Volume 22 Issue 2
Feb.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(2): 321-325
LOU Zheng, LIU Ying, REN Jingjing. A study of the opinions of general practitioners in Zhejiang Province on the diagnosis and treatment of medically unspecified disease[J]. Chinese Journal of General Practice, 2024, 22(2): 321-325. doi: 10.16766/j.cnki.issn.1674-4152.003394
Citation: LOU Zheng, LIU Ying, REN Jingjing. A study of the opinions of general practitioners in Zhejiang Province on the diagnosis and treatment of medically unspecified disease[J]. Chinese Journal of General Practice, 2024, 22(2): 321-325. doi: 10.16766/j.cnki.issn.1674-4152.003394
shu

A study of the opinions of general practitioners in Zhejiang Province on the diagnosis and treatment of medically unspecified disease

doi: 10.16766/j.cnki.issn.1674-4152.003394
  • 1.

    Department of General Practice, Affiliated Tiantai Hospital, Hangzhou Medical College, Taizhou, Zhejiang 317200, China

Funds:

 72274169

 Y202146068

 CX2022021

  • Received Date: 2023-02-18
    Available Online: 2024-03-27
    Abstract
  •   Objective  To understand the perspectives of general practitioners regarding the diagnosis and treatment of medically unspecified disease (MUD).  Methods  From June to August 2019, a total of 425 general practitioners from 11 prefecture level cities of Zhejiang Province were selected using stratified cluster sampling. These practitioners were investigated using a self-designed questionnaire that covered their basic information and perspectives on the diagnosis and treatment of MUD. The questionnaire utilized the "Likert Scale" scoring method for evaluation and subsequent statistical analysis.  Results  A total of 425 questionnaires were distributed, with 325 recovered and deemed valid. Among the respondents, there were 127 males (39.1%) and 198 females (60.9%), with an average age of (38.41±7.74) years. The survey found that 54.1% of general practitioners expressed pressure when treating MUD patients, while 41.6% expressed uncertainty in handing MUD cases. However, a significant majority (72.0%) of general practitioners believed it was worthwhile to assist these patients. Additionally, 70.5% of general practitioners considered MUD challenging to diagnosis, and 68.3% found MUD treatment to be challenging. Notably, male general practitioners in general hospitals demonstrated a higher willingness to treat MUD, which correlated with their years of experience. Overall, general practitioners acknowledged the significant pressure posed by MUD patients. Furthermore, age, length of service, professional title, educational background, workplace, and hospital level all affected doctors ' approach to the diagnosis and treatment of MUD.  Conclusion  Currently, general practitioners lack confidence in the diagnosis and treatment of MUD. To address this issue, it is necessary to establish a MUD diagnosis and treatment center under the leadership of the general medical department in a general hospital. This center should collaborate with multidisciplinary teams and community hospitals to develop a standardized MUD diagnosis and treatment process. Additionally, implementing an early training plan is necessary to foster general practitioners ' general practice thinking, improve their communication skills, and enhance their diagnosis and treatment ability. It is important to establish a harmonious doctor-patient relationship and promote individualized joint decision-making between doctors and patients. Finally, comprehensive management of MUD should be supported by providing recommendations and guidance.

     

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    • References(20)
  • [1]
    娄铮, 刘颖, 邵双阳, 等. 未分化性疾患(未分化疾病)的研究进展[J]. 全科医学临床与教育, 2021, 19(7): 636-639. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYL202107017.htm

    LOU Z, LIU Y, SHAO S Y, et al. Research progress of MUD[J]. Clinical Education of General Practice, 2021, 19(7): 636-639. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYL202107017.htm
    [2]
    POLONI N, IELMINI M, CASELLI I, et al. Medically unexplained physical symptoms in hospitalized patients: a 9-year retrospective observational study[J]. Front Psychiatry, 2018, 9: 626.
    [3]
    邱艳, 任文, 刘颖, 等. 综合性医院全科线上-线下门诊就诊情况分析[J]. 中华医院管理杂志, 2018, 34(7): 552-555.

    QIU Y, REN W, LIU Y, et al. Analysis on the features of outpatients between online and offline general practice clinics[J]. Chinese Journal of Hospital Administration, 2018, 34(7): 552-555.
    [4]
    HOUWEN J, LUCASSEN P L, STAPPERS H W, et al. Improving GP communication in consultations on medically unexplained symptoms: a qualitative interview study with patients in primary care[J]. Br J Gen Pract, 2017, 67(663): 716-723. doi: 10.3399/bjgp17X692537
    [5]
    朱佳宏, 刘颖, 任菁菁, 等. 以乏力为表现的未分化疾病全科诊疗思路[J]. 中华全科医学, 2023, 21(4): 539-543. doi: 10.16766/j.cnki.issn.1674-4152.002926

