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Doctor-patient communication: An important but often ignored aspect in clinical medicine
Abstract
Communication is an important component of patient care. However, doctors are generally not given any specific training in how to communicate well with patients. Traditionally, communication in medical school curricula was incorporated informally as part of rounds and faculty feedback, but without a specific or intense focus on skills of communication per se. It has been shown that good doctor-patient communication has an impact on better health outcomes, higher compliance to therapeutic regimens in patients, higher patient and clinician satisfaction, and a decrease in malpractice risk. It is the need of time to conduct more research in this area and to actively include teaching the art of communication skills in undergraduate and postgraduate learning programmes for the benefit of both the doctor and the patient.
... Peranan doktor dalam komunikasi membantu menjalinkan hubungan antara perorangan yang baik dan memberi kesan signifikan terhadap penjagaan kesihatan pesakit (Shukla et al., 2010). Unsur komunikasi yang diaplikasikan secara lisan atau tanpa lisan turut mempengaruhi persepsi pesakit dari aspek kepuasan, perkongsian maklumat dan hubungan antara perorangan. ...
... Kejelasan maklumat memerlukan teknik penyebaran informasi melalui amalan komunikasi yang berkesan. Shukla et al. (2010) menekankan bahawa keupayaan doktor dalam mendapatkan dan menyalurkan maklumat yang jelas berupaya mengatasi kebimbangan dan kekhuatiran pesakit mengenai masalah kesihatan yang dihadapi. Gaya komunikasi semasa memberi penerangan maklumat memerlukan strategi yang sistematik menerusi penggunaan bahasa yang mudah difahami. ...
... Pendekatan ini bertujuan membina dan membantu meredakan emosi pesakit yang berhadapan dengan masalah kesihatan. Pengkaji seperti Benson (2014), Shukla et al. (2010) dan Woodhead et al. (2015) merumuskan bahawa unsur komunikasi dalam amalan khidmat perubatan merupakan suatu pendekatan penting dalam menjalinkan hubungan komunikasi yang beretika. ...
... Con estos antecedentes, considerando que la comunicación efectiva es una habilidad que puede perfeccionarse, aprenderse y modularse a lo largo de la carrera se han propuesto instrumentos validados que aportan en la docencia. Entre los más utilizados se pueden mencionar: MAAS-Global Rating Test, Liverpool Communication Skills Assessment Scale, Kalamazoo Consensus Statement Assessment Tools, escala CICCA, Guía Calgary Cambridge (Dalen et al., 2001;Shukla et al., 2010;Kurtz et al., 2003). ...
... El enfoque estructurado y el aprendizaje formal incorporan habilidades para una efectiva comunicación médico paciente (M. et al., 2016;Shukla, Yadav, & Kastury, 2010). ...
Introducción: la comunicación dentro del ámbito médico es esencial para obtener buenos resultados de la consulta; esta habilidad debe enseñarse a lo largo de la carrera y no suponer que es innata. Después de una revisión sistemática de la metodología de enseñanza en Ecuador y el poco desarrollo que ha tenido dentro de las universidades sobre todo del sur del país se realiza un estudio evaluando las habilidades comunicacionales de los estudiantes de medicina. Metodología: cien estudiantes de último año que realizan su año de internado en el Hospital Vicente Corral Moscoso, participaron en un estudio que valoró por observación directa las entrevistas con los pacientes utilizando la Guía Calgary – Cambridge como método de evaluación. Resultados: el promedio obtenido por los evaluados fue de 13,96 de 24 habilidades evaluadas, se realizó una comparación entre aquellos estudiantes que tenían formación en comunicación medica (19) y los que no tenían ninguna (81). Se encontró los estudiantes con formación en comunicación desarrollan entrevistas con mayor empatía, escucha efectiva, respeto por las expectativas de los pacientes y son capaces de resumir los hallazgos en busca de resultados más eficaces de la comunicación. Conclusión: se observan algunas diferencias entre ambos grupos comparables con estudios internacionales. Se urge a las escuelas de medicina para llevar adelante una modificación del currículo formal que favorezca el desarrollo y aprendizaje de la comunicación como habilidad efectiva en el aprendizaje médico. El objetivo se humanizar la comunicación y favorecer una mejor relación entre médico y paciente.
... The practice of good communication among health professionals is integral for the development of meaningful and trustworthy relationships beneficial to them and the patients and greatly enhances diagnostic capability and better management of the patient [3][4][5]. For the clinicians likewise the laboratory staff; proper information about the nature, course and prognosis of the disease is important [3]. ...
... Good communication has been considered extremely important for medical practitioners in the western world since decades [5] and its significance is now being acknowledged the world over as integral for the development of meaningful trustworthy relationship among the health professionals in achieving better patients management [4,10]. ...
Background: Good communication between the clinics and the laboratories and among the health professionals enhances diagnostic capability, efficiency and better management of the patient and is necessary for accurate and precise results. The study was carried out to audit and assess communication flow between the clinic and laboratory at the Haematology Department of the University of Nigeria Teaching Hospital-Enugu. Method: A total of 1000 laboratory request forms were collated in the study and each of these forms was monitored from time of inception till dispatch. Information in the laboratory request forms were grouped into four categories; patient's biodata, clinical information, laboratory parameters and administrative parameters and analyzed statistically. Results: In patients biodata; age, sex and ethnic group fell short by 74.7%, 13.3% and 35.7% respectively. In clinical information category; clinical detail, provisional diagnosis, previous haematological requests and nature of specimen were insufficiently completed in 68.0%, 14.0%, 84.4% and 7.4% of the forms respectively. Ward, referring doctor and hospital reference number, were deficient by 1.2%, 2.4% and 65.0% respectively. Date, time of collection and date of arrival in the laboratory were lacking in all the forms. Out of the 1000 samples that arrived to the laboratory, 2% were inadequately collected or clotted and hence rejected. The information about these specimens was not communicated to the clinic/ward either through telephone or immediate dispatch for necessary repeat collection. Conclusion: We observed poor information communication between the clinicians and the laboratory and this may affect the accuracy of results. The inclusion of formal training in investigations, collection and handling of pathological samples in medical curriculum and training of practicing doctors through continuing education is recommended. Advances in technology or change in procedure should be adequately communicated to all concerned in the utility of laboratory results. Pathologists should play the critical roles of not only interpreting the results of the tests but also the continuing education of young doctors.
... The statement supported in literature that effective communication between doctor and patient is an essential element in healthcare as it is requisite for constructing a therapeutic doctorpatient relationship (Ha & Longnecker, 2010). Similarly, scholars have also pointed out that patient-centered care and consumerism in medicine have further represented the significance of effective doctor-patient communication (Shukla, Yadav & Kastury, 2010). Interpersonal communications between doctors and patients is critical in diabetes management, as it enables ...
... 41,42 The importance of the aforementioned attributes has led to increased calls to improve patient communication skills in the curriculum of doctoral healthcare programs. 43,44 Not only does effective healthcare provider communication help the patient, but it decreases the stress on the healthcare provider as well. Effective patient communication by healthcare providers has been shown to lower work-related stress and improve job satisfaction. ...
Objective:
The purpose of this study was to determine if there was a difference in history-taking skills between male and female chiropractic student interns.
