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Article
Publication date: 29 August 2008

Atie van den Brink‐Muinen, Heidi‐Ingrid Maaroos and Heli Tähepõld

This paper aims to investigate doctor‐patient communication in consultations of newly qualified general practitioners (GPs) in a newly reorganised health care system and…

Abstract

Purpose

This paper aims to investigate doctor‐patient communication in consultations of newly qualified general practitioners (GPs) in a newly reorganised health care system and differences in consultation characteristics and communication patterns between new European Union (EU)‐countries (Estonia, Poland and Romania) and the old West‐European EU‐countries.

Design/methodology/approach

Observation of videotaped doctor‐patient consultations by means of Roter's Interactional Analysis System; GP, patient and observer questionnaires. Data were collected from 92 GPs and 1,376 patients in Estonia, Poland and Romania and compared with known data from old EU countries. Main outcome measures were verbal and nonverbal communication of GPs and patients, as well as consultation characteristics.

Findings

Differences were found in the communication patterns of the new EU‐countries Estonia, Poland and Romania compared to the old EU‐countries. For instance, the verbal contribution of the GPs in the new EU‐countries was greater than in the old EU‐countries. Differences were also found between the three new EU‐countries. In Romania there was more psychosocial talk than in the two other new EU‐countries, whereas in Poland and Estonia there was more biomedical talk. The Estonian communication was more affective, the Polish and Romanian more instrumental. In general, the differences were not found to be related to a “new‐old” or “east‐west” distinction. Clearly, cultural norms and values play an important role in doctor‐patient communication.

Research limitations/implications

The sampling method differed somewhat from one country to another.

Practical implications

With the integration of Europe in progress, cross‐cultural aspects should be addressed when doctors are being trained in communication skills in their undergraduate and postgraduate education.

Originality/value

This is the first study to investigate doctor‐patient communication in newly reorganised health care systems and differences in doctor‐patient communication between new and old EU‐countries.

Details

Health Education, vol. 108 no. 5
Type: Research Article
ISSN: 0965-4283

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Article
Publication date: 9 February 2015

Barend Van Den Assem and Victor Dulewicz

The purpose of this paper is to provide a greater understanding of the general practitioner (GP)-patient relationship for academics and practitioners. A new model for…

Abstract

Purpose

The purpose of this paper is to provide a greater understanding of the general practitioner (GP)-patient relationship for academics and practitioners. A new model for dyadic professional relationships specifically designed for research into the doctor-patient relationship was developed and tested. Various conceptual models of trust and related constructs in the literature were considered and assessed for their relevance as were various related scales.

Design/methodology/approach

The model was designed and tested using purposefully designed scales measuring doctors’ trustworthiness, practice orientation performance and patient satisfaction. A quantitative survey used closed-ended questions and 372 patients responded from seven GP practices. The sample closely reflected the profile of the patients who responded to the DoH/NHS GP Patient Survey for England, 2010.

Findings

Hierarchical regression and partial least squares both accounted for 74 per cent of the variance in “overall patient satisfaction”, the dependent variable. Trust accounted for 39 per cent of the variance explained, with the other independent variables accounting for the other 35 per cent. ANOVA showed good model fit.

Practical implications

The findings on the factors which affect patient satisfaction and the doctor-patient relationship have direct implications for GPs and other health professionals. They are of particular relevance at a time of health reform and change.

Originality/value

The paper provides: a new model of the doctor-patient relationship and specifically designed scales to test it; a greater understanding of the effects of doctors’ trustworthiness, practice orientation and performance on patient satisfaction; and a new framework for examining the breadth and meaning of the doctor-patient relationship and the management of care from the patient’s viewpoint.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 11 May 2015

Elena A. Platonova and Richard M. Shewchuk

The purpose of this paper is to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient…

Abstract

Purpose

The purpose of this paper is to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient perception of PCP professional competence, patient assessment of the relationship with the doctor and patient demographic characteristics using a segmentation approach.

Design/methodology/approach

The authors surveyed 514 adult patients waiting for appointments with their PCPs in two US primary care clinics. A latent class analysis was used to identify mutually exclusive unobserved homogeneous classes of patients.

Findings

The authors identified three distinct classes/groups with regard to patient assessment of physician communication and the physician-patient relationship. The largest group (53 percent of the sample) assessed their PCP communication and other doctor-patient relationship aspects as excellent. However, 37 percent provided mostly negative assessments, expressed high general dissatisfaction with the physician and disagreed with the statement that their PCP was well qualified to manage their health problems. These patients were on average more educated and affluent and the group included more males. About 10 percent of patients expressed generally lower satisfaction with the PCP, though their dissatisfaction was not as extreme as in the highly dissatisfied group.

Research limitations/implications

Further studies are needed to help physicians develop skills to communicate with different patients.

