Frequent attenders in primary health care:a cross-sectional study of frequent attenders’ psychosocial and family factors, chronic diseases and reasons for encounter in a Finnish health centre
Notice bibliographique
Résumé
The aim of this cross-sectional controlled study was to determine frequent attenders' chronic diseases and their reasons for encounter in primary health care.Furthermore, the study aimed to determine the associations of social, psychological and family factors with frequent attendance in a Finnish health centre.Patients who made eight or more annual visits to physicians in the health centre during one year were defined as frequent attenders (FA).All the FAs during 1994 (N = 304) and 304 randomly selected age-and sex-matched controls constituted the study population.The data were collected from annual statistics, medical records and postal questionnaires.Over one third of the study population was interviewed.International Classification of Primary Care (ICPC) was used to determine the reasons for encounter and Symptom Checklist -36 (SCL-36) to assess the psychological distress.Toronto Alexithymia Scale -20 (TAS-20) was used as a measure of alexithymia and Whiteley Index (WI) to determine hypochondriacal beliefs.The results showed that 4.7% of the whole population aged 15 years or older in Oulainen were FAs.They accounted for 23.5% of all visits made within the respective age group.The mean age of the FAs was 49.8 years.Over two thirds of them were female.The FAs had lower basic education and occupational status than the controls.The FAs visited physicians in the health centre mostly for reasons related to the musculoskeletal, respiratory and digestive systems.There appeared to be more chronic diseases among the FAs than among the controls.The FAs had over three times more mental disorders than the controls.The interviewed FAs had significantly more psychological distress, somatization and hypochondriacal beliefs than the controls.The risk of frequent attendance was higher in the older family life cycle phases than in the younger family life cycle phases.Multivariate analyses showed chronic somatic disease and hypochondriacal beliefs to be risk factors for frequent attendance.Concurrence of somatization and hypochondriacal beliefs increased the risk to be a FA.As a conclusion, the results emphasize the need to consider the FAs' own bodily concerns expressed as hypochondriacal beliefs when managing them.Furthermore, the study implicates a need to integrate the biomedical, psychological and social dimensions in the care of FAs in primary health care.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».