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8 Less than 10% of risky drinkers attended the primary healthcare benefit from BI. 7 The main barriers in implementing EI and BI in primary care are time constraints, lack of financial incentives, insufficient training or absence of services to refer patient to and risk of upsetting patient.
As a supervisor I have helped supervisees who are struggling with serious and upsetting patient complaints, seriously ill relatives, personal illnesses and serious clinical errors, all of which can trigger the kind of breakdown that leads one to seek professional help.
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Staff concerns about potentially upsetting patients were cited more frequently than patient concerns.
When deciding who to advise, GPs try to avoid upsetting patients [ 20] and are more comfortable discussing smoking with smokers who want to stop [ 15].
Uncertainty about how and when to raise the topic of weight, and the threat of alienating and/or upsetting patients, are contributing to an unease and a lack of motivation by healthcare professionals to identify weight as an issue.
To avoid upsetting patients and extinguishing hope, some clinicians talked about heart failure in euphemistic terms, such as having an 'ageing heart'stiffiff heart' or 'heart not pumping efficiently'.
General Practitioners have reported giving patients advice on likely outcomes, but in the same study avoidance of the term 'osteoarthritis' for fear of upsetting patients, appeared to be associated with a perception by GPs that OA does in fact have a poor outcome [ 23].
Explain this in a straightforward and non-accusatory manner to avoid upsetting the patient.
The societal stigma associated with excess weight means that weight status terms may be misunderstood, cause offence and risk upsetting patient-professional relationships.
Patients often do not recall and understand the information given, and when information is particularly upsetting, most patients are too stunned to register any further information given to them (Hogbin and Fallowfield, 1989).
"But these two particular shortages have been very, very upsetting to patients and to us".
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com