Ohood Ghurmallah Alrabie^1,, Saeed Yahya Alzahrani²

Background: Meeting difficult patients in complex encounters in Primary Health Care (PHC) is a common situation and creates a stressful moment for both the practitioner and the user. Objectives: To estimate the percentage of difficult patients met by primary health care physicians and identify their characteristics and the conditions that make them challenging for their physicians and to evaluate coding strategies and self-efficacy of.PHC physicians in dealing with these patients. Subjects and methods: It is a facility based descriptive cross sectional study carried out in Taif city, Saudi Arabia among all primary healthcare physicians (PHCPs) working at primary healthcare centers, Ministry of health (MOH). Self-administered valid questionnaire in English Language was used in data collection. It included personal characteristics of the physicians, details of dealing with “difficult patients”, and self-rating of physicians regarding coping strategies followed in dealing with difficult patients. Results: The study included 100 PHCPs; 39% aged 31-40 years, 55% were males, 69% were Saudi nationals and half of them were Family Medicine board holders. Majority of them had history of dealing with difficult patients (93%). Among them, 48.4% reported meeting less than 10% of challenging patients in their practice whereas 21.5% met more than 25% of challenging patients. Demanding patients ranked first of the difficult patients` traits with a mean±SD of 5.32±2.51. Regarding difficult patients` conditions, poly-pharmacy patients ranked first with a mean±SD of 5.64±2.54 while patients with high blood pressure (4.13±2.49) and depression (4.06±2.38) ranked the last two conditions. Regarding strategies followed by primary healthcare physicians during dealing with difficult patients, remain calm and avoid arguing most or all the time were reported by 55.8% and 48.4% of them, respectively The highest score of coping with difficult patients was observed among physicians with experience ranged between 6 and 10 years in healthcare, p=0.001. Conclusion: Majority of primary health care physicians, MOH in Taif city had history of dealing with difficult patients. Coping with difficult patients was highest observed among physicians with experience ranged between 6 and 10 years in healthcare.

difficult, patients, communication skills, primary healthcare physicians