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Holmes CT, Huggins C, Knowles H, Swoboda TK, Kirby R, Alanis N, Bulga A, Schrader CD, Dunn C, Wang H. The Association of Name Recognition, Empathy Perception, and Satisfaction With Resident Physicians' Care Amongst Patients in an Academic Emergency Department. J Clin Med Res 2023; 15:225-232. [PMID: 37187709 PMCID: PMC10181348 DOI: 10.14740/jocmr4901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Background Recognition of the provider's name, provider empathy, and the patient's satisfaction with their care are patient-provider rapport measures. This study aimed to determine: 1) resident physicians' name recognition by patients in the emergency department; and 2) name recognition in association with patient perception of the resident's empathy and their satisfaction with the resident's care. Methods This was a prospective observational study. A patient recognizing a resident physician was defined as the patient remembering a resident's name, understanding the level of training, and understanding a resident's role in patient care. A patient's perception of resident physician empathy was measured by the Jefferson Scale of Patient Perception of Physician Empathy (JSPPPE). Patient satisfaction of the resident was measured utilizing a real-time satisfaction survey. Multivariate logistic regressions were performed to determine the association amongst patient recognition of resident physicians, JSPPPE, and patient satisfaction after adjustments were made for demographics and resident training level. Results We enrolled 30 emergency medicine resident physicians and 191 patients. Only 26% of studied patients recognized resident physicians. High JSPPPE scores were given by 39% of patients recognizing resident physicians compared to 5% of those who were not recognized (P = 0.013). High patient satisfaction scores were recorded in 31% of patients who recognized resident physicians compared to 7% who did not (P = 0.008). The adjusted odds ratios of patient recognition of resident physicians to high JSPPPE and high satisfaction scores were 5.29 (95% confidence interval (CI): 1.33 - 21.02, P = 0.018) and 6.12 (1.84 - 20.38, P = 0.003) respectively. Conclusions Patient recognition of resident physicians is low in our study. However, patient recognition of resident physicians is associated with a higher patient perception of physician empathy and higher patient satisfaction. Our study suggests that resident education advocating for patient recognition of their healthcare provider's status needs to be emphasized as part of patient-centered health care.
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Affiliation(s)
- Chad T. Holmes
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
| | - Charles Huggins
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
| | - Heidi Knowles
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
| | - Thomas K. Swoboda
- Department of Emergency Medicine, The Valley Health System, Touro University Nevada School of Osteopathic Medicine, Las Vegas, NV 89144, USA
| | - Ryan Kirby
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
| | - Naomi Alanis
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
| | - Alexandra Bulga
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
| | - Chet D. Schrader
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
| | - Cita Dunn
- TCU and UNTHSC School of Medicine, Fort Worth, TX 76107, USA
| | - Hao Wang
- Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA
- Department of Emergency Medicine, The Valley Health System, Touro University Nevada School of Osteopathic Medicine, Las Vegas, NV 89144, USA
- Corresponding Author: Hao Wang, Department of Emergency Medicine, John Peter Smith Health Network, Fort Worth, TX 76104, USA.
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Park S, Kim HK, Lee M. An analytic hierarchy process analysis for reinforcing doctor-patient communication. BMC PRIMARY CARE 2023; 24:24. [PMID: 36670353 PMCID: PMC9860231 DOI: 10.1186/s12875-023-01972-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND As the health paradigm shifts toward patient-centeredness, patients can actively participate in their own treatment. However, there is still a unilateral aspect of doctor-patient communication, so it is necessary to specify obstacles between doctors and patients. Therefore, this study attempted to extract obstacles that block doctor-patient communication and to analyze differences in perception of doctor-patient communication. METHODS A total of 35 questionnaires composed of brainstorming for the study were distributed, and a total of 21 questionnaires were used for analysis. The collected data was analyzed by AHP using dress ver 17.0. RESULTS As a result of the study, doctors ranked the priority of health communication in the order of professionalism, reliability, fairness, communication, and psychologically. On the other hand, for patients, the priority factors of health communication were communication, fairness, professionalism, reliability, and psychologically. CONCLUSION In order to improve the quality of health communication between doctors and patients, doctors will be able to communicate from the patient's point of view and strengthen communication with patients by providing consistent medical services and patients need to trust the doctor and patients need to trust their doctors and participate in the medical process faithfully.
