The board members whispered in anxious consultation.
Most reported feeling anxious going into consultations and worrying about being reprimanded by health professionals if their child's glycaemic control had not improved.
Operating in the consultation: a coherent narrative emerged, gathered from almost all of the participants, of practitioners being anxious in the consultation because of an uncertainty about what to do and of what was expected of them as primary care clinicians.
Nevertheless, oncologists were shown to respond well to patients' behavioural cues of anxiety, as they spent a greater amount of time talking to patients who reported being more anxious before the consultation.
Some of these patients are obviously anxious about a consultation, and all GPs said that their focus was on the patient, communicating directly with the ID patients, even though they were accompanied by others.
In another study, patients with a QPL endorsed by their clinician were significantly less anxious after the consultation and recalled significantly more information about treatment issues and side effects than patients with a QPL alone.
In the most recent of these studies (Brown et al, 2001), provided the oncologist specifically addressed questions in the QPL during the consultation, those patients who received the prompt list were significantly less anxious immediately after the consultation and had better recall and significantly shorter consultations.
Many patients feel anxious and intimidated in consultations and often they want more information about the progression of their disease than a doctor can impart economically.
The clinicians were told explicitly that such intuitive feelings might arise from the condition of the child (for example, a feeling that the child was unduly lethargic despite a lack of localising signs) or the behaviour of the parents (for example, a feeling that the mother was unusually anxious compared with previous consultations).
Suggestions for the content of training included; myth busting; risk factors for self-harm and how it presents in young people; raising the issue; using the right language, including phrases and questions to ask and techniques for dealing with difficult consultations with anxious parents.
