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The medical consultation is one of the requirements in diseases diagnosis and patient treatment. In addition, a high-quality consultation is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to identify factors affecting the high-quality consultation in medical communications.

The following electronic databases were searched: MEDLINE (via PubMed), Web of Science, Cochrane, EMBASE, Scopus and ProQuest until December 2018. In addition, the authors searched Google Scholar. Qualitative and quantitative studies were assessed using the Critical Appraisal Skills Programme, Qualitative Checklist and the Center for Evidence-Based Management appraisal checklist, respectively. A stepwise approach was conducted for data synthesis.

Of 3,826 identified studies, 29 met the full inclusion criteria. Overall, after quality assessment of studies, 25 studies were included. The studies were conducted in the USA (n=6), the UK (n=6), the Netherlands (n=4), Canada (n=2), Belgium (n=2), Poland (n=2), Germany (n=1), Iran (n=1), Finland (n=1), Austria (n=1), Qatar (n=1), Denmark (n=1) and China (n=1), and five studies were excluded. Data synthesis showed that high-quality consultation consisted of three main categories: structural (4 main themes with 26 sub-themes), process (2 main themes with 33 sub-themes) and outcome (3 main themes with 12 sub-themes) quality.

Using the indicators of consultation quality improvement can develop physicians’ clinical competence and skills. Decision makers can use them to monitor and evaluate physicians’ performance. A high-quality consultation can be useful in social prescribing that helps patients to manage their disease.

Many patients feel anxious when entering the consultation room, but seldom verbalize their emotions explicitly in the medical encounter. The authors designed a study to analyse the visibility of patient pre‐consultation (state) anxiety in their communication during the consultation. In an attempt to learn more about how general practitioners' (GPs') communication can help patients to express their worries, the paper also aims to explore the relationship between physicians' communication and patients' articulation of concerns and worries during the consultation.

From a representative sample of videotaped consecutive consultations of 142 Dutch GPs with 2,095 adult patients, 1,388 patients (66.3 per cent) completed the pre‐consultation questionnaire, including state anxiety (STAI), subjective health (COOP‐WONCA‐charts) and the reason for encounter (ICPC). GPs assessed the psychosocial background of patients' presented problems on a five‐point Likert scale. The videotaped consultations were coded with RIAS, including global affect measures. GPs' patient‐directed gaze was measured as a time‐measure.

The results show that, on average, the patients had slightly elevated anxiety levels and one‐third of the patients were highly anxious. As expected, the anxious patients seldom expressed emotional concerns directly, but did show a nonverbal and verbal communication pattern which was distinctively different from that of non‐anxious patients. Whether or not patients expressed concerns verbally was significantly related to GPs' affective communication and partnership building. Nonverbal communication seemed to play a dominant role both in sending and receiving emotional signals

In more than half of the consultations worries were not openly expressed, even by patients with high levels of anxiety. Patients tended to express their concerns in a more indirect way, partly by verbal, partly by nonverbal signals. GPs can facilitate patients to express their concerns more openly, not by direct questioning, but by showing verbal and nonverbal affect to the patient.

Focuses on the important role of verbal and nonverbal affect in physicians' communication.

Measurements of the quality of physician‐patient communication are important in assessing patient outcomes, but the quality of communication is difficult to quantify. The aim of this paper is to develop a computer analysis system for the physician‐patient consultation process (CASC), which will use a quantitative method to quantify and analyze communication exchanges between physicians and patients during the consultation process.

CASC is based on the concept of narrative‐based medicine using a computer‐mediated communication (CMC) technique from a cognitive dialog processing system. Effective and ineffective consultation samples from the works of Saito and Kleinman were tested with CASC in order to establish the validity of CASC for use in clinical practice. After validity was confirmed, three researchers compared their assessments of consultation processes in a physician's office with CASCs. Consultations of 56 migraine patients were recorded with permission, and for this study consultations of 29 patients that included more than 50 words were used.

Transcribed data from the 29 consultations input into CASC resulted in two diagrams of concept structure and concept space to assess the quality of consultation. The concordance rate between the assessments by CASC and the researchers was 75 percent.

In this study, a computer‐based communication analysis system was established that efficiently quantifies the quality of the physician‐patient consultation process. The system is promising as an effective tool for evaluating the quality of physician‐patient communication in clinical and educational settings.

This chapter focusses on the contribution of health professionals' communication competences to patients. We propose a model of communication to be used in the therapeutic relationship, supported by a literature review. The methodology is qualitative. Four focus groups (FGs) composed of Portuguese health professionals (N = 25), such as medical doctors, nurses and professors in health fields, were conducted during 2017 and 2018. All the participants of FGs validated a three-factor aggregated and interdependent model, which is composed of assertiveness, clear language and positivity (ACP model). The factors reinforce the therapeutic relationship and improve health literacy, thus reinforcing the patient's health and well-being. The argument is that health is wealth, so if the communication can improve health, then this has positive social implications. The study is a response to the lack of consensus in the literature on what specific and operative communication competences the health professional should perform in clinical encounters with the patients, and how these competences can improve, in the final instance, their health and well-being.

