JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Evaluation of healthcare workers’ perceptions of difficult patients: Samsun province example
Abstract
Aims: In this study, it was aimed to evaluate the difficult patient perceptions of physicians/dentists, midwives/nurses, medical secretaries, security personnel and other healthcare professionals working in public hospitals in Samsun by comparing them according to their gender, age, marital status, profession, educational status and place of duty.
Methods: Exploratory and confirmatory factor analysis was conducted within the scope of the validity and reliability analysis of the survey created to evaluate the perceptions of difficult patients among 238 healthcare professionals working in public hospitals in Samsun, and 28 statements were collected under 4 dimensions. Student-t test, ANOVA test and post-hoc analyzes were performed at 5% significance level to test the research hypotheses.
Results: While the struggle levels of health workers were generally low, it was observed that the struggle levels of women, under 40 years of age, and health workers working in polyclinics and emergency services were lower when compared according to gender, age and the units they worked in. While the burnout levels of healthcare professionals are generally found to be above average or high, it was found that the burnout levels of female, single, undergraduate and graduate educated healthcare professionals, physicians and nurses working in outpatient clinics, emergency services and inpatient services were higher when compared according to gender, marital status, education, profession and the units where they work.
Conclusion: Within the framework of health management and organization, it is thought that in-service training should be organized for healthcare professionals with lower levels of struggle to increase their level of coping with difficult patients, and to reduce the burnout levels of healthcare professionals with higher levels of burnout, and they should be supported with tools that will enable staff empowerment.

Keywords : Difficult patient, healthcare workers, level of struggle, level of burnout, health management