Originality/value

Patient segmentation can be an important tool for healthcare quality improvement particularly for emerging approaches to primary care such as patient-centered care.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 April 2014

Anothai Ngamvichaikit and Rian Beise-Zee

The aim of this paper is to contribute a conceptualization of the information and communication needs of medical tourists from Western countries in an Asian health care…

Abstract

Purpose

The aim of this paper is to contribute a conceptualization of the information and communication needs of medical tourists from Western countries in an Asian health care context.

Design/methodology/approach

Multi-phase, semi-structured, in-depth interviews and observations were conducted with 27 multi-source informants who have communication experience in the international healthcare setting.

Findings

Multi-level information provision should be used to address communicative incongruence in Asian healthcare provider – Western patient encounters as was self-reported by the participants and observed by authors. The use of an informative communication model is proposed in order to facilitate interaction and the effective transfer of information with Western patients to overcome negative, underlying emotions and enable autonomous decision making by the patients.

Research limitations/implications

This exploratory study is focused on Western patients and Asian practitioners in Thailand. Future research in other countries and with patients from other geographical areas could expand to generalize findings.

Practical implications

Fostering information sharing with Western patients by using an integrative communication model can improve patient satisfaction and health outcomes. The need for developing and implementing these improved practices for communicating with Western patients is reflected by the healthcare industry's current developmental trends helping to lead to a future of health service internationalization.

Originality/value

This is the first empirical study to provide insights concerning the communication needs and coping strategies of Western patients with Asian doctors in developing countries.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 8 no. 1
Type: Research Article
ISSN: 1750-6123

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Article
Publication date: 7 May 2021

Shih-Chuan Chen

This study aims to explore the information-seeking behavior of female patients engaged in doctor shopping. An investigation was conducted on the following aspects: the…

Abstract

Purpose

This study aims to explore the information-seeking behavior of female patients engaged in doctor shopping. An investigation was conducted on the following aspects: the reasons for doctor-shopping behavior (DSB), patients’ information needs and sources, patients’ use of the obtained information and the degree of satisfaction with the information collected.

Design/methodology/approach

In-depth interviews were conducted in this study. In total, 30 female participants who lived or worked in the Taipei metropolitan area, Taiwan, were recruited.

Findings

Dissatisfaction with treatment, confirmation of illness conditions, inconvenient treatment locations and hours and dissatisfaction with doctor’s attitude were the main reasons for DSB. Family members, friends, the internet and mass media were sources of information for participants when they sought second and successive doctors. In most cases, the degree of satisfaction toward the obtained information increased after each visit to a doctor during the doctor-shopping journey. However, not all participants shared information with doctors. The participants suggested that detailed explanations provided by doctors and better communication with doctors may reduce the occurrence of doctor shopping.

Originality/value

The findings of this study help medical personnel better understand DSB. The findings revealed the significance of information to patients and indicated that the information collected during doctor shopping is beneficial for patients.

Details

The Electronic Library , vol. 39 no. 1
Type: Research Article
ISSN: 0264-0473

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Article
Publication date: 25 January 2013

Marjan J.B. Govaerts, Margje W.J. van de Wiel and Cees P.M. van der Vleuten

This study aims to investigate quality of feedback as offered by supervisor-assessors with varying levels of assessor expertise following assessment of performance in…

Abstract

Purpose

This study aims to investigate quality of feedback as offered by supervisor-assessors with varying levels of assessor expertise following assessment of performance in residency training in a health care setting. It furthermore investigates if and how different levels of assessor expertise influence feedback characteristics.

Design/methodology/approach

Experienced (n=18) and non-experienced (n=16) supervisor-assessors with different levels of assessor expertise in general practice (GP) watched two videotapes, each presenting a trainee in a “real-life” patient encounter. After watching each videotape, participants documented performance ratings, wrote down narrative feedback comments and verbalized their feedback. Deductive content analysis of feedback protocols was used to explore quality of feedback. Between-group differences were assessed using qualitative-based quantitative analysis of feedback data.

Findings

Overall, specificity and usefulness of both written and verbal feedback was limited. Differences in assessor expertise did not seem to affect feedback quality.

Research limitations/implications

Results of the study are limited to a specific setting (GP) and assessment context. Further study in other settings and larger sample sizes may contribute to better understanding of the relation between assessor characteristics and feedback quality.

Practical implications

Findings suggest that even with supervisor-assessors with varying levels of assessor expertise who are trained in performance assessment and the provision of performance feedback, high-quality feedback is not self-evident; coaching “on the job” of feedback providers and continuous evaluation of feedback processes in performance management systems is crucial. Instruments should facilitate provision of meaningful feedback in writing.

Originality/value

The paper investigates quality of feedback immediately following assessment of performance, and links feedback quality to assessor expertise. Findings can contribute to improvement of performance management systems and assessments for developmental purposes.

Details

European Journal of Training and Development, vol. 37 no. 1
Type: Research Article
ISSN: 2046-9012

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Article
Publication date: 14 February 2020

Po-Chien Chang, Ting Wu and Juan Du

The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and…

Abstract

Purpose

The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the role of doctor-patient communication as a critical contingent variable in the psychological contract violation of patient’s antisocial behaviour relationship.

