Crying patients in General/Family Practice: incidence, reasons for encounter and health problems
DOI:
https://doi.org/10.5712/rbmfc7(24)629Keywords:
Crying, Primary Care, General Practice, Family Medicine, Doctor-patient RelationshipAbstract
Context: Despite evidence demonstrating the benefits of understanding patients, there is a paucity of information about how physicians address psychological and social concerns of patients. No one study has been published about the incidence of crying in General/Family Practice. Objective: To know the incidence of crying in primary care/general practice, and the patients’ characteristics, their reasons for encounter and their health problems. Design: A descriptive, prospective study, of one year, of three general practitioners/family physicians in Madrid, Spain. Setting: primary care (doctors’ office and patients’ home). Subjects: Face to face encounters with crying patients. Main outcome measure: At least one rolling tear. Results: Patients cried in 157 encounters out of a total of 18,627 giving an incidence rate of 8.4 per thousand. More frequent reasons for encounters were: feeling depressed (12.7%), social handicap (mainly social isolation/living alone) (6.4%), relationship problem with partner (5.1%) and feeling anxious (3.2%). More frequent health problems were: depressive disorder (23.6%), anxiety disorder (8.3%), cerebrovascular disease (5.1%) and loss/death of partner (3.8%). Conclusions: Crying in primary care is not uncommon. Reasons for crying cover the whole range of human problems, mainly social and psychological problems.
Downloads
Metrics
References
Yeo M, Longhurts M. Intimacy in the patient-physician relationship. Can Fam Physician. 1996; 42: 1505-8.
Platt FW. Conversation repair: Case studies in doctor-patient communication. Boston: Little, Brown and Co.; 1995.
Wilmer HA. The doctor-patient relationship and the issues of pity, sympathy, and empathy. Br J Med Psychology. 1968; 41: 243-8. http://dx.doi.org/10.1111/j.2044-8341.1968.tb02029.x DOI: https://doi.org/10.1111/j.2044-8341.1968.tb02029.x
Krauser PS. Tears. JAMA. 1989; 261: 3612. http://dx.doi.org/10.1001/jama.1989.03420240126039 DOI: https://doi.org/10.1001/jama.1989.03420240126039
Wagner RE, Hexel M, Bauer WW, Kropriunigg U. Crying in hospitals: a survey of doctors’, nurses’, and medical students’ experience and attitudes. Med J Aust. 1997; 166: 13-6. DOI: https://doi.org/10.5694/j.1326-5377.1997.tb138695.x
Nieuwenhuis-Mark RE, Van Hoek A, Vingerhoets A. Understanding excessive crying in neurologic disorders: nature, pathophysiology, assessment, consequences, and treatment. Cogn Behav Neurol. 2008; 21: 111-23.
http://dx.doi.org/10.1097/WNN.0b013e31816be8f8 DOI: https://doi.org/10.1097/WNN.0b013e31816be8f8
Paparrigopoulos T, Ferentinos P, Kouzoupis A, Koutsis G, Papadimitriou GN. The neuropsychiatry of multiple sclerosis: focus on disorders of mood, affect and behaviour. Int Rev Psychiatry. 2010; 22: 14-21. http://dx.doi.org/10.3109/09540261003589323 DOI: https://doi.org/10.3109/09540261003589323
Presecki P, Mimica NP. Involuntary emotional expression disorder- new/old disease in psychiatry and neurology. Psychiatr Danub. 2007; 19: 184-8.
Robinson RG, Parikh RM, Lipsey JR, Starkstein SE, Price TR. Pathological laughing and crying following stroke: Validation of a measurement scale and a double-blind treatment study. Am J Psychiatry. 1993; 150: 286-93. DOI: https://doi.org/10.1176/ajp.150.2.286
Grinblat N, Grinblat E, Grinblat J. Uncontrolled crying: characteristics and differences from normative crying. Gerontology. 2004; 50: 322-9. http://dx.doi.org/10.1159/000079131 DOI: https://doi.org/10.1159/000079131
Vingerhoets AJ, Rottenberg J, Cevaal A, Nelson JK. Is there a relationship between depression and crying? A review. Acta Psychiatr Scand. 2007; 115: 340-51. http://dx.doi.org/10.1111/j.1600-0447.2006.00948.x DOI: https://doi.org/10.1111/j.1600-0447.2006.00948.x
Nyman K. The weeping patient. Aust Fam Physician. 1991; 20: 444-5.
Petricek G, Vric-KeglenicM, Lazic C, Murgic L. How to deal with a crying patient? A study from a primary care setting in Croatia using the “critical incident technique”. Eur J Gen Pract. 2011; 17: 153-9. http://dx.doi.org/10.3109/13814788.2011.576339 DOI: https://doi.org/10.3109/13814788.2011.576339
Gérvas J, Pérez-Fernández MM, Starfield B. Primary care, financing and gatekeeping in Western Europe. Fam Pract. 1994; 11: 307-17. http://dx.doi.org/10.1093/fampra/11.3.307 DOI: https://doi.org/10.1093/fampra/11.3.307
Gérvas J, Pérez Fernández M. Organização da atenção primária em outros países do mundo. In: Gusso G, Lopes JMC, coordenadores. Tratado de Medicina de Familia e Comunidade. Porto Alegre: SBMFC Artmed; 2011. v. 1, p. 42-51.
