Sabotaging one's own medical care. Prevalence in a primary care setting
R. A. Sansone, M. W. Wiederman, L. A. Sansone and S. Mehnert-Kay
Department of Psychiatry, University of Oklahoma College of Medicine, Tulsa, USA.
This study determines the prevalence of medically self-sabotaging behaviors
reported by patients in a primary care setting. A 19-item self-report
survey was completed by patients on-site at the Family Medicine Clinic,
University of Oklahoma College of Medicine-Tulsa. Four hundred eleven
consecutive male and female patients were seen for nonemergent care. Each
of the 19 items was endorsed by at least 1 respondent. The most commonly
endorsed self-sabotaging behaviors were not seeking medical care when
needed (37.2%) and not taking a prescribed medication (25.1%).
Significantly more women (26.4%) than men (17.5%) reported not taking a
prescribed medication (P < .05). After excluding these 2 commonly
endorsed items, 27 (6.6%) of the respondents reported at least 1 other
self-sabotaging behavior, with most indicating 1 (63.0%) or 2 (22.2%); the
remaining 4 individuals reported 4 to 12 behaviors. Significantly more men
(4.8%) than women (0.6%) reported not following instructions from a
physician or nurse to prolong illness (P < .05). A few patients (6.6%)
seen in a primary care university outpatient clinic acknowledged the active
and intentional sabotage of their medical care, beyond not taking a
prescribed medication or seeking medical care when needed. This is probably
a conservative estimate and indicates that medical care is actively
compromised by a few patients.