Methods:
This study included 2040 patient histories collected by student interns over a 3-year period. Students were assessed by chiropractic college clinicians on reasoning (ability to derive clinically relevant information using a mnemonic for taking a history), communication, and professionalism using a modified Dreyfus model scoring system on a 1-4 scale (1 = novice, 4 = proficient). Ordinal dependent variables were scores for reasoning, communication, and professionalism. The categorical independent variable was sex of the student intern (male or female). A Mann-Whitney U test was used to compare for differences in nonparametric dependent variables by the sex of the students.
Results:
The Mann-Whitney U test revealed that communication scores were greater for female chiropractic interns compared with male chiropractic interns (p < .001, with a small effect size (r = -.08). There was no statistically significant effect for sex on reasoning (p = .263) or professionalism (p = .098).
Conclusion:
Female chiropractic student interns scored higher than male interns on communication skills during a history-taking patient encounter. This supports the trend seen among female medical school students and physicians that women score higher than men on communication-related assessments.
... Not only the scientific and expertise in various medical specialties, but also effective doctorpatient communications is necessary for building a therapeutic doctor-patient relationship.42 In recent years, a growing emphasis on patient autonomy, patientcentered care, and consumerism has further exemplified the importance of effective doctor-patient communication.43 Good doctor patient communication allows patients to freely share vital information essential for an accurate diagnosis of their problems and enables the doctor to have a better understanding of their patient needs and potentially lead to better symptom reduction.44 ...
... 11 In fact, training doctors to develop their communication skills could be cost-effective as it enhances patients' adherence. 12 The present study aimed at measuring the level of public speaking anxiety among medical residency program trainees in Riyadh city, Saudi Arabia. ...
Objective
The present study aimed at measuring the level of public speaking anxiety (PSA) among medical residents in Riyadh, in addition to identifying the factors influencing public speaking anxiety from the perspective of the medical residents.
Method
A cross-sectional survey was conducted over a sample of 203 medical residents in Riyadh. The study adopted the questionnaire as a data collection tool. The questionnaire consisted of a demographic data part, PSA scale (17 items) and a third part concerned with the factors influencing public speaking anxiety among medical residents.
Results
The results of the study revealed that medical residents in Riyadh had a low level of public speaking anxiety (47.3±11.32). The participants had a low PSA score on all scale domain; cognitive (23.28±5.43), behavioral (10.45±4.16), and physiological (13.54±3.44). Moreover, the findings of the study showed that stuttering (91.1%), negative perceptions of individuals’ own voice (77.8%), and language barriers (76.8%) were the main factors influencing the public speaking anxiety among medical residents. Finally, we found through linear regression analysis that PSA is not significantly predicted by participants’ living region, marital Status, gender, residency level, type of pre-college school, age or being previously diagnosed by a mental health issue.
Conclusion
There is a low level of public speaking anxiety among medical residents in Riyadh. In addition, the study concluded that stuttering, negative perceptions about voice and language barriers are negatively influencing the public speaking anxiety among medical residents in Riyadh.
... These aims could be achieved by creating good doctor-patient relationships. Poor quality doctor-patient communication has been found to be associated with patient dissatisfaction, reduced treatment adherence and poor health outcomes [14][15][16][17][18][19]. ...
Background:
Communication skills are fundamental to successful medical practice and can greatly impact patient satisfaction, compliance and outcomes. This study evaluated knowledge and practice of doctor- patient communication among the urban family physicians based on main items of Calgary Cambridge Observation Guides.
Method:
This cross-sectional study was conducted from July to September, 2019, in a 400 randomly selected sample of family physicians of Shiraz, Fars province. The data collection tool was a self-administered, second-part questionnaire developed by the researchers. Participants were asked about their age, gender, practice setting, and years of work experience and if they received any formal training in doctor- patient communication. Data were analyzed using SPSS (Version 16, SPSS Inc., Chicago, IL, USA). A p-value of less than 0.05 was considered statistically significant.
Results:
The study participants included 204 male and 196 female family physicians with a mean age of 46.7 ± 7.7 years. The mean communication skills knowledge score was 41.5 (SD: ± 2.8) indicating a high level of knowledge. The mean score for practices was 38.7 (SD: ± 3.4), implying a moderate level of practice. Based on Bloom's scale, nearly 80% of family physicians had good knowledge about doctor-patient communication skills, however, 55% of participants reported moderate to poor level of practice in this regard. Results of multivariate regression analysis suggest that higher levels of related knowledge, having higher age or longer work experience, and working in the public sector can predict better practice scores (P < 0.005).
Conclusion:
There is a potential gap between knowledge and self-reported practices toward communication skills among a sample of Iranian family physicians. They have fundamental weakness in the most important evidence-based items of doctor- patient communication. Considering significant role of family physicians in prevention and control of non-communicable diseases (NCDs) as an emerging challenge of our country, the topic of communication skills should be inserted as a top educational priority of family physicians.
... For this we should identify what and how the communication barrier perceived by patient. Understanding patient perception of barriers should be considered the first step to solving communication problems, as satisfactory communication is impossible without an adequate understanding of the perceptions of the patients 13 . Likewise in our context there are many factors are affect the nurse-patient communication therefore the study methodology approach in order to find-out nurse-patient communication barriers as perceived by patient. ...
The quantitative descriptive cross sectional design was employed to find out nurse-patient communication barriers as perceived by patients. The Pretested semi-structure interview schedule along with likert rating scale ranging from five to one was used. Total patients (201) admitted in general wards at least three days of hospital stay were selected. Chi square test was used bivariate analysis to find association of nurse pateint communication barrier with their socioeconomic , demographic factors as perceived by pateint. Common factors, nurse related, patients related, and environment related factors were major factor under study. During research, 78.10 % of patients percieved most barriers during nurse-patient communication. There was statistical association between common factors with age(p=0.004), marital status (p=0.025), education status (p=0.049), and types of family (p=0.022). Likewise, association also evident between nurse-related factors, types of family (p=0.02), and occupation (p=0.01). Similarly, regarding the environment-related factors, age (p=0.041), education status (p=0.05), and religion (p=0.009) had statistical association. The Result found that there was positive correlation among all factors. Among them, nurse-related factors and patient-related factors (r=0.54) have shown moderately positive correlation. It is concluded that majority of patients had perceived level of barriers in over all as most barriers.
... 2,3,9,10 Good communication skill has been considered extremely important for medical practitioners in the western world since decades. Its significance is now being acknowledged in our country and some authors have expressed the view that it is "the need of the hour" to train medical professionals in this important yet ignored aspect in clinical medicine 11,12 In this context, the present study is planned to assess the existing level of communication skills of the medicos and perceived barriers of communication by the student. ...
ntroduction: Good communication skills are a core competency for all health professionals. Any formal training on communication is in not given to students in the present curriculum. Hence the study was conducted to assess existing level of communication skills and student perceived communication barriers among third year medical students. Methodology: A cross sectional study was conducted in the field practice area of a medical college for 2 months among a convenient sample of 40 medical students. The existing levels of communication skills of students were assessed using Kalamazoo Essential elements check list and communication barriers as perceived the student were obtained using a pretested questionnaire. Results: The communication skills were very good in 50% of students, 20% excellent and 30% were having poor to average skills. Majority of the students reported lack of familiarity with place and person as a barrier [78.3% males, 58.8% females] followed by perceived interpersonal barriers like age difference, socioeconomic class difference. Conclusion: The present study revealed that most of the students have very good level of communication skills, but still 30% were falling in poor to average levels. All students perceived one or the other barriers for communication but more so with familiarity with place and person. Formal training of students on communication skills in curriculum is necessary to overcome various barriers and enable them to communicate effectively.