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Affiliation(s)
- Sewon Park
- grid.251916.80000 0004 0532 3933Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - Han-Kyoul Kim
- grid.412484.f0000 0001 0302 820XDepartment of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea ,National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yang- Pyeong, South Korea
| | - Munjae Lee
- grid.251916.80000 0004 0532 3933Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, South Korea ,grid.411261.10000 0004 0648 1036Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, South Korea
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Jiang MM, Wu ZY, Tu AX. Research on the Cooperative Governance Path of Multiple Stakeholders in Doctor-Patient Disputes under the Environment of Information Asymmetry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1597. [PMID: 36674353 PMCID: PMC9863217 DOI: 10.3390/ijerph20021597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
The number of doctor-patient conflicts and disputes in China has been increasing recently. In order to solve the current social problems of the tense doctor-patient relationship and frequent medical disputes, this article, based on grounded theory, uses qualitative analysis software to conduct grounded coding on 622 cases of doctor-patient disputes randomly selected by stratification. After successively adopting open, axial, and selective coding, the relationship structure between the causes and development of medical disputes is summarized. Furthermore, this relationship structure can be used to analyze further and discuss the causes of doctor-patient disputes from the perspective of multiple co-governance and the governance framework of doctor-patient disputes. Finally, it reminds us of the need to standardize government's regulatory responsibilities, promote the equal distribution of medical resources, strengthen the communication awareness between doctors and patients, reduce the information asymmetry between doctors and patients, and build a preventive mechanism-oriented multi-subject collaborative governance path to promote the relationship between doctors and patients in China. We provide relevant countermeasures and suggestions for harmonious development and the smooth resolution of doctor-patient conflicts.
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Affiliation(s)
- Mao-Min Jiang
- School of Public Affairs, Xiamen University, Xiamen 361005, China
| | - Zheng-Yu Wu
- School of Public Affairs, Xiamen University, Xiamen 361005, China
| | - Ai-Xian Tu
- School of Management, Hainan Medical University, Haikou 571199, China
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Chen L, Tang H, Guo Y. Effect of Patient-Centered Communication on Physician-Patient Conflicts from the Physicians' Perspective: A Moderated Mediation Model. JOURNAL OF HEALTH COMMUNICATION 2022; 27:164-172. [PMID: 35579286 DOI: 10.1080/10810730.2022.2071505] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Physician-patient conflicts are detrimental to doctor-patient relationship and sustainable healthcare delivery. In China, the status quo of the doctor-patient relationship is in great tension. Based on the uncertainty reduction theory (URT), the present study examined the relationship between patient-centered communication (PCC) and medical conflict, as well as the roles of perceived patients' trust, doctors' empathy, and expertise from physicians' perspectives. In March 2020, 509 physicians in China were recruited to participate in an online survey. The results revealed that PCC was negatively associated with physician-patient conflicts and that patient trust mediated the relationship. Additionally, doctors' empathy moderated PCC on patient trust, while expertise positively predicted physician-patient conflicts. Theoretical and practical implications for improving doctor-patient relationships were discussed.
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Affiliation(s)
- Liang Chen
- School of Journalism and Communication, Tsinghua University, Beijing, Haidian, China
| | - Hongjie Tang
- School of Journalism and Communication, Tsinghua University, Beijing, Haidian, China
| | - Yu Guo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macau, Taipa, China
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Lungu DA, Røislien J, Wiig S, Shortt MT, Ferrè F, Berg SH, Thune H, Brønnick KK. The Role of Recipient Characteristics in Health Video Communication Outcomes: Scoping Review. J Med Internet Res 2021; 23:e30962. [PMID: 34967758 PMCID: PMC8759013 DOI: 10.2196/30962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/21/2021] [Accepted: 10/29/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The importance of effective communication during public health emergencies has been highlighted by the World Health Organization, and it has published guidelines for effective communication in such situations. With video being a popular medium, video communication has been a growing area of study over the past decades and is increasingly used across different sectors and disciplines, including health. Health-related video communication gained momentum during the SARS-CoV-2 pandemic, and video was among the most frequently used modes of communication worldwide. However, although much research has been done regarding different characteristics of video content (the message) and its delivery (the messenger), there is a lack of knowledge about the role played by the characteristics of the recipients for the creation of effective communication. OBJECTIVE The aim of this review is to identify how health video communication outcomes are shaped by recipient characteristics, as such characteristics might affect the effectiveness of communication. The main research question of the study is as follows: do the characteristics of the recipients of health videos affect the outcomes of the communication? METHODS A scoping review describing the existing knowledge within the field was conducted. We searched for literature in 3 databases (PubMed, Scopus, and Embase) and defined eligibility criteria based on the relevance to the research question. Recipient characteristics and health video communication outcomes were identified and classified. RESULTS Of the 1040 documents initially identified, 128 (12.31%) met the criteria for full-text assessment, and 39 (3.75%) met the inclusion criteria. The included studies reported 56 recipient characteristics and 42 communication outcomes. The reported associations between characteristics and outcomes were identified, and the potential research opportunities were discussed. Contributions were made to theory development by amending the existing framework of the Integrated-Change model, which is an integrated model of motivational and behavioral change. CONCLUSIONS Although several recipient characteristics and health video communication outcomes were identified, there is a lack of robust empirical evidence on the association between them. Further research is needed to understand how the preceding characteristics of the recipients might affect the various outcomes of health video communication.
