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The purpose of this study is to investigate the relationship between women’s sexual health agency and their intent to initiate communications with their doctors. The research questions examined the effect sexual health agency has on patient-doctor communication, women’s emotional responses to health advertisements encouraging patient communication with their doctors, attitude toward the message and behavioral intentions after exposure to the advertising message.

An experimental design was implemented via an online questionnaire instrument to test the differences between younger-aged women (25 to 45 years) and mature-aged women (46 to 70 years). It was observed that 188 women who reported their status as single and sexually active in the past 12 months were exposed to a health advertisement that encouraged patient-doctor communication. Analyses were conducted to compare between-group measures on sexual health agency, emotional response and attitude toward the ad and behavioral intention.

No statistical difference existed between younger and older women. In general, women expect their doctor to lead conversations about sexual health but are positively reinforced by health messages that encourage their assertiveness as patients.

The small sample size also may have limited the study’s potential to evaluate differences between age segments. Future research should explore this further.

The study provides evidence that sexual health advertising can reinforce women’s intent to initiate conversations with doctors regardless of age.

Health communications can bolster women’s sexual health agency and improve patient-initiated conversations with doctors.

The study is the first to explore advertising messaging’s potential for applying health agency as a communication strategy for encouraging sexual health communications between women and their doctors.

The potential for including patients in implementation processes has received limited attention in the literature. The purpose of this paper is to explore the different roles adopted by 63 patients that emerged during and after four participatory quality improvement interventions, and the nature of their impact upon implementation processes and outcomes.

A cross-case ethnographic comparison of Experience-based Co-design in two clinical pathways in two UK NHS Trusts.

Two key themes emerge from the data. First, the authors found a range of different roles adopted by patients within and across the four projects; some were happy to share their experiences, others also helped to identify improvement priorities alongside staff whilst others were also involved in developing potential solutions with the staff who had cared for them. A few participants also helped implement those solutions and became “experts by experience” through engaging in the whole co-design process. Second, in terms of the impact of patient engagement with the co-design process whilst the changes championed by patients and carers were often small scale, as co-designers patients provided innovative ideas and solutions. Through their involvement and contributions they also acted as catalysts for broader change in the attitudes of staff by providing a motivation for wider organisational and attitudinal changes.

The research was conducted in two clinical pathways in two NHS trusts. However, the findings complement and add to the growing body of knowledge on experience based co-design.

Patient engagement is likely to require support and facilitation to ensure that patients can play a meaningful role as partners and co-designers in service improvement and implementation. Different roles suited particular individuals, with participants stepping in and out of the co-design process at various stages as suited their needs, capacities and (albeit sometimes perceptions re) skills. In this context, facilitation needs to be sensitive to individual needs and flexible to support involvement.

Patients and carers can play active roles in service improvement, particularly where the approach facilitate active engagement as co-designers.

Analysis of the role patients and carers in implementation and improvement.

Delivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three experiential dimensions (Physical Environment, Empowerment and Dignity and Patient–Doctor Relationship) on patient's Experiential Satisfaction is assessed.

259 structured interviews were performed with patients in private and public hospitals across Italy. The research methodology is based in testing mediation and moderation effects of the selected variables.

The study shows that: perceived quality of Physical Environment has a positive impact on patient's Experiential Satisfaction; perceived quality of Empowerment and Dignity and perceived quality of Patient–Doctor Relationship mediate this relationship reinforcing the role of Physical Environment on Experiential Satisfaction; educational level is a moderator in the relationship between perceived quality of Patient–Doctor Relationship and overall Satisfaction: more educated patients pay more attention to relational items. Subjective Health Frailty is a moderator in all the tested relationships with Experiential Satisfaction: patients who perceive their health as frail are more reactive to the quality of the above-mentioned variables.

Physical Environment items are enablers of both Empowerment and Dignity and Patient–Doctor Relationship and these variables must be addressed all together in order to improve the value proposition provided to patients. Designing a hospital, beyond technical requirements that modern medicine demands and functional relationships between different medical departments, means dealing with issues like the anxiety of the patient, the stressful working environment for the hospital staff and the need to build a sustainable and healing building.

The purpose of this paper is to propose a general model that examines the contextual factors underlying the decision‐making process of international hospital outshopping.

Patients who chose medical treatment abroad were selected to analyze the drivers of internationalization in medical services. A total number of 27 international patients who traveled from developed countries to receive medical treatment at the largest hospital in Thailand were interviewed and their responses assessed through narrative analysis.

The narrative analysis reveals that while high costs and the deteriorating conditions of health care in developed countries are initially driving consumers to leave their local service area and choose foreign service providers, pull factors such as innovation, organizational efficiency, emotional service quality and patient‐doctor relationships in service encounters are nurturing a real preference for choosing foreign health care providers.

This exploratory study is limited to the largest hospital in South East Asia. Future research could expand upon its findings and comparisons be made with other different foreign health care providers.

In order to attract foreign customers a personal service, such as medical treatment, must be based on and sustained by continuous innovation in service quality.

The paper is the first empirical in‐depth study that examines the factors underlying the decision‐making process of international hospital outshopping.