The main purpose of the paper was to examine whether a short patient training session on various ways of requesting physicians to clarify a piece of previously elicited information during medical consultation would improve information communication, thus increasing patient satisfaction.

A total of 114 adult patients voluntarily participated in the study which was carried out at a clinic in Canada. Half of the participants were randomly assigned to the experimental group and half to the control group. Males and females were evenly distributed in both experimental and control groups. Prior to their medical visits, participants in the experimental group received 10‐15‐minute face‐to‐face training, whereas the control group did not receive any training. The purpose of the training was to facilitate information transmission, with the intention to increase communication effectiveness and patient satisfaction. Immediately after their medical visits, all participants filled out a patient satisfaction questionnaire.

On all four dimensions of patient satisfaction (i.e. overall satisfaction, relationship satisfaction, communication satisfaction and expertise satisfaction), patients who received training scored significantly higher (were more satisfied) than patients who received no training. No consistent gender differences were found in patient satisfaction in both experimental and control groups.

This study applied a psycholinguistics theory, conversational grounding, to the field of patient education and achieved positive results.

The success of the short training session provides health practitioners with a new method to help patients communicate more effectively, thus increasing satisfaction in medical interviews.

Focuses on a means to elicit information from patients in medical consultations.

This chapter discusses challenges faced by older adult health-care consumers in obtaining access to responsive care from physicians relevant to a broad spectrum of health issues ranging from prevention to chronic illness and end-of-life care. Based on our prior research with community-dwelling elders (E. Kahana & B. Kahana, 2003, 2010), we propose a conceptual model of consumer self-advocacy for better access to effective health care in late life. We argue that older adults who are well informed and confident health-care partners and who involve their physicians in active dialogue will experience better care, and will be more satisfied with their health care. We present findings from our studies of cancer prevention and from our research focused on end-of-life care relevant to patient self-advocacy. We also discuss the role of educational interventions and of patient empowerment in facilitating greater access to responsive health communication and health care, particularly among elders who are disadvantaged and who have low health literacy.

A fairly consistent finding in research on trust in physicians is that racial and ethnic minorities cite lower levels than whites. This research typically samples only health care users, which limits our understanding of what underlies distrust. It remains unclear whether the distrust is generalized, which is distrust that is unrelated to using health care regularly or recently.

Using data from the Health Information National Trends Survey, multivariable logistic regressions assessed whether racial and ethnic differences in distrust (1) are equivalent among health care users and non-users; (2) regardless of respondents’ health and socio-economic status; and (3) manifest in other health information sources.

Racial and ethnic minorities are less likely than whites to trust physicians as health information sources. These racial and ethnic differences are equivalent among health care users and non-users, regardless of respondents’ health and socio-economic status. The racial and ethnic patterns do not manifest when predicting trust in other health information sources (Internet, family or friends, government health agencies, charitable organizations).

Data are derived from a cross-sectional survey, which makes it difficult to account comprehensively for self-selection into being a health care user. Despite the limitations, this research suggests that racial and ethnic minorities possess a generalized distrust in physicians, necessitating interventions that move beyond improving health care experiences.

Many researchers have surmised that a generalized distrust in physicians exists among racial and ethnic minorities. This chapter is the first to explicitly examine the existence of such distrust.

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

We examine how Emotional and Social Competence (ESC) data measures how well a leader positively attracts or repels others. It is believed that leaders with high emotional and social competence are more skilled at building positive interpersonal relationships with their employees and translates to increased employee engagement.

Individuals denoted as leaders in their respective organizations took a 66-question self-reported survey (ESC) that measured their current emotional and social competency levels. Direct reports of these leaders took a 62-question self-reported assessment that measured constructs of employee engagement. The leaders then commenced participation in a program (PDT) that focused on building their emotional and social competency levels. After completing the program (PDT) both the leaders and their direct reports retook their respective surveys and the scores were compared to the pre-program (PDT) results.

Results indicate that ESC scores increased by 8.21%, with a similar increase in employee engagement of 5.62%. Another key finding was how quickly the group bonded during the first two meetings.

As corporations move from a hierarchical to a self-managed team organizational structure, this program provides an evidence-based model of how to increase the ESC scores of leaders, leading to an increase in employee engagement and retention. The process-designed methodology incorporates a “use inspired” research framework, offering applications to study the impact of a leader’s emotional social competence on employees feeling a higher sense of membership, empowerment, and purpose.

This study investigates the apparent methodological shortcomings of the current literature that considers patients’ evaluations of their care. In an effort to resolve the evident discrepancies between stated assertions and empirical evidence, integrates the two prominent streams of research to produce a more comprehensive model. Results suggest that just two distinct dimensions of the care experience were found to capture 74 per cent of the variance in satisfaction‐quality, with patients’ sociodemographic differences accounting for only 1 per cent.