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Affiliation(s)
- Daniel Adrian Lungu
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jo Røislien
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Siri Wiig
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marie Therese Shortt
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Francesca Ferrè
- Management and Health Laboratory, Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Siv Hilde Berg
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Henriette Thune
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Kallesten Brønnick
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Moult A, McKinley RK, Yeates P. Understanding patient involvement in judging students' communication skills in OSCEs. MEDICAL TEACHER 2021; 43:1070-1078. [PMID: 34496725 DOI: 10.1080/0142159x.2021.1915467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Communication skills are assessed by medically-enculturated examiners using consensus frameworks which were developed with limited patient involvement. Assessments consequently risk rewarding performance which incompletely serves patients' authentic communication needs. Whilst regulators require patient involvement in assessment, little is known about how this can be achieved. We aimed to explore patients' perceptions of students' communication skills, examiner feedback and potential roles for patients in assessment. METHODS Using constructivist grounded theory we performed cognitive stimulated, semi-structured interviews with patients who watched videos of student performances in communication-focused OSCE stations and read corresponding examiner feedback. Data were analysed using grounded theory methods. RESULTS A disconnect occurred between participants' and examiners' views of students' communication skills. Whilst patients frequently commented on students' use of medical terminology, examiners omitted to mention this in feedback. Patients' judgements of students' performances varied widely, reflecting different preferences and beliefs. Participants viewed variability as an opportunity for students to learn from diverse lived experiences. Participants perceived a variety of roles to enhance assessment authenticity. DISCUSSION Integrating patients into communications skills assessments could help to highlight deficiencies in students' communication which medically-enculturated examiners may miss. Overcoming the challenges inherent to this is likely to enhance graduates' preparedness for practice.
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Affiliation(s)
- Alice Moult
- School of Medicine, Keele University, Keele, UK
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Chandra S, Mohammadnezhad M. Doctor-Patient Communication in Primary Health Care: A Mixed-Method Study in Fiji. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147548. [PMID: 34300006 PMCID: PMC8306632 DOI: 10.3390/ijerph18147548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/18/2021] [Accepted: 07/08/2021] [Indexed: 02/05/2023]
Abstract
From a clinical perspective, effective and efficient communication is part of a strategy to ensure doctors are providing high-quality care to their patients. Despite the positive impact of effective doctor–patient communication on health outcomes, limited information is available on this in Fiji. This study was carried out to determine the current patients’ perception of doctors’ communication behaviour and identify factors affecting the doctor–patient communication in Fiji. This mixed-method study was conducted in the outpatient setting of three randomly selected health centres in the Suva Subdivision, Fiji. For the quantitative phase, systematic random sampling was used to select the 375 participants who completed the structured questionnaire; of those, 20 participants were selected for the qualitative interview. From the patients’ perception, 45.6% of them perceived doctors’ communication behaviour as good, 53.6% as fair, and 0.8% as poor communication behaviour. Qualitative findings highlight factors such as the attitude of the doctors, their approach, their interaction with the patients, and them providing an explanation as important factors during doctor–patient communication. In Fiji, the majority of patients perceived doctors’ communication behaviour as fair to good and the doctors’ skills were important for effective doctor–patient communication. This study highlighted the importance of doctor–patient communication and suggested that doctors might not be practicing patient-centred care and communication; thus, they need to upgrade their patient-centred communication skills.