Design/methodology/approach

The data were collected from 483 hospitalized patients distributed in Shanxi province, China by using a self-administered survey.

Findings

The results indicated that psychological contract violation is positively associated with patient antisocial behaviour via patient trust. Moreover, the study found that doctor-patient communication moderates the mediated effects of psychological contract violation on patient’s antisocial behaviour through patient trust; that is, the mediated effect on antisocial behaviour is weaker when both doctor and patients have more communication.

Research limitations/implications

Due to a cross-sectional design in nature, the causal relationship cannot be developed based on the results. Despite the limitation, the present study provides insights for improving doctor-patient relationship by emphasizing the importance of increasing patient trust and doctor-patient communication.

Practical implications

To improve the quality of doctor-patient relationship, this study addresses the significance of properly showing understandings and care to regain mutual trust and reducing the likelihood of patient’s antisocial behaviour.

Social implications

The research findings have implications for both the health system and medical schools in China to reinforce the professional ethics and improve their medical humanities as the main concerns to generate a more sustainable doctor–patient relationship.

Originality/value

This study includes patient trust as a mediator and doctor-patient communication as a moderator to investigate the moderated mediation relationship among patients and medical professionals. By further examining the doctor-patient relationship, the results may not only help improve the efficient implementation of medical practices but also support the institutes and develop medical professionals for more positive doctor-patient relationships.

Details

International Journal of Conflict Management, vol. 31 no. 4
Type: Research Article
ISSN: 1044-4068

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Article
Publication date: 26 October 2018

Ariel Belasen and Alan T. Belasen

The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies.

Abstract

Purpose

The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies.

Design/methodology/approach

The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC.

Findings

The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor–patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients’ overall ratings of hospitals.

Research limitations/implications

More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse.

Practical implications

When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program’s efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use.

Originality/value

The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.

Details

Journal of Health Organization and Management, vol. 32 no. 7
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 15 June 2015

Sabina Cerimagic, Nariman Ahmadi, Howard Gurney and Manish I. Patel

– The purpose of this paper is to examine doctor-patient communication, focusing on ethnic Australian urological cancer patients.

Abstract

Purpose

The purpose of this paper is to examine doctor-patient communication, focusing on ethnic Australian urological cancer patients.

Design/methodology/approach

Samples of 50 Australian urological cancer patients of ethnic origin were chosen to participate in this study. The patients completed a 31-question survey, followed by a one-on-one semi-structured 30-40-minute interview with the patient.

Findings

Most (90 per cent, n=45) of the patients indicated that they can communicate with their doctor without feeling stereotyped or judged. However, despite these responses 48 per cent (n=24) of the patients reported they did not ask for the doctor to explain the medical terms or meanings they did not understand. This resulted in 46 per cent (n=23) of the patients not knowing the stage of their cancer.

Research limitations/implications

This is only a pilot study and the sample was limited to 50 patients. The limitations of this study make the results of the findings more suggestive rather than definitive. Further research would benefit by repeating this study with a larger sample size, to address the shortcomings of the study and to venture further into the realm of doctor and overseas patients communication in Australia.

Practical implications

This research found that patients from lower socioeconomic backgrounds for whom English is not their first language have low levels of medical literacy and therefore require additional written information about their illness and treatment such as informative brochures, educational booklets and educational videos on their illness.

Originality/value

To the knowledge, this is the first study that focuses on ethnic Australian urological cancer patients and their doctor-patient communication.

Details

International Journal of Human Rights in Healthcare, vol. 8 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 21 June 2011

Jonna Koponen, Eeva Pyörälä and Pekka Isotalus

This study aims to compare Finnish medical students' perceptions of the suitability of three experiential methods in learning interpersonal communication competence (ICC)…

Abstract

Purpose

This study aims to compare Finnish medical students' perceptions of the suitability of three experiential methods in learning interpersonal communication competence (ICC). The three methods it seeks to explore are: theatre in education; simulated patient interview with amateur actors; and role‐play with peers. The methods were introduced in a pilot course of speech communication.

Design/methodology/approach

Students (n=132) were randomly assigned to three groups. The data were collected via questionnaire and focus group interviews, and analysed using qualitative content analysis and cross‐case analysis.

Findings

Most of the medical students thought these methods were suitable or very suitable for learning ICC. The methods had five similar elements: the doctor's role, the patient's role, reflective participation, emotional reactions and teachers' actions. Being in a doctor's role, realistic scripts and patient‐roles, observing the interaction and reflection in small groups were the most helpful elements in these methods.

Originality/value

The results of this study show that simulated patient interview with amateur actors, role‐play with peers, and TIE are very suitable methods for practising professionally relevant ICC in the context of doctor‐patient encounters from the medical students' perspective.

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