The purpose of this study is to propose a framework for extracting medical information from the Web using domain ontologies. Patient–Doctor conversations have become prevalent on the Web. For instance, solutions like HealthTap or AskTheDoctors allow patients to ask doctors health-related questions. However, most online health-care consumers still struggle to express their questions efficiently due mainly to the expert/layman language and knowledge discrepancy. Extracting information from these layman descriptions, which typically lack expert terminology, is challenging. This hinders the efficiency of the underlying applications such as information retrieval. Herein, an ontology-driven approach is proposed, which aims at extracting information from such sparse descriptions using a meta-model.

A meta-model is designed to bridge the gap between the vocabulary of the medical experts and the consumers of the health services. The meta-model is mapped with SNOMED-CT to access the comprehensive medical vocabulary, as well as with WordNet to improve the coverage of layman terms during information extraction. To assess the potential of the approach, an information extraction prototype based on syntactical patterns is implemented.

The evaluation of the approach on the gold standard corpus defined in Task1 of ShARe CLEF 2013 showed promising results, an F-score of 0.79 for recognizing medical concepts in real-life medical documents.

The originality of the proposed approach lies in the way information is extracted. The context defined through a meta-model proved to be efficient for the task of information extraction, especially from layman descriptions.

The purpose of this study is to investigate and compare the views of doctors, nursing staff and hospitalized patients on the level of information they provide and receive respectively in public hospitals, focusing on the factors that affect their communication.

The study used a cross-sectional survey with a sample of 426 participants from two general hospitals in Greece–Pella and KAT Attica. Data were collected through a questionnaire in March–May 2020 and was analyzed with mean comparisons and correlations.

The results showed discrepancy in the satisfaction rate, with 67.3% satisfied patients from doctors' communication vs. 83.7% satisfied doctors. Improvements in hospital staff – patient communication are required especially on alternative therapies' discussion and time spent on communication. All respondents agreed that staff shortage is a deterrent factor for effective communication. Seamless for all respondents' groups, the factors that affect the communication satisfaction level are the duration of communication, time allowed for expressing questions and interest in patients' personal situation.

Strengthening the communication skills of medical staff and providing clear guidelines on when and how to inform patients are essential.

This study contributes to the growing body of research on doctor–patient communication. Its originality lies on the fact that communication satisfaction level was examined simultaneously for doctors, nurses and patients. The study provides additional evidence supporting the link among satisfaction and duration of communication and personalized relationship. The study's findings are important in the training of medical staff and the management of patients' expectations.

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

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.

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.

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.

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.

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

In the light of an increasing healthcare burden, this paper seeks to offer insight about how intrinsic motivation could play a pivotal role in improving the pre‐existing healthcare service delivery systems by altering clinician behaviour. The paper argues the case for four salient dimensions worth exploring through the lens of intrinsic motivation – non‐financial incentives, positive affective states, organizational culture and prescribing quality.

This article reviews literature from both social sciences and health management practices to provide rationale on how intrinsic motivational approaches could optimize healthcare service delivery systems.

The scrutiny of the body of evidence leads to the assertion that there is neglect in the initiatives to reinforce intrinsic motivation as a method to address the ailing morale of doctors. This seems to have exacerbated negative outcomes that include job dissatisfaction, compromise in the quality of care and poor patient‐doctor relationships. Diminution in positive affective states amongst doctors, largely controlled by intrinsic motivation, led to strained doctor‐patient communication and poor quality of care. Barriers in a healthcare organizational culture that restricts autonomy and empowerment seem to directly undermine job satisfaction.

The article argues that it is crucial to shift away from the conventional tendencies promoting tangible rewards. A more holistic approach should be adopted by conducting formal research into intrinsic motivation and how it could aid the formulation of policies tailored to meet the current demands of the healthcare system.

This study is oriented towards getting insight into the perspectives, knowledge and practices among Syrian refugees regarding antibiotic use and prescribing in Dutch primary care.

A thematic qualitative study was carried out using semi-structured interviews with 12 Syrian refugees living in the Netherlands. Data analysis consisted of three steps and was oriented towards the development of themes.

Participants were confronted with restricted access to antibiotics in the Netherlands which was contrary to their experiences in Syria. Some of them continued to self-prescribe antibiotics, while others adhered to the Dutch General Practitioner (GP)’s advice. Especially mothers with young children took up the Dutch GP’s advice. Syrian refugees expressed health beliefs about the healing effects of antibiotics which are related to their past experiences of use and which influenced their current use. Respondents complained about the Dutch health-care system and expressed a preference for the one in Syria.

Syrian refugees vary in their way of dealing with restricted access to antibiotics in Dutch primary care. More in-depth knowledge is required to improve refugee patient–doctor communication about antibiotic use.

The message that antibiotics are not needed may be challenging. Additional communication seems to be necessary to persuade Syrian refugees from self-prescribing antibiotics. Therefore, identifying refugee patient concerns and carefully counseling and communicating it with them is substantial. Developing educational toolkits consisting of various experiences of antibiotic use and ways of dealing with it can equip doctors to more adequately react to migrants’ needs for care.

Primary care professionals seem insufficiently equipped to tackle issues related to antibiotic use amongst newly arrived migrants. Therefore, it is important to support professionals in their communication with this patient group about the proper use of antibiotics.

This study shows that more in-depth knowledge is needed about the strategies of newly arrived migrants and their complex reactions to treatment prescriptions with which they are not familiar.

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.