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Purpose: The Internet provides patients easy access to scientific information originally, limited to medical professionals. However, this information may not be entirely relevant to the patient’s context. Therefore, doctor–patient conversations need to contextualize this information to the specific circumstances of the patient’s illness. A problem exists insofar as this conversation may not always meet the patient’s expectations. Interpersonal competence, an important aspect of emotional intelligence, is therefore critical for medical practice in the digital era. “Medicine” is viewed as a “masculine” profession requiring competence, while compassion as “feminine”. Gender stereotyped socialization prescribes gender - congruent emotional display norms for men and women thereby, influencing both gender behavior and emotions. Psychological androgyny is the coexistence of masculine and feminine behavior traits in the same individual irrespective of biological sex. This leads to responses, which are appropriate for situations irrespective of biological sex, rather than gender-stereotyped behaviour. In this study, I explored the role of gender personality and interpersonal competence in doctor–patient interaction.

Design/ methodology/approach: Sixty Indian doctors across different specializations completed the self-report format of emotional intelligence appraisal (Emotional Intelligence Appraisal-EIA) as measure of interpersonal competence and Bem’s Sex role Inventory (BSRI) as a measure of psychological androgyny.

Findings: Psychologically androgynous doctors scored significantly higher on interpersonal competence than non-androgynous doctors.

Practical implication: Since both male and female doctors undergo similar training, there is a need to explore in greater depth the nature of the relationship between androgynous gender behaviors in doctors and corresponding interpersonal competence correlates, to understand their impact on patient care and healthcare related outcomes for both patients and doctors. This is especially critical because, in addition to increasing incidents of violence against doctors in Internet-empowered world, previous research also points to varying patient outcomes and legal complications based on biological sex of doctors.

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.

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.

Professional interpreter use improves care in patients with limited English proficiency (LEP) but inequalities in outcomes remain. We explore the experience of US Latinos with LEP and diabetes in language discordant care.

We conducted in-depth interviews of 20 low-income Latino patients with diabetes and LEP. We interviewed participants in Spanish, digitally recorded and transcribed interviews, and read transcripts to identify themes and interpret meanings using interpretive phenomenology as theoretical framework.

While patients preferred, and experienced greater trust in, language concordant clinical encounters, they did not believe that language discordance affected outcomes because they felt that these depended largely on their compliance with physicians’ recommendations. Patients also downplayed structural barriers to care and outcomes. Self-blame was paradoxically encouraged by physicians’ praise vis-à-vis favorable outcomes.

Limitations include small and convenience sample and limited generalizability. However, findings illustrate communicational dynamics between patients and clinicians with important implications for health care practice and policy. They support the perception that trust develops best within language concordant care, which underscores the importance of recruiting clinicians with diverse language skills. They highlight the importance of sensitizing clinicians to the social determinants of health, which may be overlooked when treating patients with conditions requiring substantial self-management, like diabetes. Language barriers in health care must be understood in the broader context of structural inequalities in health care. The necessary emphasis on self-management may (inadvertently) strengthen the hegemonic view that places responsibility for diabetes outcomes on patients’ ability to self-manage their condition to the neglect of social/political determinants of diabetes.

Studies have quantitatively examined the effects of language discordant care on diabetes outcomes, yet few have done so qualitatively. To our knowledge, no study has attempted to understand the experience of language discordance from the perspective of LEP patients with diabetes and how this experience may explain observed differences in outcomes.

This chapter provides both an introduction to the volume and a brief review of literature on technology, communications, and health disparities.

Literature review.

The chapter argues for the importance of greater examination of technology, communications, and their linkages to health disparities and other related factors.

Reviews the topic of technology, communication, and health disparities and previews this book.

Pain is socially and culturally experienced. This chapter builds on previous research into the value of visual images for communicating pain in the UK, which evidenced ways in which images can improve doctor–patient interaction. It discusses ways in which photographs co-created with people living with chronic pain can be catalysts for discussion of pain and suffering in a range of cultural contexts, including higher education and healthcare training. We draw on a pilot project in Delhi, India where images were used as stimuli to dialogue and exploration of shared understanding of pain and current work in UK higher education using visual and other participatory methods. Students have a chance to work with and discuss images which depict qualities and characters of pain. Through seeing and hearing about patients’ experiences of pain, students learn about the commonalities and diversities in people’s experiences of their bodies and minds and how these impact on lives. As future health professionals, their own responses to this are important. Chronic pain can be a disabling condition leaving people vulnerable, with their sense of self and how they are seen by others threatened. People living with pain have to (re)negotiate their identity, with themselves and others, to see who they can be, as well as what they can do in this new state. Exploration of this through visual arts and verbal participatory activities can provide otherwise untapped insights and understandings of the human condition and its diversity. Exploring ways in which this approach could be extended to and adapted to other contexts are part of our future plans.

Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted diseases (STDs), medical encounters occur at a stigmatized crossroads of social control and gendered norms of sexual behavior. When women are diagnosed and treated for chronic STDs, practitioner demeanor has an important impact on how patients will view not only their health status but also their moral status. This chapter draws on in depth interviews with 40 women diagnosed with genital infections of herpes and/or human papillomavirus (HPV – the cause of genital warts) to explore three models of patient–practitioner interaction. The analysis focuses on the relationship between gender, construction of illness, and practitioner interaction style. In a broader context, the health risks posed by particular interaction styles to female STD patients shed light on larger public health implications of combining morality with medicine for the broader range of patients with stigmatizing diagnoses.