... The complaints from these patients included 'a feeling of being rushed', 'being neglected' and a lack of explanations for tests performed. 10 Other barriers to good communication in the doctor-patient relationship, include patients' anxiety and fear, doctors' burden of work, fear of litigation, fear of physical or verbal abuse, and unrealistic patient expectations. ...
Context
Effective doctor-patient communication is the basic requirement in building a good doctor-patient relationship. Safe practices and effective, patient-centered communication is key to quality care. Good doctor-patient communication has the potential to help regulate patients’ emotions, facilitate comprehension of medical information and allow for better identification of patients’ needs, perceptions and expectations. Doctors with better communication and interpersonal skills are able to detect problems earlier, can prevent medical crisis and expensive intervention, and provide better support to their patients.
Current research indicates that ineffective communication among healthcare professionals is one of the leading causes of medical errors and patient harm. There are many barriers to good communication in the doctor-patient relationship, including patients’ anxiety and fear, doctors’ burden of work, fear of litigation, fear of physical or verbal abuse, and unrealistic patient expectations. National accreditation board for hospitals and healthcare providers (NABH) standards and international patient safety goals focus on the importance of effective communication in healthcare settings and how it leads to patient safety.
This study is an attempt to identify gaps in patient physician communication in the current healthcare settings, find the barriers in communication and give recommendation to enhance good practices in the future.
Aims
The aim of the study is to analyze the current levels of effective patient communication in a tertiary care hospital in Delhi-NCR with help of a self-administered questionnaire. The study will assess the level of information shared with the patient.
Settings and design
The design of our proposed study is a descriptive study where we will use a self-administered questionnaire to assess the level of patient-physician communication in the selected study setting.
Materials and methods
The NABH standard were used as a guideline for preparing the self-administered questionnaire. All admitted vulnerable patients of the selected study area will consist of the population for the study. Simple random sampling technique will be used to derive the sample out of the population.
Statistical analysis used
Correlation and analysis of variance (ANOVA) were used to establish associations between the independent and dependent variables.
Results
The study shows that 48% of the respondents were of opinion that they were given partial information, while 20% of the respondents alleged that they were not given any information about the explanation of their disease, its prognosis and the treatment option that were available, i.e. a total of 62% of the patients said that they had partial information to complete lack of information that would have made them aware of their diseases, its prognosis and the treatments options available to cure it, while only 32% of the patients agreed that they were supplied with thorough information during their interaction with the physicians.
Conclusion
The majority of the patients were not wellinformed about their disease, its prognosis, treatment plan and continuity of care. There was a significant positive correlation between the communication made at initial stages of hospital stay and during the end stages of stay of patient. The main barrier to patient physician communication was time.
Key message
To ensure patient safety, it is imperative to inform patients about all the important aspects starting from admission till discharge.
How to cite this article
Sabherwal N, Mittal A, Pandey NK, Kaushal G, Kaustav P. A Study of Patient-Physician Communication and Barriers in Communication. Int J Res Foundation Hosp Healthc Adm 2015;3(2):71-78.
... Strongly agree and agree were considered 'high perception" for positive statements [1,3,6,7,8,9,10], while disagree and strongly disagree represented high perception for negative statements [2,4,5]. A total perception score was calculated; high perception was considered when the total score was greater than the mean. ...
Introduction: Effective physician-patient communication plays a crucial role in establishing a successful therapeutic outcome. Having good quality communication skills is vital for doctors to build up an agreeable doctor-patient connection. In Egypt, the discipline of effective doctor-patient communication is still underestimated Aim of work: This study aimed to assess physicians' perception concerning the significance of effective physician-patient communication and to evaluate their actual practice and patient communication skills. Materials and methods: A cross-sectional study was conducted among physicians working at outpatient clinics at Tanta University Hospitals. Data collection was done using a self-administered questionnaire sheet conveyed to 275 randomly selected physicians working in different outpatient clinics. Physicians' perception concerning effective communication was assessed by means of self-assessment questions created by Samuel and Albert, and the level of physician-patient communication practice was assessed using the adapted Kalamazoo Checklist. Results: The study included 275 physicians; 48.6% of participants had highly perceived the significance of effective communication. 'Effective doctor-patient communication is highly associated with increased patient satisfaction' showed the highest perception among physicians (94.5%). The medical curriculum followed by media and the internet were the commonest sources of participantsìnformation. About 41.8% of participant physicians had 'good' communication with a higher percentage among female doctors. Significant positive correlations were found between physicians' years of experience and communication skills practice competencies. Conclusion: About half of the physicians highly perceived the significance of effective doctor-patient communication and more than two-fifths of them had good doctor-patient communication skills. Enforcement of training courses concerning effective physician-patient communication is substantially recommended for both undergraduate students and graduated physicians.
... recently start emphasizing on the significance of doctorpatient communication and did start incorporating teaching of communication skills in many undergraduate and postgraduate programmers, still it is in its infancy in India. 2 Resident doctors/postgraduate students are the one who are directly involved in the delivering healthcare in medical colleges. Due to the nature of work they are subjected to, they need to communicate with patients and relatives at a special level. ...
Background: The pillar of doctor patient relationship is the bond of mutual trust. This pillar is strengthened by effective communication between doctor and patient/relatives. It has been widely accepted that a doctor needs to have very good communication skills in addition to clinical knowledge and skills required for effective healthcare. Every doctor duly needs to demonstrate humanity, healthy behaviour, as well as sensible communication with patients which can build the sustainable ‘trust’ in the treatment offered by that doctor. However, the current curriculum of medical courses is enormously focused on providing competent medical knowledge but lacking the focus on inculcating communication skills.Methods: A cross sectional study was carried out amongst 377 resident doctors of first to third year, from randomly selected medical colleges of Maharashtra having postgraduate courses in clinical subjects and affiliated to Maharashtra University of Health Sciences, Nashik, Maharashtra, India during the period of February 2017 to January 2019. Data was entered in MS Excel sheet and analyzed using percentages and proportions wherever appropriate.Results: Highest study respondents were from General Medicine with 13% of total and having 17.4% males and 8% females among respective genders followed by General surgery and Pediatrics residents with 12.5% each specialty.Conclusions: The study has shown that there was varied knowledge about the communication skills among the resident doctors. The residents have shown fair attitudes and behaviours towards mindfulness and basic communication skills.
... There is enough evidence in literature to suggest that poor communication between doctors and patients is an important attributing factor. [6,7] Didactic lectures are not able to teach communication skills to students. Role plays in the safe environment of classrooms help students experience and understand both the doctor's as well as patient's perspectives and also learn the complexity of the doctor-patient interview. ...
PURPOSE
Communication skills are essential for medical practice throughout the life of a doctor. Traditional undergraduate medical teaching in pediatrics focuses on teaching students with theoretical and practical knowledge of diseases, their diagnosis, and treatment modalities. This study was done to use role play as a tool to teach basic communication skills to the final-year undergraduate students in pediatrics and to assess perceptions of students and faculty for using role play to teach counseling and communication skills in pediatrics.
METHODS
It was an observational, questionnaire-based study conducted in the Department of Pediatrics on the final-year medical undergraduates. Two modules for role play on common pediatric topics were designed and role play was conducted. At the end of the session, student and faculty feedback were taken by a prevalidated questionnaire with both close (using the 5-point Likert scale) and open-ended questions. In pre- and post-role play sessions, communication skills assessment scoring was done. Statistical evaluation of the collected data was then carried out using SPSS 22.
