Factors influencing general practitioners' management of psychosocial and physical problems: a study using case vignettes.

The reactions of a random sample of 72 Oxfordshire general practitioners to case vignettes illustrating psychosocial and physical presentations were assessed with a set of attitude rating scales. Two main underlying factors appeared to influence responses. The first reflected positive attitudes to both physical and psychosocial problems, and was associated with postgraduate experience in psychiatry and with older age. The second, reflecting measures of flexibility and responsibility for outcome, was associated with younger age and not having received vocational training. Other characteristics of the practitioners and their practices were not significantly related to these factors, and there was considerable unexplained variance. In addition, certain sex differences emerged: men general practitioners rated their ability to manage cases more highly than did their women colleagues, while women practitioners experienced more anxiety. These findings suggest that personal traits and qualities may remain a stronger determinant of general practitioners' reactions to patients' problems than formal training and qualifications.