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8
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Van Vliet M, Doornenbal BM, Boerema S, van den Akker-van Marle EM. Development and psychometric evaluation of a Positive Health measurement scale: a factor analysis study based on a Dutch population. BMJ Open 2021; 11:e040816. [PMID: 33550237 PMCID: PMC7925905 DOI: 10.1136/bmjopen-2020-040816] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/14/2020] [Accepted: 12/27/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The My Positive Health (MPH) dialogue tool is increasingly adopted by healthcare professionals in the Netherlands as well as abroad to support people in their health. Given this trend, the need arises to measure effects of interventions on the Positive Health dimensions. However, the dialogue tool was not developed for this purpose. Therefore, this study aims to work towards a suitable measurement scale using the MPH dialogue tool as starting point. DESIGN A cross-sectional study design. PARTICIPANTS AND SETTINGS A total of 708 respondents, who were all members of the municipal health service panel in the eastern part of the Netherlands, completed the MPH dialogue tool. METHODS The factor structure of the MPH dialogue tool was explored through exploratory factor analysis using maximum likelihood extraction. Next, the fit of the extracted factor structure was tested through confirmatory factor analysis. Reliability and discriminant validity of both a new model and the MPH scales were assessed through Cronbach's alpha tests. RESULTS Similar to the MPH dialogue tool, the extracted 17-item model has a six-factor structure but named differently, comprising the factors physical fitness, mental functions, future perspectives, contentment, social relations and health management. The reliability tests suggest good to very good reliability of the aimed measurement tool and MPH model (Cronbach's alpha values ranging from, respectively, 0.820 to 0.920 and 0.882 to 0.933). The measurement model shows acceptable discriminant validity, whereas the MPH model suggests overlap between domains. CONCLUSION The results suggest that the current MPH dialogue tool seems reliable as a dialogue, but it is not suitable as a measurement scale. We therefore propose a 17-item model with improved, acceptable psychometric properties which can serve as a basis for further development of a measurement scale.
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Affiliation(s)
| | - Brian M Doornenbal
- Salut, Arnhem, The Netherlands
- School of Business and Economics, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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Tran VT, Messou E, Mama Djima M, Ravaud P, Ekouevi DK. Patients' perspectives on how to decrease the burden of treatment: a qualitative study of HIV care in sub-Saharan Africa. BMJ Qual Saf 2019; 28:266-275. [PMID: 29706594 PMCID: PMC6860734 DOI: 10.1136/bmjqs-2017-007564] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 04/09/2018] [Accepted: 04/15/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Patients living with HIV infection (PLWH) in sub-Saharan Africa face an important burden of treatment related to everything they do to take care of their health: doctor visits, tests, regular refills, travels, and so on. In this study, we involved PLWH in proposing ideas on how to decrease their burden of treatment and assessed to what extent these propositions could be implemented in care. METHODS Adult PLWH recruited in three HIV care centres in Côte d'Ivoire participated in qualitative interviews starting with 'What do you believe are the most important things to change in your care to improve your burden of treatment?' Two independent investigators conducted a thematic analysis to identify and classify patients' propositions to decrease their burden of treatment. A group of experts involving patients, health professionals, hospital leaders and policymakers evaluated each patient proposition to assess its feasibility. RESULTS Between February and April 2017, 326 participants shared 748 ideas to decrease their burden of treatment. These ideas were grouped into 59 unique patient propositions to improve their personal care and the organisation of their hospital or clinic and/or the health system. Experts considered that 27 (46%), 19 (32%) and 13 (22%) of patients' propositions were easy, moderate and difficult, respectively, to implement. A total of 118 (36%) participants offered at least one proposition considered easily implementable by our experts. CONCLUSION Asking PLWH in sub-Saharan Africa about how their care could be improved led to identifying meaningful propositions. According to experts, half of the ideas identified could be implemented easily at low cost for minimally disruptive HIV care.