RESULTS
A total of 98 final-year students participated in this study. Role play was found to be the most preferred tool (33%) for teaching communication skills to the students. Majority of the students (88.78%) and faculty (91.67%) felt that role play helped in teaching communicating skills. Comparison of pre- and post-role play scores on communication skills showed statistically significant improvement (P < 0.001).
CONCLUSION
Role play can be used as an effective tool to teach communication skills to undergraduate medical students in pediatrics.
... With the increase in demand for patient-centered care, together with the rise in consumerism in medicine, health service research on the doctor-patient communication has become an important area for both medical researchers and administrators in a similar way. (2) Effective communication is achieved when providers understand and integrate the information gathered from patients, and when patients catch accurate, complete and clear messages from providers in a way that enables them to take part actively in their care. (3) The provider who encourages open communication usually gets more complete information, more accurate diagnosis, and help appropriate counseling, thus potentially improving adherence to treatment plans that benefit long-term health. ...
Background: Good doctor-patient communication has multiple impacts as higher compliance,
satisfaction for both patients and clinicians and decrease in malpractice.
Objective(s): To assess physicians’ perception towards importance of effective doctor-patient
communication, as well as to measure their actual practice and skills of communication according to the
items of the Kalamazoo checklist before and after training program.
Methods: An intervention study was carried out at outpatient clinics in a general hospital at Zagazig
district. A randomly selected sample of 198 physicians was chosen. The phases of the study were: 1-
Assessing the level of doctor patient communication practice using the Kalamazoo Checklist. 2-
Assessing physicians’ perception towards effective communication, using a self-administered
questionnaire. 3- Assessing the level of doctor patient communication practice after training program.
Results: 46.5% of physicians highly perceived the importance of effective communication; with higher
perception among females. The highest perceived items (more than 80%) were the effect of good
communication on patients’ compliance, patients’ satisfaction and physicians’ satisfaction. The
intervention program significantly improved the physicians’ communication skills.
Conclusion: Less than half of the physicians highly perceived the importance of effective
communication. Training can significantly impact communication skills.
... The internship is a transition from a medical student to a certified doctor, when a new graduate takes formal training on basic skills of patient management. Many countries offer formal training and workshops on communication for freshly graduated [31][32][33][34][35] doctors before they start internship . ...
p>Proper doctor-patient communication produces therapeutic benefit on the patient. The arts and tips of communication skill can change the feelings of a patient forever. Good communication skill should have verbal, non-verbal and para-verbal components. Unfortunately, many postgraduate doctors of our country cannot satisfy the demand of their patients due to lack of training on communication skills. In this paper, a model for communication skill training has been proposed for newly graduated doctors which includes formal lecture, video demonstration, role play and evaluation by creating different scenarios. The selected time for communication skill training would be the time gap between publication of result of final professional MBBS and starting the internship training. With increasing demand of creating more communicative physicians, implementation and further recommendations on communication skill training for new graduates are encouraged.
Bangladesh Journal of Medical Education Vol.9(2) 2018: 32-36</p
... Los resultados y reflexiones presentados hasta este momento poseen importantes consecuencias para la formación de los agentes del sistema de salud y la conformación de los equipos que trabajan en salud materna en territorios rurales. Respecto de la formación de los agentes del sistema de salud, se hace evidente la necesidad de reconsiderar la importancia de incluir el desarrollo de capacidades para la identificación de diferencias culturales y para la comprensión de la perspectiva (prioridades, intereses, etc.) y situación material de los pacientes de áreas rurales, así como para lidiar con estas diferencias y situaciones de manera eficaz 26,27 . A nivel de la conformación del equipo de salud, una consecuencia adicional es el reconocimiento del potencial que tienen los promotores y agentes sanitarios para funcionar como mediadores culturales en la interfaz social que constituyen los CPN 28 . ...
Resumen La adherencia a controles prenatales constituye una herramienta fundamental para disminuir la mortalidad materna. Usualmente se piensa la adherencia a partir de las características de las mujeres asistidas o de las particularidades del sistema de salud y sus agentes. Aquí se la aborda como emergente del modo en que se articulan las racionalidades y mundos de vida de profesionales y mujeres asistidas. Se realizó un estudio de casos múltiple buscando a comprender la adherencia a controles prenatales de mujeres rurales. Se realizaron 47 entrevistas en el norte argentino a mujeres embarazadas o que habían sido madres en los últimos años y a agentes del sistema de salud. El contenido de las entrevistas fue codificado con el apoyo del software Atlas Ti. El estudio permitió identificar dos tipos de interacción médico-paciente. El primero se caracteriza por una representación de las pacientes como ignorantes y desinteresadas, lo que lleva al agente a insistir con sus recomendaciones sin atender a las dificultades vividas por las mujeres. El segundo parte de concebir a las mujeres como cumplidoras y responsables, lo que permite un mayor diálogo, aún sin que se observe un interés claro por conocer el contexto de vida de las mujeres atendidas.
... Patients who understand the nature of their illness and its treatment, and who believe the provider is concerned about their well-being, show greater satisfaction with the care received and are more likely to comply with treatment regimes. Despite widespread acknowledgement of the importance of interpersonal communication, the subject is not always emphasized in medical training (Shukla et al., 2010). ...
Having good communication skills is essential for healthcare providers to establish good healthcare provider-patient relationships. Good patient-healthcare provider communication has better health outcomes, high compliance to therapeutic regimes, higher patient and healthcare provider satisfaction and a decrease in malpractice risk. Sadly, medical colleges tend to emphasise much on the biomedical sciences at the expense of communication skills subjects. This study explored communication curriculum that is offered to nursing students at Mzuzu University to establish whether the courses prepare students to address critical communication skills needed by nurses in practice. Self-administered questionnaires (N=280) were issued to healthcare providers, student nurses and patients. Analysis was done using SPSS Version 20 and Chi-Square tests were carried out. Findings support literature suggesting that communication skills are important and that some healthcare providers have problems when communicating with their clients.
... 31 Another important factor for compliance is doctor-to-patient communication. 32 Six percent of patients with DME and two percent of patients with AMD indicated a lack of communication during their interaction with doctors. A possible solution might be to employ interpreters in hospitals to overcome language barriers. ...
Purpose:
We assessed differences in compliance and adherence (lateness of patients, visual acuity, reasons for abstaining) between patients with diabetic macular edema (DME) and patients with age-related macular degeneration (AMD), both under anti-vascular endothelial growth factor therapy.
Methods:
We included 136 patients with DME (36% women, 65 years, 22 visits, 13.9 injections, and 29.9 months of follow-up) and 109 patients with AMD (59% women, 76 years, 20 visits, 14.7 injections, and 22.3 months of follow-up) (minimum follow-up of 12 months and at least 5 injections). We assessed missed appointments (lateness >14 days) and therapy break-offs (lateness >100 days). All delayed patients were called and interviewed for abstaining reasons.
Results:
Forty-six percent of patients with DME and 22% of patients with AMD had at least one break-off. Thirty-five percent of patients with DME and 50% of patients with AMD were always on schedule. In patients with DME, there was significant correlation (P = 0.017) between the number of break-offs and change of visual acuity. In 60% DME and 38% AMD of break-off cases, visual acuity was worse than the before break-off. The most common reason for abstaining was comorbidities (33% AMD and 20% DME).
