Tailoring the orthopaedic consultation: How perceived patient characteristics influence surgeons' communication

Patient Pre-operative Planning of Gluteal Augmentation

Demand for autologous gluteal augmentation with fat transfer continues to rise paralleling the increasingly complex nature of the operation. Improved overall aesthetic outcomes are a result of: (1) donor site fat harvest has evolved to circumferential torso high-definition lipo-sculpting; (2) a shift from indiscriminate buttock augmentation to precise gluteal re-shaping. Discussing complex operations with patients, particularly ones of artistic nature, can be challenging. The senior author has developed a gluteal re-shaping graphic to focus a patient's attention to the four most important areas. It also serves as a foundation for surgeons to create operative plans and track outcomes for professional development.

Non-verbal Adaptation to the Interlocutors' Inner Characteristics: Relevance, Challenges, and Future Directions

Human diversity cannot be denied. In our everyday social interactions, we constantly experience the fact that each individual is a unique combination of characteristics with specific cultural norms, roles, personality, and mood. Efficient social interaction thus requires an adaptation of communication behaviors to each specific interlocutor that one encounters. This is especially true for non-verbal communication that is more unconscious and automatic than verbal communication. Consequently, non-verbal communication needs to be understood as a dynamic and adaptive process in the theoretical modeling and study of social interactions. This perspective paper presents relevance, challenges, and future directions for the study of non-verbal adaptation in social interactions. It proposes that non-verbal adaptability is more pertinently studied as adaptation to interlocutor's inner characteristics (i.e., expectations or preferences) than to interlocutor's behaviors per se, because behaviors are communication messages that individuals interpret in order to understand their interlocutors. The affiliation and control dimensions of the Interpersonal Circumplex Model are proposed as a framework to measure both the interlocutors' inner characteristics (self-reported) and the individuals' non-verbal responses (external coders). These measures can then be compared across different interactions to assess an actual change in behavior tailored to different interlocutors. These recommendations are proposed in the hope of generating more research on the topic of non-verbal adaptability. Indeed, after having gathered the evidence on average effects of non-verbal behaviors, the field can go further than a “one size fits all” approach, by investigating the predictors, moderators, and outcomes of non-verbal adaptation to the interlocutors' inner characteristics.

Communication Preferences in Total Joint Arthroplasty: Exploring the Patient Experience Through Generative Research

BACKGROUND

Improving communication and information services for people receiving a total joint (knee or hip) arthroplasty (TJA) depends on the differences in patient communication needs and personal characteristics.

PURPOSE

The purpose of this study was to further examine individual differences in TJA patient preferences regarding communication and information provision.

METHODS

Nineteen patients participated in generative research, which meant they actively reflected on their TJA experiences and communication preferences through creative exercises (e.g., collage making). Audio transcripts of their shared reflections were qualitatively analyzed through an inductive approach.

RESULTS

Some participants wanted detailed health education, others did not. Participants also reported different support needs (e.g., at hospital discharge or during rehabilitation). Moreover, participant preferences for social connections with care providers differed.

CONCLUSIONS

An individual patient's mindset, his or her social support needs, physical condition, and medical history should guide the provision of tailored services.

Tailoring the amount of treatment information to cancer patients' and survivors' preferences: Effects on patient-reported outcomes

OBJECTIVES

Tailoring medical information to cancer patients' needs is recommended, but there is little guidance on how to tailor, and limited research exists about its effects. Tailoring to the amount of preferred information may be easily implementable in clinic and is tested here.

METHODS

A video-vignette experiment was used to systematically vary video patients' information preferences (limited/extensive) and amount of provided information (additional/no additional). N = 253 cancer patients/survivors evaluated these video-recorded consultations, serving as analogue patients (APs), and completed outcome measures.

RESULTS

Tailoring information to video patients' preferences had no effect on APs' evaluation of the consultation (satisfaction, trust). Yet, there was a main effect of APs' own information preferences: Those preferring extensive information recalled (MΔ = 5.8%) and recognized (MΔ = 3.5%) more information than those preferring limited information. Moreover, information provision mattered among APs who preferred limited information: They recognized even less if provided with extensive information.

CONCLUSIONS

Tailoring to the amount of video patient's information preferences did not affect APs' evaluation of the consultation (satisfaction, trust), while APs' personal information preferences determined their recall and recognition of medical information.

PRACTICE IMPLICATIONS

Information preferences should be assessed and tailored to in clinical practice. Overwhelming patients/survivors, who prefer limited information, should be prevented.

Tailored Healthcare: Two Perspectives on the Development and Use of Patient Profiles

Calls for a more tailored approach to the management of cardiometabolic and musculoskeletal diseases have been increasing. Although tailored care is a centuries-old concept, it is still unclear how it should be best practised. The current paper introduces two phenotype-based Dutch approaches to support tailored care. One approach focuses on patients with type 2 diabetes, the other on patients undergoing total joint replacement. Using the patient profiling approach, both projects propose that care can be tailored by the assessment of biopsychosocial patient characteristics, stratification of patients into subgroups of patients with similar care needs, abilities, and preferences (so-called patient profiles) and tailoring of care in concordance with the common care preferences of these profiles. In this article, the advantages and disadvantages of the method are discussed to enable researchers or clinicians who want to extend the patient profiling approach to other patient populations to carefully evaluate these in relation to their project’s focus and available resources.

Funding: Novo Nordisk B.V., the Netherlands Organisation for Scientific Research (NWO) (Grant 314-99-118) and Zimmer Biomet Inc.