Abstract

ABSTRACT
Objective: An exploratory study to investigate general
practitioners’ (GPs’) views and experiences of
consulting with young people (aged 12–19 years)
presenting with emotional distress in general practice.
Design: A qualitative study using grounded theory and
situational analysis. Empirical data were generated
through in-depth interviews based on a topic guide
developed from the literature, and augmented with a
series of situational maps. Continuous field notes and
theoretical memos were recorded during data collection
and analysis.
The data were analysed using the constant
comparative method of grounded theory. There were
three levels of analysis. The first level developed the
open codes and is presented here.
Setting: 18 general practices located in the north east
of England. The practices recruited included rural,
urban and mixed populations of patients who were
predominantly living in socioeconomically
disadvantaged communities.
Participants: 19 GPs (10 women) aged between 29
and 59 years participated. The modal age range was
40–49 years. Theoretical sampling was used to guide
recruitment and continued until theoretical saturation
was reached.
Results: The overarching finding was that anxiety
about practice dominated clinical consultations
involving young people presenting with emotional
distress. GPs responded differently to anxiety and to
related uncertainties about professional practice,
independent of GP age or gender. Anxiety occurred in
the consultation, at an external level, across
disciplinary boundaries, in relation to communication
with young people and secondary to the complexity of
presentations.
Conclusions: Adolescent emotional distress presents
professional challenges to GPs who feel ill-equipped
and inadequately prepared to address early need.
Medical education needs to prepare doctors better.
More research is needed to look at what factors
facilitate or prohibit greater GP engagement with
emotionally distressed young people.