Conclusion:
There are significant differences between patients with AMD and DME regarding compliance and adherence, which also affects outcome. Strategies to tie patients with DME to costly intravitreal therapy need to be developed to improve outcomes and efficacy.
... Transcultural awareness also plays an important role in effective Health care professional -patient communication. Appropriateness of eye contact, of hand gestures, physical contact between sexes (e.g., shaking hands), and cultural beliefs surrounding the illness, are certain important aspects which should be taken into account [38]. ...
Now that chronic illnesses are the main cause of death and disability worldwide, patients must be involved in healthcare process, contributing to almost every level of decision or action. Communication is a process that is dynamic and continuous and influenced by a number of factors, and in the field of health care is of particular importance. Communication of patients with healthcare professionals affects patients' outcomes, helps them learn to regulate their emotions, increases compliance and is correlated with patient confidence and satisfaction as well as quality of life. Health communication strategies should respond to the needs of the public so that it complies with its health recommendations.
... In addition to being knowledgeable scientific experts in various specialties, effective doctor-patient communication is required for building a therapeutic doctor-patient relationship 1 . In recent years, a growing emphasis on patient autonomy, patient-centered care, consumerism in medicine has further exemplified the importance of effective doctor-patient communication 2 . Despite this, good doctor-patient communication remains a challenge for physicians, and is the underlying reason for the major part of patient complaints. ...
Purpose: Despite communication skills training in medical school, junior doctors continue to demonstrate poor patient-doctor communication skills, where patient unhappiness from the encounter often manifests as patient complaints. We sought to identify crucial communication skills that should be incorporated in the communications curriculum by learning from patient complaints, to explore how the communication lapses occur. Method: 38 cases of anonymized negative patient feedback about junior doctors were analysed using qualitative content analysis. A two-step fine-coding system involving four researchers was employed. Results: Four main themes of communication errors were identified, namely: non-verbal (eye contact, facial expression and paralanguage), verbal (active listening and inappropriate choice of words), and content (poor quantity and quality of information provided); and poor attitudes (lack of respect and empathy). Discussion: Patient-doctor communication is a complex interpersonal interaction that requires an understanding of each party׳s emotional state. We identified important but overlooked communication lapses such as non-verbal paralinguistic elements that should be incorporated into communications curriculum, with an emphasis on dialectical learning. These include integrating these findings into a simulation-based communications module for training doctors at a post-graduate level as well as monitoring and analyzing patient complaints regularly to iteratively update the content of the training module. Beyond these skills training, there is also a need to highlight negative emotions of doctors in future research, as it influences their communication patterns and attitudes towards patients, ultimately shaping how patients perceive them. Keywords: Communication skills training, Patient complaints, Patient negative feedback, Patient-Doctor communication, Residency training
... In addition, communication should simultaneously employ a patient-centred approach and interpersonal interaction to promote patient satisfaction. (14) Although much emphasis has been put on the importance of effective communication and good doctor-patient relationship in affecting patient health outcomes and satisfaction, physician satisfaction with their professional life can also be an important determinant of a good doctor patient relationship. (16) The purpose of this study is to highlight the importance of good communication in influencing the knowledge and practice of CL use which is not optimally achieved by simply giving a handout and this can inturn ensure safe contact lens wear. ...
Background: Contact lens (CL) is a modified lens generally preferred by young people as they provide a wider field of vision, reduce aberrations, do not fog, boost self-confidence and are more convenient for physical activity. Care and maintenance of CL is imperative to prevent complications such as Contact Lens Associated Red Eye [CLARE], papillary conjunctivitis, dry eye, corneal epithelial microcyst and microbial keratitis. The practice of good communication skills in the medical profession is integral for compliance to medical advice and education improves knowledge of good practices in CL use. The purpose of this study is to highlight the importance of good communication in influencing the knowledge about good practice of CL among medical students which in turn can ensure safe CL wear. This is not optimally achieved by simply giving a handout. Objectives: To assess the effectiveness of an interactive talk and demonstration in establishing good practices of CL use compared to just giving the participant a handout alone using a pre-structured questionnaire for assessment. Methodology: The study was a randomised controlled trial to assess the use and care of CL among 64 college students using CL. All students who were current CL users for correction of refractive power were recruited to the study, if they gave written informed consent. The sociodemographic data and relevant details of the participants were collected and the knowledge and practice questionnaire on CL use was administered. Each participant was allocated by permuted block randomisation, with allocation concealment, to one of the two arms of the study. Participants in Group A received the printed handout with interactive talk and demonstration regarding CL lens use and care while those allocated to Group B only received the CL information handout. Results: Out of the 64 students surveyed, 46 (71.9%) were medical students and 18(28.1%) were non-medical students and the majority were females (95.3%). Regarding type of CL, 60.9% used monthly disposable soft CL, 26, 6% used yearly replaceable soft CL while 7.8% used extended wear CL.CL was being used by 17.2 % for more than 5 years, by 54.7% students for 1-5 years and 28.1% for less than a year. Only 39 students (60.9%) followed the recommended method of hand washing and only 42 (65.6%) students correctly followed the ideal method of cleaning contact lens. Complications during CL use were reported by 24 students (37.5%) of whom only 16 students (66.6%) immediately consulted the doctor. There was a significant improvement in the learning scores of students of Group A, who received the interactive talk, demonstration and questionnaire compared to Group B. (p<0.001) Conclusion: The study highlights the importance of good communication in educating CL wearers about good practices of CL use, as it significantly improved the learning scores of the taught group while this was not optimally achieved by simply giving a handout alone.
... Certainly, the loss of faith in the medical profession has resulted from large malpractice scandals incriminating senior doctors during the last decade. 10,11,12 Regulation of Medical Profession: The Current Scenario Self-regulation was instituted and has been maintained because it was felt that it would benefit society. The concept was established in part because of the complexity of the knowledge base and the difficulty that the average citizen would have in comprehending medical issues in the absence of prolonged education and training. ...
Medical profession is essentially self-regulated, since historical times. The physicians convinced society that science-based medicine was superior to alternative therapies and that their profession represented a trustworthy moral enterprise. We constructed information from Pubmed/Medline, Google database and text books to provide an overview. Complexity of the knowledge base and skills required, especially as technology advanced, would make regulation by non-professionals difficult. The major obstacles for credible self-regulation are providing assurance that those in practice maintain their competence; taking appropriate action once a problem with an individual practitioner has been identified and regulating conflict of interest. Conflict is inherent in a profession in which individuals are expected to be altruistic, while, as human beings, still pursue their own interests. Self-regulation of the medical profession is complex, and involves multilaminar, clairvoyant oversight aimed at guaranteeing the competence of the practicing physician. The privilege of self-regulation of medical profession has gradually made way to establishment of licensing laws worldwide. Standards were considered to be weak, variable and inconsistently applied, and physicians were further accused of using collegiality as a means of shielding poorly performing peers. Identifying problem physicians and taking appropriate disciplinary action against them can be a complex situation and can tarnish the reputation of the entire medical profession. When the society becomes dissatisfied with the performance of the profession; changes the terms of the social contract and reclaim some of these powers, the medical profession's rights to self-regulation tends to decline. The principal regulatory body may have a majority of lay members, which would mean that the profession is no longer self-regulating. Profession must accept greater accountability and should not hesitate to act on professional misconduct. Self-regulation is a privilege that can be maintained only with public consent and trust. The present generation of doctors needs to adapt and accept the changing scenario and develop a scientific approach to achieve the lost glory.