Gómez-Rodríguez E, Moreno-Raymundo P, Hernández-Monsalve M, Gérvas J. Socio-economic status, chronic morbidity and health services utilization by families. Fam Pract. 1996; 13: 382-5. http://dx.doi.org/10.1093/fampra/13.4.382 DOI: https://doi.org/10.1093/fampra/13.4.382
World Organization of National Colleges, Academies – WONCA. International Classification Committee. International Classification of Primary Care. 2nd ed. Oxford: Oxford University Press; 1998.
Palomo L, Gérvas J, García-Olmos L. La frecuencia de las enfermedades atendidas y su relación con el mantenimiento de la destreza del médico de familia [The frequency of illness attended and its relationship with the maintenance of the family doctor’s skill]. Aten Primaria. 1999; 23: 363-70.
Fitjen GH, Blijham GH, Knottnerus JA. Occurrence and clinical significance of overt blood loss per rectum in the general population and in medical practice. Br J Gen Pract. 1994; 44: 320-5.
Lamberts H, Brouner HJ, Mohrs J. Reason for encounter and episode of care and process oriented standard output from the transition project. Amsterdam: Department of Family Medicine; 1991. v. 1-2.
McCormick A, Fleming D, Charlton J. Morbidity statistics from general practice. Fourth national study 1991-1992. London: HMCO; 1995.
Soler JK, Okkes I, Oskams S, Van Boven K, Zivotic P, Jevtic M, et al. An international comparative family medicine study of the Transition Project data from the Netherlands, Malta and Serbia. Is family medicine an international discipline? Comparing incidence and prevalence rates of reasons for encounter and diagnostic titles of episodes of care across populations. Fam Pract. 2012; 29: 283-98. http://dx.doi.org/10.1093/fampra/cmr098 DOI: https://doi.org/10.1093/fampra/cmr098
Taylor RB, David AK, Johnson TA, Melesa-Phillips D, Scheger JE. Family medicine: Principles and practice. 4th ed. New York: Spinger Verlag; 1994.
Rakel RE. Textbook of family practice. 5th ed. Philadelphia: WB Saunders; 1995.
Barker LR, Burton JR, Zieve PD. Principles of ambulatory medicine. 4th ed. Baltimore: Willians and Wilkins; 1995.
Noble J, Greene HL, Modest GA, Levison W, Young MJ. Textbook of primary care medicine. 2nd ed. St. Louis: Mosby; 1996.
Sloane PD, Slatt LM, Ebell MH, Jacques LB. Essentials of familiy medicine. 4th ed. Baltimore: Lippincott Williams Wilkins; 2002.
Sociedad Española de Medicina Familiar y Comunitaria - SEMFYC. Tratado de medicina de familia y comunitaria. Barcelona: SEMFYC; 2007.
Gusso G, Lopes JM (organizadores). Tratado de Medicina de Família e Comunidade. Porto Alegre: SBMFC Artmed; 2012. DOI: https://doi.org/10.11606/issn.1679-9836.v91i0p43-44
Gérvas J, Pérez Fernández M, Gutierrez Parres B. Consultas sagradas: serenidad en el apresuramiento [Sacred encounters: serenity in haste]. Aten Primaria. 2009; 41: 41-4. http://dx.doi.org/10.1016/j.aprim.2008.05.005 DOI: https://doi.org/10.1016/j.aprim.2008.05.005
Andersen TF, Mooney G, editors. The challenges of medical practice variations. Hampshire: MacMillan Press; 1990. DOI: https://doi.org/10.1007/978-1-349-20781-7
García-Olmos LM, Abraira V, Gérvas J, Otero A, Pérez-Fernández M. Variability in GP’s referral rates in Spain. Fam Pract. 1995; 12: 159-62. http://dx.doi.org/10.1093/fampra/12.2.159 DOI: https://doi.org/10.1093/fampra/12.2.159
Gérvas J. Hospitalizaciones evitables en España: el poderoso atractivo del hospital y la debilidad de la atención primaria [Ambulatory Care Sensitive Conditions in Spain: the strong attraction of hospital and the weakness of primary care]. En:Variabilidad en las hospitalizaciones potencialmente evitables relacionadas con las reagudizaciones de enfermedades crónicas. Atlas de Variaciones en la Práctica Médica. 2011; 8(4): 329-30.
Hart JT. Innovative consultation time as a common European currency. Eur J Gen Pract. 1995; 1: 34-7. http://dx.doi.org/10.3109/13814789509160753 DOI: https://doi.org/10.3109/13814789509160753
Pastor-Sánchez R, López-Miras A, Pérez-Fernández M, Gérvas J. Continuidad y longitudinalidad en medicina general en cuatro países europeos [Continuity and longitudinality of care in general practice in four European countries]. Rev Esp Salud Pública. 1997; 71: 479-85. http://dx.doi.org/10.1590/S1135-57271997000500006 DOI: https://doi.org/10.1590/S1135-57271997000500006
Lamberts H, Wood M, Hofmans-Okkes I, editors. The International Classification of Primary Care in the European Community. Oxford: Oxford University Press; 1993.
Forés M, Gérvas J, Bonet M, Marcos L, Tomás P, Sagués A, et al. ICPC in Spain. Epidemiological aspects of patient data in Spanish general practice. In: Lamberts H, Wood M, Hofmans-Okkes I, editors. The International Classification of Primary Care in the European Community. Oxford: Oxford University Press; 1993. p. 119-24.
Downloads
Published
How to Cite
Issue
Section
License
By submitting a manuscript to the RBMFC, authors retain ownership of the copyright in the article, and authorize RBMFC to publish that manuscript under the Creative Commons Attribution 4.0 license and identify itself as the vehicle of its original publication.