, possession of a moderate income level, being married, and being a civil servant as the patient characteristics most frequently causing difficulties. The mean length of time spent with an ordinary patient was 7.4±0.1 minutes, but this rose to 12.6±0.3 in case of difficult patients. The coping method most frequently employed by FPs in the face of difficult encounters was empathy. Ninety-two percent of the FPs reported experiencing a communication problem with patients at least once a year. Only 22.5% of FPs reported having taken part in training regarding managing difficult situations. Conclusion: FPs frequently experience difficult encounters. The most frequent of these involve demanding, frequently presenting patients with numerous complaints. The principal reason for FPs experiencing difficult encounters was found to be problems in the health service. Although empathy was the most frequently employed coping method, a lack of training on the subject was also identified.

Özet

Amaç: Bu çalışma ile aile hekimlerinin zor durumlarla karşılaşma durumlarının ve hekimlik pratiklerin saptanması amaçlanmıştır. Gereç ve Yöntem: Kesitsel tipteki bu çalışma 15 Haziran-15 Temmuz 2019 tarihleri arasında bir anket formu ile yürütülmüştür. Anket formunda sosyodemografik özellikler, karşılaşılabilecek zor durumlar ve zor durumlarla başa çıkabilme yöntemleri yer almaktadır. Çalışmaya toplam 325 aile hekimi katılmıştır. Bulgular: Aile hekimleri en sık “gereksiz yere rapor talepleri” ve “endikasyon olmadan tektik isteyen hastaların” kendilerini zorladığını belirtmektedir. Aile hekimlerini zorlayan hasta özellikleri erkek olma, 31-40 yaş arası olma, orta gelir düzeyinde olma, evliler ve devlet memurları olarak bildirilmiştir. Sıradan bir hasta görüşmesi ortalama 7,4±0,1 dakika iken, zor hastalarda 12,6±0,3 dakikaya çıktığı bildirilmiştir. Aile hekimleri zor durumlarla karşılaştıklarında en sık başa çıkma yöntemi olarak empati kurmaya çalıştığını belirtti. Aile hekimlerinin %92’si son 1 yılda en az bir kez hastalarla bir iletişim problemi yaşadıklarını belirtmiştir. Zor durum yönetimi ile ilgili sadece %22,5’i bir eğitime katıldığını belirtti. Sonuç: Aile hekimleri zor durumlar ile çok sık karşılaşmaktadır. Talepkar, sık başvuran, çok sayıda şikâyeti olanlar hastalar en sık karşılaşılan zor durumlardır. Aile hekimleri tarafından zor karşılaşmaların en önde gelen nedeni olarak sağlık sistemi sorunları gösterilmektedir. Empati kurma en sık kullanılan başa çıkma yöntemi olsa da bu konuda eğitim eksikliği olduğu saptanmıştır.

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Cite This Article

Aker, S., Şahin, M. K. (2023). Difficult Encounters Experienced by Family Physicians and the Coping Methods They Employ: A Cross-sectional Study. KONURALP TIP DERGİSİ, Volume: 15 Issue: 1. https://doi.org/10.18521/ktd.1194748

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References (37)