Download Article


1. Koekkoek B, Van Meijel B, Hutschemaekers G. &ldquo;Difficult patients&rdquo; in mental health care: a review. <em>Psychiat Serv.</em> 2006; 57(6):795-801.
2. Ozen ME, Orum MH, Kalenderoglu A. Difficult patient in psychiatry practice: a case-control study. <em>Adıyaman &Uuml;ni J Health Sci.</em> 2018;4(3):1064-1073.
3. Hahn SR. Physical symptoms and physician-experienced difficulty in the physician-patient relationship. <em>Ann Int Med.</em> 2001;134(9):897-904.
4. Katz A. How do we define &ldquo;difficult&rdquo; patients? <em>Oncol Nurs Forum.</em> 2013;40(6):531.
5. Tanoubi I, Cruz-Panesso L, Drolet P. The patient, the physician, or the relationship: who or what is &ldquo;difficult&rdquo;, exactly? An approach for managing conflicts between patients and physicians. <em>Int J Environ Res Public Health</em>. 2021; 18(12517):1-7.
6. Rosenstein AH, O&rsquo;Daniel M. A survey of the impact of disruptive behaviors and communication defects on patient safety. <em>Jt Comm J Qual Patient Saf</em>. 2008;34:464-471.
7. O&rsquo;Malley AS, Swankoski K, Peikes D. et al. Patient dismissal by primary care practices. <em>JAMA Int Med</em>. 2017;177:1048-1050.
8. Rozel JS. Difficult relationships: patients, providers, and systems. <em>Curr Emer Hospital Med Reports</em>. 2018;6:1-7.
9. Tengilimoglu D. Chapter 2: Customer satisfaction in healthcare institutions. In: Kaya S. Quality Management in Health Institutions. <em>Anadolu Uni Open Edu Fac. </em>2013;1821:32-54.
10. Mota P, Selby K, Gouveia A, et al. Difficult patient-doctor encounters in a Swiss University outpatient clinic: cross-sectional study. <em>BMJ Open.</em> 2019;9(e025569):1-6.
11. Branson CF, Houseworth J, Chipman JG. Communication deficits among surgical residents during difficult patient family conversations. <em>J Surg Edu.</em> 2018;00(00):1-7.
12. Tamura H, Shikino K, Sogai D, et.al. Association between physician empathy and difficult patient encounters: a cross-sectional study. <em>J General Int Med.</em> 2023;38(8):1843-1847.
13. Steinmetz D, Tabenkin H. The &lsquo;difficult patient&rsquo; as perceived by family physicians. <em>Fam Pract.</em> 2001;18:495-500.
14. Shikino K, Mito T, Ohira Y, et.al. Frequency of difficult patient encounters in a Japanese university hospital and community hospitals: a cross-sectional study. <em>Japanese Soc Int Med Inter Med. </em>2023;62:533-537.
15. &Ccedil;ıkrıklar HI, Y&uuml;r&uuml;mez Y, Y&uuml;cel M, et al. Management of difficult patients in the emergency department. <em>Sakarya Med J.</em> 2016;6(1):20-26.
16. Sulzer SH. Does &ldquo;difficult patient&rdquo; status contribute to de facto demedicalization? The case of borderline personality disorder. <em>Social Sci Med.</em> 2015;142:82-89.
17. Dobrina R, Chialchia S, Palese A. &ldquo;Difficult patients&rdquo; in the advanced stages of cancer as experienced by nursing staff: a descriptive qualitative study.<em>Eur J Oncol Nurs</em>. 2020. doi:10.1016/j.ejon.2020.101766
18. Akgun Cıtak E, Avcı S, Basmacı O, Durukan I. Examination of nurses&rsquo; communication behaviors with patients they define as &ldquo;difficult patients&rdquo; in a university hospital. <em>J Res Develop Nurs.</em> 2011;1:36-44.
19. Bilişli Y, Altas B, Zetter SA. &ldquo;Difficult patient&rdquo; as an obstacle to quality health communication. <em>J Health Academi.</em> 2017;4(4):290-299.
20. &Ccedil;elik R, Erdem R. Frequency of grumpy patients in hospitals and its effect on hospital staff. <em>Hacettepe J Health Administr.</em> 2014;17(2):78-85.
21. Karag&ouml;z Y. SPSS 21.1 applied biostatistics. <em>Nobel Publish Distr.</em> 2014.
22. &Ccedil;elik R. A research on the difficult patient phenomenon and hospitals in Isparta city center (doctoral dissertation). Inst Social Sci: S&uuml;leyman Demirel Uni. 2012.
23. Kistler E. Characteristics of difficult patients in prisons compared to difficult patients in primary care settings. Indiana State University Department of Psychology, The College of Graduate and Professional Studies, Indiana. Doctoral thesis, 2011:70-103.
24. Hahn SR, Kroenke RL, Sptizer D, et.al. Degruy III, the difficult patient: prevalence, psychopathology, and functional impairment. <em>J General Int Med.</em> 1996;11:1-8.
25. Tabachnick BG, Fidell LS. Using multivariate statistics. Boston, Pearson. 2013.
26. Field AP. Discovering statistics using SPSS: and sex and drug and rock &lsquo;n&rsquo; roll (4<sup>th</sup> Edition). London: Sage, 2013.
27. Koktepe-Karahuseyınoglu E, Oguzoncul AF. Perception of difficult patient and coping methods in primary healthcare institutions. <em>Ann Clin Anal Med.</em> 2021;12(3):281-285.
28. Gibb SJ, Beautrais AL, Surgenor LJ. Health-care staff attitudes towards self-harm patients. <em>Australian New Zealand J Psy</em>. 2010; 44(8):713-720.
29. Krebs EE, Garrett JM, Konrad TR. The difficult doctor? Characteristics of physicians who report frustration with patients: an analysis of survey data. <em>BMC Health Serv Res</em>. 2006; 6(128):1-8.
30. Yıldız MS. Violence against healthcare workers in Turkey: research in Ankara province. <em>Hacettepe J Health Adminis.</em> 2019; 22(1):135-156.
31. Cannarella-Lorenzetti R, Jacques CH, Donovan C, Cottrell S, Buck J. Managing difficult encounters: understanding physician, patient, and situational factors. <em>Am Fam Physician. </em>2013;87:419-425.
32. An PG, Rabatin JS, Manwell LB, et.al. Burden of difficult encounters in primary care: data from the minimizing error, maximizing outcomes study. <em>Arch Int Med.</em> 2009;169:410-414.
33. Haas LJ, Leiser JP, Magill MK, et al. Management of the difficult patient. <em>Am Fam Phy. </em>2005;72:2063-2068.
Article available in :
Volume 7, Issue 4, 2024
Page : 426-435
https://doi.org/10.32322/jhsm.1489180
Article Information
Received : 24 May 2024
Accepted : 15 Tem 2024
Published : 30 Tem 2024
Corresponding Author :

Yavuz Selim Küçük: Department of Health Management, Faculty of Humanities and Social Sciences, Samsun University, Samsun, Turkiye

[email protected]
Citation : Küçük YS. Evaluation of healthcare workers’ perceptions of difficult patients; Samsun province example. J Health Sci Med. 2024;7(4):426-435.

Read: 158
Cited: 0
Download : 69
_Footer