A new study finds that many patients who have faced domestic violence, sexual assault, depression or thoughts of suicide are likely to hide this information from their healthcare providers.
The findings, published online in JAMA Network Open, show that up to 47.5 percent of patients who have experienced one or more of these four threats do not disclose this critical information to care providers out of embarrassment, fear of judgment or the possible long-term implications of sharing such information.
Understanding how to make patients feel more comfortable with clinicians is key to helping patients address such life-threatening risks, says the study’s senior author Angela Fagerlin, PhD, chair of the department of Population Health Sciences at the University of Utah Health.
“For primary care providers to help patients achieve their best health, they need to know what the patient is struggling with,” says Fagerlin. For example, patients who withhold they have been sexually assaulted are potentially at risk for post-traumatic stress disorder and sexually-transmitted diseases, she explains.
“There are numerous ways providers can help patients, such as getting resources, therapy and treatment.”
The study involved more than 4,500 people in two national online surveys from 2015. Participants in one survey averaged 36 years old, while participants from the second had a median age of 61.
The respondents reviewed a list of medically relevant information and were asked to indicate whether they had ever withheld this information from a clinician. They were also asked the reasons why they withheld the information.
The surveys show that 40 to 47.5 percent of participants chose not to tell their provider that they had experienced at least one of the four threats. Over 70 percent said the reason why was embarrassment or fear of being judged or lectured.
If the patient was female or younger, the odds were higher they would keep this information to themselves. What compounds this issue is that several recent studies have shown how health care providers downplay or fail to take seriously women’s medical complaints.
One limitation noted by the study’s first author, Andrea Gurmankin Levy, PhD, MBe, a professor in social sciences at Middlesex Community College in Middletown, Connecticut, is that study participants may have not shared in their survey responses all the information they withheld, meaning that this phenomenon may be even more prevalent than the study reveals.
Levy says the survey reinforces that there is discomfort and a lack of trust between patients and providers. If patients filled out a questionnaire about sensitive information when they arrive at the provider’s office, might that improve the information flow? For example, is it easier to tell a piece of paper something sensitive than to look into your clinician’s eyes and say it?
This is the team’s second article based on the 2015 surveys. The first, published in November 2018, revealed that 60 to 80 percent of those surveyed did not share pertinent information with their provider regarding daily issues like diet and exercise. One third did not speak up when they disagreed with their provider’s recommendations.
Both surveys raise concerns about communication and trust between patients and their caregivers. Improving this relationship falls both on providers’ and patients’ shoulders, the authors say.
Providers need to establish an atmosphere where the patient feels neither judged nor rushed, but rather are able to share concerns fundamental to their well-being. In addition, patients will benefit by sharing sensitive information with their providers.
Researchers from University of Utah Health, Middlesex Community College, University of Michigan and University of Iowa collaborated on the study.
Source: University of Utah Health