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At the heart of general practice since 1960

Happy? Never more so, say GPs

Openness is not always the best policy when talking to patients about their illness, a new study concludes.

Researchers found that giving patients stark medical terms can increase their anxiety without improving their understanding.

The study reopens the debate on how much information it is appropriate to give patients, with one GP trainer calling the findings 'paternalistic'.

Researchers surveyed 447 patients and found those told they had 'heart failure' had a significantly stronger emotional reaction than those given GPs' favourite euphemism ­ 'fluid on your lungs as your heart is not pumping hard enough'.

They also believed their condition would be more serious, more variable over time and would last for longer, without showing any greater understanding of their illness.

Study leader Professor Jane Ogden, professor of health psychology at the University of Surrey, said: 'This study suggests the area of heart failure may be one where GPs may choose to compromise openness for sake of the patient and that this fear of upsetting people is well founded.

'The evidence does show that shock and fear can lead to denial and blocking rather than behaviour change.'

In the same study, researchers assessed the view of 42 GPs and found they tended to use one of five euphemisms for heart failure (see box).

GPs also tended to use 'lump' instead of 'tumour', 'need palliative care' instead of 'dying' and 'down there' instead of sexual organs, Professor Ogden said.

Dr Olly O'Toole, a GP trainer and a GP in Dunstable, Bedfordshire, said: 'I think we have a duty to inform patients what is wrong with them in a general way, but if we went into too much detail then it would scare them.'

But Dr Richard Stokell, a GP in Prenton, Wirral, and a GP trainer, said: 'As a general rule it is probably paternalistic not to tell people what their diagnosis is.'

The study is published in next month's Patient Education and Counselling.

GPs top five

euphemisms for

heart failure

1You have fluid on your lungs as your heart is not pumping hard enough

2Your heart is a bit weaker than it used

to be

3Your heart is not pumping properly

4Your heart is not working efficiently

5Your heart, which is a pump, is not working as well as it should, causing back pressure on the lungs

By Cato Pedder

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