• Nancy C Elder, C Jeffrey Jacobson, Therese Zink, and Lora Hasse.
• Department of Family Medicine, University of Cincinnati, Cincinnati, Ohio 45267-0582, USA. Eldernc@fammed.uc.edu
• Ann Fam Med. 2005 Nov 1; 3 (6): 537544537-44.

PurposeWe wanted to explore how patients' experiences with preventable problems in primary care have changed their behavioral interactions with the health care system.MethodsWe conducted semistructured interviews with 24 primary care patients, asking them to describe their experiences with self-perceived preventable problems. We analyzed these interviews using the editing method and classified emotional and behavioral responses to experiencing preventable problems.ResultsAnger was the most common emotional response, followed by mistrust and resignation. We classified participants' behavioral responses into 4 categories: avoidance (eg, stop going to the doctor), accommodation (eg, learn to deal with delays), anticipation (eg, attend to details, attend to own emotions, acquire knowledge, actively communicate), and advocacy (eg, get a second opinion).ConclusionsUnderstanding how patients react to their experiences with preventable problems can assist health care at both the physician-patient and system levels. We propose an association of mistrust with the behaviors of avoidance and advocacy, and suggest that further research explore the potential impact these patient behaviors have on the provision of health care.

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