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Article
Publication date: 2 October 2017

Janna Olynick, Alexandra Iliopulos and Han Z. Li

The patient healthcare experience is a complex phenomenon, as is encouraging patient compliance with medical advice. To address this multifaceted relationship, the purpose…

Abstract

Purpose

The patient healthcare experience is a complex phenomenon, as is encouraging patient compliance with medical advice. To address this multifaceted relationship, the purpose of this paper is to explore the ways resident physicians verbally encourage patient compliance and the relationship between these compliance-seeking strategies and patient satisfaction.

Design/methodology/approach

A total of 40 medical interviews between resident physicians and patients were audio-recorded, transcribed, coded, and analysed. Patient questionnaires were also administered and analysed.

Findings

It was found that resident physicians used indirect orders most frequently, followed by motivation, persuasion, scheduling, and direct orders. It was also found that female patients received (marginally) more messages than male patients; female residents used more messages with female patients than with male patients; female residents used more persuasion messages with female patients than with male patients; male residents were less likely than female residents to use motivational messages with female patients; and compliance was significantly correlated with expertise satisfaction, overall satisfaction, and communication satisfaction.

Originality/value

This study advances existing research by examining various ways in which residents verbally encourage patient compliance and the relationship between these messages and patient satisfaction. Findings can be used to inform physicians on strategies to encourage patient adherence to medication regimen, appointments, and lifestyle changes.

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Article
Publication date: 29 August 2008

Han Z. Li, Zhi Zhang, Young‐Ok Yum, Juanita Lundgren and Jasrit S. Pahal

The purpose of this paper is to examine interruption patterns between residents and patients as well as the correlations between three categories of interruptions and…

Abstract

Purpose

The purpose of this paper is to examine interruption patterns between residents and patients as well as the correlations between three categories of interruptions and patient satisfaction.

Design/methodology/approach

A total of 40 resident/patient consultations in a Canadian clinic were audiotaped, transcribed and analyzed for intrusive, cooperative and unsuccessful interruptions.

Findings

Residents made significantly more interruptions than patients, especially in the categories of intrusive interruptions. These findings provide support for situated identity theory. High correlations were found between residents and patients on all three categories of interruptions, providing unequivocal support for communication accommodation theory. Patient satisfaction was negatively correlated with residents' intrusive interruptions and positively correlated with residents' cooperative interruptions. Patient satisfaction was higher among patients those who inserted more cooperative interruptions; to increase patient satisfaction, it is necessary to raise patient participation in the medical consultation. In comparison with healthier patients, sicker patients were interrupted more frequently and were less satisfied with the way they were treated.

Originality/value

The negative correlations between residents' intrusive interruption and patient satisfaction, as well as the positive correlation between patient satisfaction and residents' cooperative interruption provides evidence that patients' perception of the medical consultation is shaped by the nature of interruptions.

Details

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

Keywords

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Article
Publication date: 11 October 2018

Xu Han, Zhonghe Han, Wei Zeng, Peng Li and Jiangbo Qian

The purpose of this paper is to study the condensation flow of wet steam in the last stage of a steam turbine and to obtain the distribution of condensation parameters…

Abstract

Purpose

The purpose of this paper is to study the condensation flow of wet steam in the last stage of a steam turbine and to obtain the distribution of condensation parameters such as nucleation rate, Mach number and wetness.

Design/methodology/approach

Because of the sensitivity of the condensation parameter distribution, a double fluid numerical model and a realizable k-ε-kd turbulence model were applied in this study, and the numerical solution for the non-equilibrium condensation flow is provided.

Findings

The simulation results are consistent with the experimental results of the Bakhtar test. The calculation results indicate that the degree of departure from saturation has a significant impact on the wet steam transonic condensation flow. When the inlet steam deviates from the saturation state, shock wave interference and vortex mixing also have a great influence on the distribution of water droplets.

Originality/value

The research results can provide reference for steam turbine wetness losses evaluation and flow passage structure optimization design.

Details

International Journal of Numerical Methods for Heat & Fluid Flow, vol. 28 no. 10
Type: Research Article
ISSN: 0961-5539

Keywords

Content available

Abstract

Details

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

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Article
Publication date: 27 February 2007

Han Z. Li, Huisheng Sun, Zhenqi Liu, Yu Zhang and Qingchun Cheng

The purpose of this paper is to find out the anti‐smoking counselling frequency and its correlates in a sample of Chinese physicians.

Abstract

Purpose

The purpose of this paper is to find out the anti‐smoking counselling frequency and its correlates in a sample of Chinese physicians.

Design/methodology/approach

In this paper, 268 physicians in Baoding, a city near Beijing, filled out a questionnaire asking about their own smoking status, their anti‐smoking behaviors as well as their opinions on how to reduce cigarette smoking in China.

