Hurtaud Aline, Laurent Clémence, Bouazzi Leïla, Merland Emilie Thery, Barbe Coralie
General Practice Department, University of Reims Champagne Ardenne, 51 Rue Cognacq Jay, Reims, 51100, France.
University of Reims Champagne Ardenne, 51 Rue Cognacq Jay, Reims, 51100, France.
BMC Prim Care. 2025 Apr 22;26(1):118. doi: 10.1186/s12875-025-02804-2.
It is important for patients to feel that they can address any topic during a consultation with a General Practitioner (GP), so that the care delivered is appropriate and relevant. This study aimed to investigate factors associated with unvoiced concerns of patients during a GP consultation, because of embarrassment, modesty and/or a fear of being judged.
Cross-sectional, observational study between December 2023 and January 2024, using a ad hoc questionnaire completed by adult subjects who accepted to participate in the study. The factors associated with unvoiced concerns with a p-value < 0.20 by univariable analysis were included in a multivariable logistic regression model.
In total, 2104 participants were included (mean age 43.7 ± 15.9 years; 73% women). Of these, 680 (32.3%, (95% CI, 30.3-34.3)) reported that they had leaved unvoiced concerns during the consultation due to embarrassment, modesty and/or a fear of being judged. The main motives for embarrassment, modesty and/or fear of being judged were: "sexual behavior, libido, perception of your gender, erectile dysfunction, vaginal dryness" (15% of respondents), and "psychological disorders, low mood, anxiety" (14%). Factors associated with a higher likelihood of unvoiced concerns were female sex (adjusted odds ratio (aOR) 1.5 [95% CI 1.2-1.9]; p = 0.0001) and third-level education (aOR 1.3 [95% CI 1.05-1.7]; p = 0.02). Conversely, heterosexuality (aOR 0.7 [95% CI 0.5-0.98]; p = 0.04) and a relationship of trust with the GP (aOR 0.6 [95% CI 0.5-0.7]; p < 0.0001) were associated with a lower likelihood of unvoiced concerns during GP consultation. Forty-seven percent of respondents said that hearing their GP reaffirm the secrecy of anything said during the consultation would have helped them to be more forthcoming, and 78% reported that they would have felt more at ease if the GP had addressed the difficult topic first.
Simple tools that could be used during primary care consultations could help to address sensitive issues and create an environment where patients can more comfortably address all their health issues without discomfort.
患者在与全科医生（GP）会诊时能畅所欲言很重要，这样提供的护理才恰当且相关。本研究旨在调查全科医生会诊期间患者因尴尬、羞怯和/或害怕被评判而未表达的担忧相关因素。
2023年12月至2024年1月进行的横断面观察性研究，使用由同意参与研究的成年受试者填写的特设问卷。单变量分析中p值<0.20的与未表达担忧相关的因素纳入多变量逻辑回归模型。
共纳入2104名参与者（平均年龄43.7±15.9岁；73%为女性）。其中，680人（32.3%，（95%CI，30.3 - 34.3））报告称，由于尴尬、羞怯和/或害怕被评判，他们在会诊期间有未表达的担忧。尴尬、羞怯和/或害怕被评判的主要原因是：“性行为、性欲、对自身性别的认知、勃起功能障碍、阴道干涩”（15%的受访者），以及“心理障碍、情绪低落、焦虑”（14%）。与未表达担忧可能性较高相关的因素是女性（调整后的优势比（aOR）1.5 [95%CI 1.2 - 1.9]；p = 0.0001）和高等教育程度（aOR 1.3 [95%CI 1.05 - 1.7]；p = 0.02）。相反，异性恋（aOR 0.7 [95%CI 0.5 - 0.98]；p = 0.04）以及与全科医生的信任关系（aOR 0.6 [95%CI 0.5 - 0.7]；p < 0.0001）与全科医生会诊期间未表达担忧的可能性较低相关。47%的受访者表示，听到全科医生重申会诊期间所说内容的保密性会有助于他们更坦率，78%的受访者报告称，如果全科医生先提及这个棘手话题，他们会感觉更自在。
在初级保健会诊期间可使用的简单工具有助于解决敏感问题，并营造一个患者能更舒适地提出所有健康问题而无不适感的环境。
