{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T03:34:18Z","timestamp":1764646458566,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"departmental resources"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Empathetic listening can be particularly challenging with patients presenting pressured speech, while time pressure and costs limit practitioners\u2019 availability. We aimed to explore general practitioners\u2019 (GPs\u2019) experiences when encountering a patient with pressured speech without pathological syndrome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using a thematic analysis method, 19 semi-structured interviews were conducted with GPs purposively sampled in Ile-de-France region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three themes emerged. First, misgivings were aroused when meeting a patient with pressured speech, including frustration, displeasure, and a struggle to maintain focus. Second, huge efforts were needed to adhere to the appropriate clinical reasoning and care for these patients who need more time and energy. The very definition of this condition varies from one clinician to another, and for some, psychiatric conditions were systematically associated. Third, implementation of specific strategies was required to adjust to these patients: trying to create distance with the patient, to organize a framework in which the patient with pressured speech can express him or herself, and even strategies to increase GPs\u2019 availability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The time and energy required to provide adequate care for patients presenting with pressured speech make it quite challenging, and this builds up pressure in the waiting room. But when medical demands take this form, there is a risk that clinicians will reject the patient or refer early to mental health services, leading to growing feelings of abandonment, the neglect of organic issues, and medical nomadism. Initial and continuing medical training focussing on advanced communication skills and multifocal approaches can foster long-term follow-up.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmad088","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T19:42:08Z","timestamp":1693597328000},"page":"575-581","source":"Crossref","is-referenced-by-count":1,"title":["General practitioners\u2019 perceptions of dealing with patients with pressured speech: a qualitative study"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5735-4342","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Lallier","sequence":"first","affiliation":[{"name":"Department of Medical Practice, Universit\u00e9 de Paris-Cit\u00e9 , Epernon, Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christelle","family":"Hourantier","sequence":"additional","affiliation":[{"name":"Department of Child, Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris , Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Gilles de la Londe","sequence":"additional","affiliation":[{"name":"Department of General Practice, University of Paris-Cit\u00e9, Health Faculty, School of Medicine , Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9970-6879","authenticated-orcid":false,"given":"Gr\u00e9goire","family":"Billon","sequence":"additional","affiliation":[{"name":"Maudsley Simulation, South London and Maudsley National Health Service (NHS) Foundation Trust , London , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-8431","authenticated-orcid":false,"given":"Jean-S\u00e9bastien","family":"Cadwallader","sequence":"additional","affiliation":[{"name":"Department of General Practice, Sorbonne University , Paris , France"},{"name":"Institut Pierre Louis d'\u00c9pid\u00e9miologie Et de Sant\u00e9 Publique, INSERM, Sorbonne University , Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6776-1611","authenticated-orcid":false,"given":"Marie-Aude","family":"Piot","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Necker-Enfants Malades Hospital-APHP , Paris , France"},{"name":"School of Medicine, Universit\u00e9 de Paris-Cit\u00e9- Health Faculty , Paris , France"},{"name":"Universit\u00e9 Paris-Saclay, UVSQ, INSERM, CESP, Team DevPsy , Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"issue":"3","key":"2023112400341024500_CIT0001","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/ACM.0b013e3182086fe1","article-title":"Physicians\u2019 empathy and clinical outcomes for diabetic patients","volume":"86","author":"Hojat","year":"2011","journal-title":"Acad Med"},{"issue":"7","key":"2023112400341024500_CIT0002","first-page":"494","article-title":"Practitioner empathy and the duration of the common cold","volume":"41","author":"Rakel","year":"2009","journal-title":"Fam Med"},{"issue":"8","key":"2023112400341024500_CIT0003","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1097\/ACM.0b013e318299f3e3","article-title":"Teaching empathy to medical students: an updated, systematic review","volume":"88","author":"Batt-Rawden","year":"2013","journal-title":"Acad Med"},{"issue":"1","key":"2023112400341024500_CIT0004","first-page":"1","article-title":"Composants, m\u00e9canismes, d\u00e9veloppement et fonctions de l\u2019empathie","volume":"13","author":"Decety","year":"2016","journal-title":"BMC Psychiatry"},{"issue":"1","key":"2023112400341024500_CIT0005","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.burn.2017.06.003","article-title":"Examining the relationship between burnout and empathy in healthcare professionals: a systematic review","volume":"6","author":"Wilkinson","year":"2017","journal-title":"Burn Res"},{"issue":"2","key":"2023112400341024500_CIT0006","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1080\/08998280.2003.11927898","article-title":"Communication gaffes: a root cause of malpractice claims","volume":"16","author":"Huntington","year":"2003","journal-title":"Proc Bayl Univ Med Cent"},{"volume-title":"La communication professionnelle en sant\u00e9","year":"2016","author":"Richard","key":"2023112400341024500_CIT0007"},{"issue":"5","key":"2023112400341024500_CIT0008","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1525-1497.2006.00443.x","article-title":"Educating for empathy. 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