... Until the 2012 Revision by the Medical Council of India Medical Education Regulations, 3 communication skill assessment was largely informal -often centred on a wardround debrief. 4 Though yet to impact the UK medical workforce, successful medical undergraduates must now: 'demonstrate an ability to communicate with patients, colleagues, and families in a manner that encourages participation and shared decision-making'. 3 Our survey and observations illuminate some of the additional challenges IMGs can face on arrival to the UK. ...
There is firm evidence that the NHS is treating an increasingly diverse population with a service built from an equally diverse global workforce.1
In addition to attaining linguistic competencies, a challenge to international medical graduates (IMGs), is adjusting to patient expectations, which can vary widely across patient populations. One PCT, NHS Dumfries and Galloway offer a generous Travelling Fellowship to doctors in training. One of its central objectives is to improve understanding of the challenges faced by international colleagues coming to the UK.
We had the opportunity as part of the Travelling Fellowship 2014 to undertake a 2 week project in Kolkata, (formerly Calcutta), India. We studied clinic-level doctor–patient interaction looking at communication and shared decision-making. One …
... Good communication skill has been considered extremely important for medical practitioners in the western world since decades. Its significance is now being acknowledged in our country and some authors have expressed the view that it is "the need of the hour" to train medical professionals in this important yet ignored aspect in clinical medicine [1,2]. Recently, the medical system has witnessed an increase in the incidences of conflict between doctors and patients or their attendants [3]. ...
The process of curing a patient requires a holistic approach which involves considerations beyond treating a disease. It warrants
several skills in a doctor along with technical expertise. Studies have shown that good communication skill in a doctor improve patient’s
compliance and overall satisfaction. There are certain basic principles of practicing good communication. Patient listening, empathy,
and paying attention to the paraverbal and non verbal components of the communication are the important ones that are frequently
neglected. Proper information about the nature, course and prognosis of the disease is important. Besides, patients and attendants
should always be explained about the necessity and yield of expensive investigations and risks/benefits involved in invasive procedures.
One should be extremely cautious while managing difficult encounters and breaking bad news. Formal training of the doctors in improving
communication skills is necessary and has proven to improve overall outcome. The authors recommend inclusion of formal training in
communication skills in medical curriculum and training of practising doctors in the form of CMEs and CPEs.
... Effective communication between nurses and patients is one of the most important elements for improving patient satisfaction, treatment compliance and health outcomes (Shukla, Yadav, & Kastury, 2010). While in the most of developed countries defined standards are applied in nurse -patient communication. ...
Introduction: Establishing an effective communication with patients is an essential aspect of nursing care. Nurse-patient communication has a key role in improving nursing care and increasing patient’s satisfaction of health care system. The study aimed at evaluation of barriers contributing in the demonstration of an effective nurse-patient communication from their viewpoint. Method: This was cross-sectional study, carried out in 2014, with a sample of 200 nurses and patients drawn from two educational hospitals in jahrom city. Data were collected by using two questionnaire structured by the researchers. Data were analyzed using SPSS software (version 16). Result: The results of this study showed that the greatest barriers of nurse-patient communication were characteristics of nursing job with an average score of 71.05 ± 10.18. The most communication barriers from patients viewpoint including: heavy work load of the nurses, age , sex and language difference between patient and nurse and the spicy morality of nurses. Conclusion: It is concluded that overcome barriers to communication and support are needed to enable nurses to communicate therapeutically with patients in order to achieve care that is effective and responsive to their needs.
... Asimismo, también se ha mencio-nado la importancia de que los profesionales se expresen con los pacientes de manera clara y comprensible, ya que el excesivo uso de tecnicismos puede llevar a la percepción de trato inadecuado 63 . De esta forma, la capacidad de escucha 61 y las habilidades de comunicación de los profesionales 43,57,64 , así como su competencia cultural 44,65 , quedan ubicadas en un lugar fundamental a la hora de superar las barreras psico-socio-culturales que pueden surgir en el vínculo entre los profesionales y los servicios de salud, y los pacientes. ...
Health services accessibility is a key health policy issue. However, few in-depth studies have addressed it theoretically. Most distinguish between availability, accessibility, and acceptability, or between geographic, financial, administrative, and cultural accessibility. We discuss and analyze the concept of accessibility as conflictive articulation between supply and demand in health. The article addresses the importance of cultural accessibility, rethinking it as a social interface, i.e., a social arena with clashing worldviews (namely, those of physicians and patients). The approach sheds light on the complex processes of grasping, translating, and reshaping knowledge and recommendations within such interaction.
The research deals with the study of communicative strategies and tactics in medical collegial discourse. The speech strategies of communicators have been studied based on audio recordings of dialogues between students/doctors and patients, and typical macro intentions of student-doctors ("support", "prohibition", "ignoring") were identified, according to this was suggested the classification of communication strategies and tactics: cognitive reframing, persuasive Communication strategy, motivational interviewing techniques, feedback tactics, information strategy. The analysis showed that the appropriateness of the selected approach depends on the context of the situation and affects the achievement of mutual understanding with the patient. The problem of studying communicative strategies and tactics of professional discourse is widely presented in the research of foreign authors such as J. Heritage, D.W. Maynard, S. Fleischman, N. Ainsworth-Vaughn, et al. Communication between a doctor and a patient is at the center of researchers' attention as a phenomenon that acts as a multifaceted construct and is considered in modern linguistics from pragmalinguistic, dialogic, culturological, and sociolinguistic positions. Reforms carried out in the healthcare system over the past years have led to the need to change the paradigm of doctor-patient communicative interaction models: the paternalistic model is replaced by a collegial model, which has led to the analysis of the effectiveness of the doctor-patient communication models, the study of the specifics of the linguistic implementation of their cognitive and speech strategies, comparing the results obtained and determining the reasons for the success or failure of specific speech strategies and tactics.
Introduction: Effective doctor-patient communication is a central clinical function and the resultant rapport is the heart and art of medicine and a central component in the delivery of health care. This communication is essential in achieving the desired outcomes of treatment. A doctor's communication and interpretational skills encompass the ability to gather information in order to facilitate accurate diagnosis, counsel appropriately, give therapeutic instructions and establish caring relationship with the patients. Methodology: The study population was the people who consulted their doctors in the hospital for any illness of their own or their children. Informed consent was taken from the patients interviewed. Data was collected from a total of 448 patients who came for a consultation to the hospital. Results: The results of our study agrees with other studies that many patients are not satisfied with the consultation and that doctors fail many a time in adequately educating the patients and providing them better compliance. Nearly 25 percent of the patients complain that they are not satisfied with their consultation and couldn't build compliance with their doctors. Conclusion: The study concludes that many crevices in doctor-patient communication are left un-filled, making most of the patients not satisfied after their consultation with doctors.
This study followed a symbolic interactionist and positivist paradigm to assess the doctor-patient communication at Adama Hospital Medical College (AHMC). Specifically, it assessed the communication competencies of medical doctors (with their own inpatients), investigated how inpatients interact with their doctors and evaluated the major barriers to doctor-patient medical communication. A descriptive, explanatory, and cross-sectional study designs were followed. Out of 66 medical doctors of AHMC, 36 were more directly and highly involved with bed-ridden patients in six wards and the remaining 22 were much more occupied with teaching and the management of the hospital and were not readily available for this study. A total sample size of 180 (144 patients + 36 medical) respondents were included. An SPSS 16 was used for interpreting quantitative data and emerging themes guided the qualitative data analysis.