    ZHU J H, LIU Y, REN J J, et al. Diagnosis and treatment of medically unspecified disease manifested by fatigue: a general practice perspective[J]. Chinese Journal of General Practice, 2023, 21(4): 539-543. doi: 10.16766/j.cnki.issn.1674-4152.002926
    [6]
    GOL J, TERPSTRA T, LUCASSEN P, et al. Symptom management for medically unexplained symptoms in primary care: a qualitative study[J]. Br J Gen Pract, 2019, 69(681): e254-e261. doi: 10.3399/bjgp19X701849
    [7]
    STORTENBEKER I, HOUWEN J, VAN DULMEN S, et al. Quantifying implicit uncertainty in primary care consultations: a systematic comparison of communication about medically explained versus unexplained symptoms[J]. Patient Educ Couns, 2019, 102(12): 2349-2352. doi: 10.1016/j.pec.2019.07.005
    [8]
    JØSSANG I H, AAMLAND A, HJÖRLEIFSSON S. Discovering strengths in patients with medically unexplained symptoms: a focus group study with general practitioners[J]. Scand J Prim Health Care, 2022, 40(3): 405-413. doi: 10.1080/02813432.2022.2139345
    [9]
    LEHMANN M, POHONTSCH N J, ZIMMERMANN T, et al. Diagnostic and treatment barriers to persistent somatic symptoms in primary care-representative survey with physicians[J]. BMC Fam Pract, 2021, 22(1): 60. doi: 10.1186/s12875-021-01397-w
    [10]
    RASMUSSEN E B, RØ K I. How general practitioners understand and handle medically unexplained symptoms: a focus group study[J]. BMC Fam Pract, 2018, 19(1): 50. doi: 10.1186/s12875-018-0745-2
    [11]
    ABRAHAMSEN C, LINDBAEK M, WERNER E L. Experiences with a structured conversation tool: a qualitative study on feasibility in general practice in Norway[J]. Scand J Prim Health Care, 2022, 40(2): 190-196. doi: 10.1080/02813432.2022.2076396
    [12]
    战京燕, 娄景秋, 王少坤, 等. 我国全科住院医师规范化培训教学模式及应用效果研究[J]. 中国全科医学, 2021, 24(19): 2401-2407. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202119005.htm

    ZHAN J Y, LIU J Q, WANG S K, et al. The Standardized training teaching mode in standardized training of domestic general practice residents and its application effect[J]. Chinese General Practice, 2021, 24(19): 2401-2407. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202119005.htm
    [13]
    裴林夕. 2015年世界家庭医生组织亚太区大会内容简介[J]. 中华全科医师杂志, 2015, 14(8): 653-655. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX201813007.htm

    PEI L X. Brief introduction of the 2015 World Family Physicians Organization Asia-Pacific Regional Conference[J]. Chinese Journal of General Practitioners, 2015, 14(8): 653-655. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX201813007.htm
    [14]
    陈孝春, 陈先建, 赵淑珍, 等. 医师职业核心素养视阈下的医患沟通障碍分析[J]. 温州医科大学学报, 2021, 51(5): 428-430. https://www.cnki.com.cn/Article/CJFDTOTAL-WZYX202105016.htm

    CHEN X C, CHEN X J, ZHAO S Z, et al. Analysis of communication barriers between doctors and patients from the perspective of doctors ' professional core literacy[J]. Journal of Wenzhou Medical University, 2021, 51(5): 428-430. https://www.cnki.com.cn/Article/CJFDTOTAL-WZYX202105016.htm
    [15]
    HOUWEN J, LUCASSEN P L B J, VERWIEL A, et al. Which difficulties do GPs experience in consultations with patients with unexplained symptoms: a qualitative study[J]. BMC Fam Pract, 2019, 20(1): 180. doi: 10.1186/s12875-019-1049-x
    [16]
    HOUWEN J, LUCASSEN P L B J, STAPPERS H W, et al. How to learn skilled communication in primary care MUS consultations: a focus group study[J]. Scand J Prim Health Care, 2021, 39(1): 101-110.
    [17]
    HUSAIN M, CHALDER T. Medically unexplained symptoms: assessment and management[J]. Clin Med (Lond), 2021, 21(1): 13-18.
    [18]
    娄铮, 刘颖, 任菁菁. 全科医生对未分化疾病诊治观点的质性研究[J]. 中国现代医生, 2022, 60(32): 16-19, 24. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS202232028.htm

    LOU Z, LIU Y, REN J J. A qualitative study of general practitioners ' views on the diagnosis and treatment of medically unspecified disease[J]. China Modern Doctor, 2022, 60(32): 16-19, 24. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS202232028.htm
    [19]
    MARCINOW M, SANDERCOCK J, D ' SILVA C, et al. Making sense of symptoms, clinicians and systems: a qualitative evaluation of a facilitated support group for patients with medically unexplained symptoms[J]. BMC Fam Pract, 2021, 22(1): 142. doi: 10.1186/s12875-021-01495-9
    [20]
    周亚夫, 方力争, 于德华, 等. 综合医院全科医学科的定位与发展策略[J]. 中国全科医学, 2021, 24(13): 1581-1584, 1591. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202113001.htm

    ZHOU Y F, FANG L Z, YU D H, et al. General Practice Department in China ' s general hospitals: functions and development strategies[J]. Chinese General Practice, 2021, 24(13): 1581-1584, 1591. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202113001.htm
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