"Starting that Conversation Is Even Harder than Having It": Female Patients' Perceptions of Physicians' Communication Competence in Communication about Sexual Behavior

Uncertainty Management Strategies in Communication About Urinary Tract Infections

Urinary tract infections (UTIs) are the most common bacterial infection, and yet the etiology, treatment, and prevention of UTIs are often clouded by uncertainty. UTIs can cause severe pain and may lead to serious infection, but communication about UTIs can help individuals manage this condition and avoid recurring UTIs. Grounded in uncertainty management theory (UMT), this study explored how individuals with female anatomy manage uncertainty surrounding UTIs. Iterative analysis was employed using UMT to analyze 21 qualitative interviews. Participants used uncertainty management strategies of talking to health care providers, eliciting social support, and using the internet to gather information. Results indicated that talking to heath care providers was a dominant strategy intended to reduce uncertainty about the diagnosis and treatment of their symptoms. However, these interactions inadvertently increased uncertainty as well, as providers did not provide information about the causes and prevention of UTIs. Some participants also engaged in deception to reduce uncertainty about how their providers would respond to their pain and their illness. Finally, participants employed metaphors to interpret and neutralize uncertainty related to their experiences. Implications for these findings include guidelines and support for patient and provider communication, communication in social networks, as well as deeper nuances and development for UMT.

Sexual history taking by doctors in primary care in North West province, South Africa: Patients at risk of sexual dysfunction overlooked

Background

Sexual history taking seldom occurs during a chronic care consultation and this research focussed on consultation interaction factors contributing to failure of screening for sexual dysfunction.

Aim

This study aimed to quantify the most important barriers a patient and doctor experienced in discussing sexual challenges during the consultation and to assess the nature of communication and holistic practice of doctors in these consultations.

Setting

The study was done in 10 primary care clinics in North West province which is a mix of rural and urban areas.

Methods

One-hundred and fifty-five consultation recordings were qualitatively analysed in this grounded theory research. Doctors and patients completed self-administered questionnaires. A structured workplace-based assessment tool was used to assess the communication skills and holistic practice doctors. Template analysis and descriptive statistics were used for analysis. The quantitative component of the study was to strengthen the study by triangulating the data.

Results

Twenty-one doctors participated in video-recorded routine consultations with 151 adult patients living with hypertension and diabetes, who were at risk of sexual dysfunction. No history taking for sexual dysfunction occurred. Consultations were characterised by poor communication skills and the lack of holistic practice. Patients identified rude doctors, shyness and lack of privacy as barriers to sexual history taking, whilst doctors thought that they had more important things to do with their limited consultation time.

Conclusion

Consultations were doctor-centred and sexual dysfunction in patients was entirely overlooked, which could have a negative effect on biopsychosocial well-being and potentially led to poor patient care.