The study found out that all medical doctors practice greeting socially and treat patients with due respect. The qualitative data indicated that some doctors exhibited communicative competence failures, and some lacked the cultural competence needed to comprehend traditional expressions. Due to heavy workload, some medical doctors show lack of interest. However, almost all doctors confirmed that they show interest in the patient’s ideas about their health. Generally, doctors allocated little time with patients who were not in a very critical situation. Almost all medical doctors assumed that they devoted their time to understand the main health concerns of patients and gave much attention. Those patients from the rural communities were often interrupted because they did not talk about their illnesses openly. This implies that some medical doctors lacked a profound knowledge of cultural communicative competence. Patients used traditional and vague expressions. Factors such as avoiding medical jargons, recounting the next steps, giving much care and concern, apportioning sufficient time, and writing legibly have been considered as major elements influencing medical communication. In the three factors (showing interest, understanding, and giving attention), doctors have been evaluated good communicators. Patients confirmed that almost all medical doctors practice greeting socially though decisions were made by doctors. Some patients were indirect. Patients were often interrupted and given less information about their ailment. This current study identified communication barriers and their possible causes. Some of these barriers have been caused due to poor communication skills, lack of the proper sense of confidentiality, the misuse or inappropriate use of medical jargons, lack of spacious workspace, language difference, the patients’ low level of understanding sickness, patients’ low level of education, inappropriate use of cultural and vague expressions, poor time allocation, patients’ taking too much time due to unnecessary repetitions, the gap between substantive lab evidence versus oral evidence and lack of family partnership and responsibility. Among other suggestions, the study recommends that the hospital needs to design a communication strategy to address these communication gaps.
Key words: Mead’s symbolic interactionism, patient- doctor communication, positivism, traditional communication, sick role, communication barrier, communication competence and effective communication
PREFACE - Professor Ralph Tench, April 2020
To conclude the book, Cristina Vaz de Almeida and Celia Belim Rodrigues ´ explore health professional’s communication competences. The chapter, ‘When the Health Professional’s Communication Competences Decide Patient’s Health: Proposal of a Communication Model’ focuses on the impact of health pro fessional’s communication competences on patients. The study is a response to the lack of consensus in the literature on what specific and operative communi cation competences the health professional should perform in clinical encounters INTRODUCTION xxi with patients, and how these competences can improve, in the final instance, health and well-being. I hope you enjoy reading these valuable contributions to our research com munity and share them with your peers. I look forward to seeing you soon at one of the forthcoming EUPRERA Congresses held every autumn. Professor Ralph Tench, April 2020
This chapter focuses on the contribution of communication competences, used by healthcare professionals in the clinical relationship with patients, to improve therapeutic adherence through a better understanding of health instructions and, hence, higher competences in health literacy. It is a main and specific goal to construct a model of communication competences that includes the interdependent use of assertiveness, clear language, and positivity by the healthcare professional, validated by a focus group of specialists. The participants of focus group validate the model and most punctuate, in assertiveness, active behavior, ability to listen, and ability to openly speak; in clarity, the simple language, utilization of verbs; and in positivity, orientation to a positive behavior of the patient. The results confirm that the assertiveness, clear language, and positivity are pivotal and strategic elements to the optimization of health literacy and clinical practices, recognized in the literature and by the participants in the focus group.
Background
Nurses are critical in the delivery of essential health services and are core in strengthening the health system. Therefore, the aim of this article was to assess the prevalence of the nurses’ communication skills and determinant factors in Amhara Region Referral Hospitals, Ethiopia, 2019.
Methods
An institution-based cross-sectional study was conducted from March 18 to April 16, 2019 in Amhara Region Referral Hospitals. A simple random sampling technique was used to select 678participants. Data were collected using pretested and self-administered questionnaires. The collected data were entered into Epi Info version 7.1.2.0 and exported to SPSS version 25.0 for analysis. Primarily, bivariate analysis was used and variables with p-values ≤ 0.2 were further examined using a multivariable logistic regression model to control for confounders. Then, variables with p-values less than 0.05 with 95% CIs were used to determine associated factors.
Results
Out of 678 study participants, 403 (61.4%) of them had effective communication skills with 96.76% of the response rate. Less than 5 years of working experience [AOR=2.77; 95% CI: (1.28, 5.99)], workload [AOR=1.52; 95% CI: (1.09, 2.12)], and poor evidence-based utilization [AOR=2.00; 95% CI: (1.40, 2.85)] were associated with the nurse’s ineffective communication skill to patients.
Conclusions
More than half (61.4%) of the participants had effective communication skills. Year of working experience, workload, and poor evidence-based utilization were the main contributing factors of communication skills.
Hospitals have various types of health services that can be seeded to maintain patient loyalty. One of them is inpatient services. Based on this perception, there will be an impression of patients on hospitals, which can then be referred to as the quality of hospital services. Factors that influence the quality of health services include technical competence, access to services, effectiveness of services, human relations, efficiency in service, continuity of service, service security, and service convenience. The purpose of this study was to analyze the effect of service quality on the satisfaction of general patients hospitalized at Tendriawaru Bone Hospital in 2020. This study is an analytical study with a cross sectional study design. Data collection uses questionnaires, where the population is 1992 people and the sample of this study is 63 people by collecting samples using the Slovin's formula. Statistical tests on bivariate analysis using the chi-square test and multivariate analysis. The results showed that there was no relationship between service access, effectiveness, continuity of service with patient satisfaction, but there was a relationship between human relationships and comfort with patient satisfaction. Furthermore, the results show that the variables that have a significant effect are the comfort variables. With a significant value of 0,005, it means that hypothesis is accepted because the value of sig <p value 0,05. This study suggests that the hospital can follow up on problems in the room, non functioning AC in one of the patient care rooms and add human resources, especially cardiologists and children.
Hospitals have various types of health services that can be seeded to maintain patient loyalty. One of them is inpatient services. Based on this perception, there will be an impression of patients on hospitals, which can then be referred to as the quality of hospital services. Factors that influence the quality of health services include technical competence, access to services, effectiveness of services, human relations, efficiency in service, continuity of service, service security, and service convenience. The purpose of this study was to analyze the effect of service quality on the satisfaction of general patients hospitalized at Tendriawaru Bone Hospital in 2020. This study is an analytical study with a cross sectional study design. Data collection uses questionnaires, where the population is 1992 people and the sample of this study is 63 people by collecting samples using the Slovin's formula. Statistical tests on bivariate analysis using the chi-square test and multivariate analysis. The results showed that there was no relationship between service access, effectiveness, continuity of service with patient satisfaction, but there was a relationship between human relationships and comfort with patient satisfaction. Furthermore, the results show that the variables that have a significant effect are the comfort variables. With a significant value of 0,005, it means that hypothesis is accepted because the value of sig <p value 0,05. This study suggests that the hospital can follow up on problems in the room, non functioning AC in one of the patient care rooms and add human resources, especially cardiologists and children.