Findings

The paper finds that 54 percent of the male and 8.4 percent of the female physicians were current cigarette smokers. When asked whether they had counselled their patients about cigarette smoking in the past year, 43.7 percent answered “always”; 38.1 percent “often”; 13.1 percent “sometimes”; 2.6 percent “occasionally”, and 2.6 percent said: “not much”. However, only 9.0 percent said that they were “very successful”. Physicians' anti‐smoking counselling practices were highly correlated with their own smoking status; whether they perceived their past anti‐smoking activities as successful; whether they thought that they should set examples by not smoking; whether they felt that they had the responsibility to help patients and whether they perceived themselves as influential in persuading patients to quit smoking.

Practical implications

The paper shows that messages aimed at increasing Chinese physicians' anti‐smoking counselling should appeal to their responsibility, exemplary role, and unique influence on patients' health‐related behaviors.

Originality/value

The paper adds to the few studies on Chinese physicians' cigarette smoking behavior and their anti‐smoking activities. In a country where cigarette smoking is a way of life among males, and few people are aware of the health consequences of cigarette smoking, physicians' efforts can be a spearhead to a cessation campaign.

Details

Health Education, vol. 107 no. 2
Type: Research Article
ISSN: 0965-4283

Keywords

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Article
Publication date: 1 December 2005

Han Z. Li and Juanita Lundgren

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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

Practical implications

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.

Originality/value

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

Details

Health Education, vol. 105 no. 6
Type: Research Article
ISSN: 0965-4283

Keywords

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Article
Publication date: 25 June 2019

Xu Han, Wei Zeng and Zhonghe Han

The purpose of this study is to improved the efficiency of condensing steam turbines by legitimately reforming the flow structure. It is of great significance to study the…

Abstract

Purpose

The purpose of this study is to improved the efficiency of condensing steam turbines by legitimately reforming the flow structure. It is of great significance to study the condensation flow characteristics of wet steam for optimizing the operation of condensing steam turbines.

Design/methodology/approach

A two-fluid model was used to study the wet steam flow in a stator cascade. The effects of the inlet temperature and pressure drop on the cascade performance were analyzed. On this basis, endwall protrusion models were set up at varied axial position on the pressure surface to evaluate the wetness control and loss under different design conditions for cascade optimization.

Findings

The analysis indicates that increasing the inlet temperature or decreasing the pressure drop can effectively control the steam wetness but increase the droplet radius. The increasing inlet temperature can delay the condensation and alleviate the deterioration of the aerodynamic performance of cascades. The non-axisymmetric endwall can significantly affect the distribution of steam parameters below its height and slightly reduce the droplet radius. Compared with the original stator cascade, the optimum design conditions reduce the steam wetness by 8.07 per cent and the total pressure loss by 6.91 per cent below a 20 per cent blade height.

Originality/value

These research results can serve as a reference for condensing steam turbine wetness losses evaluation and flow passage optimization design.

Details

International Journal of Numerical Methods for Heat & Fluid Flow, vol. 29 no. 12
Type: Research Article
ISSN: 0961-5539

Keywords

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Article
Publication date: 3 June 2021

Hongya Niu, Zhenxiao Wu, Fanli Xue, Zhaoce Liu, Wei Hu, Jinxi Wang, Jingsen Fan and Yanqi Lu

This study aims to acquire a better understanding on the characteristics and risks of heavy metals (HMs) in PM2.5 from an industrial city – Handan, China.

Abstract

Purpose

This study aims to acquire a better understanding on the characteristics and risks of heavy metals (HMs) in PM2.5 from an industrial city – Handan, China.

Design/methodology/approach

PM2.5 samples were collected on the basis of daytime and nighttime at the state controlling air sampling site in Handan city. Ten metal elements (V, Cr, Mn, Fe, Ni, Cu, Rb, Sr, Cd and Ba) in PM2.5 were determined with an inductively coupled plasma mass spectrometry. The pollution levels of metals were characterized by enrichment factors, and the sources of metals were identified with principle component analysis and cluster analysis. The ecological and health risks of metals were assessed using ecological and health risk indexes.

Findings

Results showed that the highest and lowest PM2.5 concentration appeared in winter and summer, respectively. The concentration of PM2.5 at night was higher than in the daytime in winter, yet it is the opposite in other seasons. The total mass concentration of detected metals was the highest in winter, and the total mass concentration in the daytime was higher than at night in all four seasons. The elements V, Rb, Sr and Ba exhibited a deficient contamination level; Cr, Ni and Cu exhibited a moderate contamination level; while Fe and Cd were at an extreme contamination level. The metals in PM2.5 originated from a mixture source of fossil fuel combustion and manufacture and use of metallic substances (34.04%), natural source (26.01%) and construction and traffic-related road dust (17.58%). Results from the ecological risk model showed that the ecological risk of metals was very high, especially risks related to Cd. Health risk model presented that both the non-carcinogenic and carcinogenic risk coefficients of metals were above the tolerance level of the human body.

Originality/value

The significance of the study is to further know the pollution characteristics of PM2.5 and related HMs in Handan city, and to provide references for ensuring local resident health and ecological environment.

Details

World Journal of Engineering, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1708-5284

Keywords

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Article
Publication date: 29 August 2008

J.M. Bensing, W. Verheul and A.M. van Dulmen

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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

Practical implications

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.

Originality/value

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

Details

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

Keywords

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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

Keywords

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