randomly selected for the study. Patients were selected if they were aged 16–75, did not
have a life-threatening condition, if they were not attending for administrative/
preventive reasons, and if the GP involved considered that they would not be upset by the
project. Overall, 359 patient were invited to take part in the study and a total of 200
patients completed all assessments and were included in the data analysis.Design The study involved a randomized controlled design with two conditions: (1)
sharing consulting style and (2) directive consulting style. Patients were randomly allo-
cated to one condition and received a consultation with the GP involving the appropriate
consulting style.Procedure A set of cards was designed to randomly allocate each patient to a condi-
tion. When a patient entered the consulting room they were greeted and asked to
describe their problem. When this was completed, the GP turned over a card to determine
the appropriate style of consultation. Advice and treatment were then given by the GP in
that style. For example, the doctor’s judgment on the consultation could have been
either, ‘This is a serious problem/I don’t think this is a serious problem’ (a directive style)
or, ‘Why do you think this has happened?’ (a sharing style). For the diagnosis, the doctor
could say either, ‘You are suffering from.. .’ (a directive style) or, ‘What do you think is
wrong?’ (a sharing style). For the treatment advice the doctor could say either, ‘It
is essential that you take this medicine’ (a directive style) or, ‘What were you hoping I
would be able to do?’ (a sharing style). Each consultation was recorded and assessed by
an independent assessor to check that the consulting style used was in accordance with
that selected.Measures All subjects were asked to complete a questionnaire immediately after
each consultation and one week later. This contained questions about the patient’s
satisfaction with the consultation in terms of the following factors:
The doctor’s understanding of the problem. This was measured by items such as
‘I perceived the general practitioner to have a complete understanding’.
The adequacy of the explanation of the problem. This was measured by items such as
‘I received an excellent explanation’.
Feeling helped. This was measured by the statements ‘I felt greatly helped’ and ‘I felt
much better’.Results
The results were analysed to evaluate differences in aspects of patient satisfaction
between those patients who had received a directive versus a sharing consulting style. In
addition, this difference was also examined in relation to patient characteristics (whether
the patient had a physical problem, whether they received a prescription, had any tests
and were infrequent attenders).80 HEALTH PSYCHOLOGY