  1. Mento C, Silvestri MC, Bruno A, Muscatello MRA, Cedro C, Pandolfo G, Zoccali RA. Workplace violence against healthcare professionals: A systematic review. Aggression and Violent Behavior. 2020;51:101381.
  2. Çevik M, Gümüştakim RŞ, Bilgili P, Ayhan Başer D, Doğaner A, Saper, SH. Violence in healthcare at a glance: The example of the Turkish physician. The International Journal of Health Planning and Management. 2020;35(6):1559-1570.
  3. Sahin MK, Dikici MF. Difficult Encounters. Türkiye Klinikleri J Fam Med-Special Topics. 2017;8:116-122.
  4. Groves JE. Taking care of the hateful patient. N Engl J Med. 1978;298:883-887.
  5. Wilson H. Reflecting on the 'difficult' patient. N Z Med J. 2005;118:U1384.
  6. Ellis CG. Making dysphoria a happy experience. Br Med J (Clin Res Ed). 1986;293:317-318.
  7. Gerrard TJ, Riddell JD. Difficult patients: black holes and secrets. BMJ. 1988;297:530-532
  8. Steinmetz D, Tabenkin H. The 'difficult patient' as perceived by family physicians. Fam Pract. 2001;18:495-500.
  9. Lorenzetti RC, Jacques CM, Donovan C, Cottrell S, Buck J. Managing difficult encounters: understanding physician, patient, and situational factors. American Family Physician. 2013;87:419-425.
  10. An PG, Rabatin JS, Manwell LB, Linzer M, Brown RL, Schwartz MD, Investigators M. Burden of difficult encounters in primary care: data from the minimizing error, maximizing outcomes study. Arch Intern Med. 2009;169:410-414.
  11. Haas LJ, Leiser JP, Magill MK, Sanyer ON. Management of the difficult patient. Am Fam Physician. 2005;72:2063-2068.
  12. Jackson JL, Kroenke K. Difficult patient encounters in the ambulatory clinic: clinical predictors and outcomes. Arch Intern Med. 1999;159:1069-1075.
  13. An PG, Manwell LB, Williams ES, Laiteerapong N, Brown RL, Rabatin JS, Schwartz MD, Lally PJ, Linzer M. Does a higher frequency of difficult patient encounters lead to lower quality care? J Fam Pract. 2013;62:24-29.
  14. Goldsmith ES, Krebs EE. Roles of Physicians and Health Care Systems in "Difficult" Clinical Encounters. AMA J Ethics. 2017;19:381-390.
  15. Hinchey SA, Jackson JL. A cohort study assessing difficult patient encounters in a walk-in primary care clinic, predictors and outcomes. J Gen Intern Med. 2011;26:588-59.
  16. Elder N, Ricer R, Tobias B. How respected family physicians manage difficult patient encounters. J Am Board Fam Med. 2006;19:533-541.
  17. Jackson JL, Kay C, Scholcoff C, Becher D, O'Malley PG. Capturing the Complexities of "Difficult" Patient Encounters Using a Structural Equation Model. J Gen Intern Med. 2021;36:549-551.
  18. Mas Garriga X, Cruz Domenech JM, Fananas Lanau N, Allue Buil A, Zamora Casas I, Vinas Vidal R. Difficult patients in primary care: a quantitative and qualitative study. Aten Primaria. 2003;31:214-219.
  19. Stacey CL, Henderson S, MacArthur KR, Dohan D. Demanding patient or demanding encounter?: A case study of a cancer clinic. Soc Sci Med. 2009; 69:729-737.
  20. Corney RH, Strathdee G, Higgs R, King M, Williams P, Sharp D, Pelosi AJ. Managing the difficult patient: practical suggestions from a study day. J R Coll Gen Pract. 1988;38:349-352.
  21. Stevens LA. Responding to the difficult patient. Bull Am Coll Surg. 2010;95:12-15.
  22. Akyuz S, Biyik E, Yalcin-Balcik P. Difficult patients from the perspective of healthcare workers: a study at a public hospital. Int J Res Med Sci. 2016;4:3554-3562.
  23. Johnson RL, Saha S, Arbelaez JJ, Beach MC, Cooper LA. Racial and ethnic differences in patient perceptions of bias and cultural competence in health care. J Gen Intern Med. 2004;19:101-110
  24. Malat JR, van Ryn M, Purcell D. Race, socioeconomic status, and the perceived importance of positive self-presentation in health care. Soc Sci Med. 2006;62:2479-2488.
  25. Cline RJ, Haynes KM. Consumer health information seeking on the Internet: the state of the art. Health Educ Res. 2001;16:671-692.
  26. White MK, Keller VF. Difficult clinician-patient relationships. JCOM-WAYNE PA- 1998;5:32-38.
  27. Mathers NJ, Gask L. Surviving the 'heart sink' experience. Fam Pract. 1995;12:176-183.
  28. Rosenberg EE, Lussier MT, Beaudoin C. Lessons for clinicians from physician-patient communication literature. Arch Fam Med. 1997;6:279-283.
  29. Salmon P, Ring A, Humphris, GM, Davies C, Dowrick CF. Primary care consultations about medically unexplained symptoms: how do patients indicate what they want? Journal of General Internal Medicine. 2009;24(4):450-456.
  30. Barr J, Threlkeld AJ. Patient--practitioner collaboration in clinical decision-making. Physiother Res Int. 2000;5:254-260.
  31. Bensing J, Schreurs K, Rijk A. The role of the general practitioner's affective behaviour in medical encounters. Psychology & Health. 1996;11:825-838.
  32. Bertakis KD, Roter D, Putnam SM. The relationship of physician medical interview style to patient satisfaction. J Fam Pract. 1991;32:175-181.
  33. Greiner KA. Patient-provider relations--understanding the social and cultural circumstances of difficult patients. Bioethics Forum. 2000;16:7-12.
  34. Dudzinski DM, Alvarez C. Repairing "Difficult" Patient-Clinician Relationships. AMA J Ethics. 2017;19:364-368.
  35. Steinkruger S, Grams J, Berger G. Skills for Managing Difficult Encounters in Primary Care. Med Educ 2020;54:1066-1067.
  36. Wells J, Cronk NJ. Practice Makes Perfect: Training Residents in Difficult Encounters. PRiMER. 2020;4:2.
  37. Levinson W, Lesser CS, Epstein RM. Developing physician communication skills for patient-centered care. Health Aff (Millwood). 2010;29:1310-1318.