Hospitals have various types of health services that can be seeded to maintain patient loyalty. One of them is inpatient services. Based on this perception, there will be an impression of patients on hospitals, which can then be referred to as the quality of hospital services. Factors that influence the quality of health services include technical competence, access to services, effectiveness of services, human relations, efficiency in service, continuity of service, service security, and service convenience. The purpose of this study was to analyze the effect of service quality on the satisfaction of general patients hospitalized at Tendriawaru Bone Hospital in 2020. This study is an analytical study with a cross sectional study design. Data collection uses questionnaires, where the population is 1992 people and the sample of this study is 63 people by collecting samples using the Slovin's formula. Statistical tests on bivariate analysis using the chi-square test and multivariate analysis. The results showed that there was no relationship between service access, effectiveness, continuity of service with patient satisfaction, but there was a relationship between human relationships and comfort with patient satisfaction. Furthermore, the results show that the variables that have a significant effect are the comfort variables. With a significant value of 0,005, it means that hypothesis is accepted because the value of sig <p value 0,05. This study suggests that the hospital can follow up on problems in the room, non functioning AC in one of the patient care rooms and add human resources, especially cardiologists and children.
Background: - Nurses are critical in the delivery of essential health services and are core in strengthening the health system. So, the aim of this article was to assess the prevalence of the communication skills of the nurses to patient and determinant factors in Amhara Region Referral Hospitals, Ethiopia, 2019
Methods: Institution based cross-sectional study was conducted from March 18 to April 16, 2019 in Amhara Region Referral Hospitals. A simple random sampling technique was used to select 684 respondents. Data was collected using pretested and self-administered questionnaire. Collected data was entered into Epi Info version 7.1.2.0 and exported to SPSS version 25.0 for analysis. Bivariate analysis was used primarily and variables with p-value ≤ 0.2 were further examined using multivariable logistic regression model to control con-founders. Then, variables having p-value less than 0.05 with 95% CI were used to determine associated factors.
Results: - Out of 678 study participants, 403 (61.4%) of them had effective communication skills with 96.8 % of the response rate. Less than 5 years of working experience [AOR=2.77; 95% CI: (1.28, 5.99)], workload [AOR=1.52; 95% CI: (1.09, 2.12)], and poor evidence-based utilization [AOR=2.00; 95% CI: (1.40, 2.85)] were associated with the nurse’s effective communication skill to patients.
Conclusions: More than half of the participants were had effective communication skills. Year of working experience, workload, and poor evidence-based utilization were the main contributing factors of the communication skills. Keywords: Communication skills, Nurses, Patients, Ethiopia
Communication perceived as significant process that supports doctors convey the health care information to patients. The purpose of this research is to study nonverbal communication skills practiced by cardiologists to communicate with patients. Qualitative method thru phenomenological approach was applied to conduct in-depth interviews and observations with 8 cardiologists who participated as informants in the study at the National Heart Institute, Kuala Lumpur Malaysia. The data were transcribed verbatim and analyzed using ATLAS.ti 7 to code the key themes, sub-themes and interrelationships. The research outcomes showed the nonverbal communication skills such as touch, body language and gesture, eye contact and tone of voice were essential elements used by the cardiologists during they consulting with their patients. The results suggested that doctors can be provided professional training to improve their nonverbal communication skills while consulting with patients. The nonverbal communication skill training can help the cardiologists effectively deliver health care service to their patients.
Ziel des vorliegenden Beitrages ist es, mögliche „Integrationsfenster“ auf Ebene der zwei Wissensfelder „Gender und Medizin“ sowie „Gender und Entrepreneurship/Innovation“ zu identifizieren, die das Ent- und Bestehen von Innovationen im Gesundheitswesen begünstigen. Hierauf aufbauend stellt der Beitrag Implikationen vor, die Ansatzpunkte bieten für die (1) Förderung einer gendersensiblen Gründungskultur im Gesundheitswesen sowie (2) Integration von Gendered-Entrepreneurship- & Innovation-Elementen in der Ausbildung von Gesundheitsberufen. Die nachfolgenden Ausführungen verorten sich damit in der anwendungsorientierten, medizinischen Geschlechterforschung und verbinden die fachlichen Perspektiven der Versorgungsforschung mit sozialwissenschaftlichen Zugängen der Forschung zum Thema Gendered Entrepreneurship & Innovation. Ein besonderes Augenmerk wird hierbei auf Aspekte der öffentlichen Gesundheit (Public Health) sowie der individuellen medizinischen Versorgung in der hausärztlichen Praxis gelegt.
A good communication skill for a doctor is central to the profession of medicine. The well established fact is that hospital staff –patient communication starts immediately on arrival of patient to hospital till his discharge or on completion of the consultation in the doctor’s chamber or an investigation or procedure for which he has reported to the hospital. Modern medicine relies more on scientific biochemical and imaging techniques and diagnosis and the communication between the patient and the doctor, as used to exist earlier, has probably taken a back seat in contemporary medical practice.
People with intellectual disability (ID) expressed dissatisfaction with doctor-patient communication and mentioned certain preferences for this communication (our research). Since many people with ID in the Netherlands have recently moved from residential care facilities to supported accommodations in the community, medical care for them was transferred from ID physicians (IDPs) to general practitioners (GPs) in the vicinity of the new accommodation. We addressed the following research question: 'What are the similarities and differences between the communication preferences of people with ID and the professional criteria for doctor-patient communication by GPs?'
A focus group meeting and interviews were used to identify the preferences of 12 persons with ID for good communication with their GP; these were compared with communication criteria used to assess trainee GPs, as described in the MAAS-Global manual.
Eight preferences for doctor-patient communication were formulated by the people with ID. Six of them matched the criteria used for GPs. Improvements are required as regards the time available for consultation, demonstrating physical examinations before applying them and triadic communication.
People with ID hold strong views on communication with their doctors during consultations. GPs, people with ID and their support workers can further fine-tune their communication skills.
Increased use of e-mail by physicians, patients, and other health care organizations and staff has the potential to reshape the current boundaries of relationships in medical practice. By comparing reception of e-mail technology in medical practice with its historical analogue, reception of the telephone, this article suggests that new expectations, practice standards, and potential liabilities emerge with the introduction of this new communication technology. Physicians using e-mail should be aware of these considerations and construct their e-mail communications accordingly, recognizing that e-mail may be included in the patient's medical record. Likewise, physicians should discuss the ramifications of communicating electronically with patients and obtain documented informed consent before using e-mail. Physicians must keep patient information confidential, which will require taking precautions (including encryption to prevent interception) to preserve patient information, trust, and the integrity of the patient-physician relationship.
The purpose of our study was to evaluate how e-mail is currently used between physicians and patients in an integrated delivery system, and to identify developments that might promote increased use of this form of communication. A paper-based survey questionnaire was administered to 94 primary care physicians. We evaluated the role e-mail currently plays in a physician's typical work day, physician views on the impact of e-mail on phone use and the barriers to increasing the use of e-mail with patients. 76% of physicians surveyed responded. All respondents currently use e-mail. Close to 75% of physicians use e-mail with their patients, but the vast majority do so with only 1-5% of those patients. 50% of physicians believe that up to 25% of their patients would send e-mail to them if given the option, with an additional 37% believing that between 25% and 50% of patients would value this option. The main reported barriers to physician-patient e-mail related to workload, security and payment. Our survey findings indicate that with adequate pre-screening, triage, and reimbursement mechanisms physicians would be open to substantially increasing e-mail communication with patients.
People with complex communication needs vary in terms of their underlying disability and the methods and strategies they use to communicate.
This article describes the varied communication profiles that a general practitioner is likely to encounter in patients with disabilities, and the various types of augmentative and alternative forms of communication that might be used in such consultations.
This article provides strategies to facilitate doctor-patient communication involving patients with complex communication needs, some of which are illustrated in a case study of a young woman with an intellectual disability.