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Affiliation(s)
- Viet-Thi Tran
- METHODS Team, Centre de Recherche Epidemiologie et Statistiques Sorbonne Paris Cité (CRESS UMR 1153), Paris, France
- Centre d’Epidémiologie Clinique–Hôpital Hôtel-Dieu, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Eugene Messou
- Programme PAC-CI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Mariam Mama Djima
- Programme PAC-CI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
- Institut Pasteur de Cote d’Ivoire, Abidjan, Côte d’Ivoire
| | - Philippe Ravaud
- Centre d’Epidémiologie Clinique–Hôpital Hôtel-Dieu, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Didier K Ekouevi
- Programme PAC-CI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
- Bordeaux Population Health (UMR1219), INSERM, Bordeaux, France
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van Vliet M, Jong MC, Jong M. A Mind-Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World. Glob Qual Nurs Res 2018; 5:2333393618805340. [PMID: 30349869 PMCID: PMC6194914 DOI: 10.1177/2333393618805340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 09/02/2018] [Accepted: 09/10/2018] [Indexed: 11/17/2022] Open
Abstract
Despite increased recognition of self-care and self-awareness as core competences for health care professionals, little attention is paid to these skills during their education. Evidence suggests that a Mind-Body (MB) skills course has the potential to enhance self-care and self-awareness among medical students. However, less is known about the meaning of this course for students and how it affects their personal and professional life. Therefore, we examined the lived experiences with an MB skills course among Dutch medical and Swedish nursing students. This course included various MB techniques, such as mindfulness meditation and guided imagery. Guided by a phenomenological hermeneutical method, three main themes were identified: "ability to be more present," "increased perception and awareness of self," and "connection on a deeper level with others." Overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world.
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Affiliation(s)
- Marja van Vliet
- Louis Bolk Institute, Bunnik, The Netherlands.,Mid Sweden University, Sundsvall, Sweden
| | - Miek C Jong
- Louis Bolk Institute, Bunnik, The Netherlands.,Mid Sweden University, Sundsvall, Sweden
| | - Mats Jong
- Mid Sweden University, Sundsvall, Sweden
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Clinical significance of stress-related increase in blood pressure: current evidence in office and out-of-office settings. Hypertens Res 2018; 41:553-569. [DOI: 10.1038/s41440-018-0053-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 12/26/2022]
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12
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Liu Y, Huang Y, Gao H, Cheng X. Communication skills training: Adapting to the trends and moving forward. Biosci Trends 2017; 11:142-147. [PMID: 28458335 DOI: 10.5582/bst.2017.01095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Communication ability is one of the core requirements of doctors' competency. Teaching communication to medical students and junior doctors has attracted much attention. With the challenge of escalating demands, the status of training communication skills has been promoted in the past several decades. The training content was integrated with other courses and various pedagogic approaches have been applied and proved to be effective. Practical strategies and mixed types were highly recommended. However, there are still many problems, including the fragmentation of the training, insufficient practice, inadequate qualified teachers, case adaptation, course localization and impediment from the environment. This paper proposes some suggestions to solve the problems.
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Affiliation(s)
- Ye Liu
- School of Basic Medical Sciences, Fudan University
| | | | - Hong Gao
- Zhongshan Hospital, Fudan University
| | - Xunjia Cheng
- School of Basic Medical Sciences, Fudan University
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13
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Derksen F, Olde Hartman TC, van Dijk A, Plouvier A, Bensing J, Lagro-Janssen A. Consequences of the presence and absence of empathy during consultations in primary care: A focus group study with patients. PATIENT EDUCATION AND COUNSELING 2017; 100:987-993. [PMID: 27989493 DOI: 10.1016/j.pec.2016.12.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 11/25/2016] [Accepted: 12/10/2016] [Indexed: 05/14/2023]
Abstract
OBJECTIVE There is general consensus that explicit expression of empathy in patient-GP communication is highly valued. Yet, little is known so far about patients' personal experiences with and expectations of empathy. Insight into these experiences and expectations can help to achieve more person-centeredness in GP practice care. METHODS Participants were recruited by a press report in local newspapers. INCLUSION CRITERIA adults, a visit to the GP in the previous year. Exclusion criterion: a formal complaint procedure. Five focus groups were conducted. The discussions were analyzed using constant comparative analysis. RESULTS In total 28 participants took part in the focus group interviews. Three themes were identified: (1) Personalized care and enablement when empathy is present; (2) Frustrations when empathy is absent; (3) Potential pitfalls of empathy. Participants indicated that empathy helps build a more personal relationship and makes them feel welcome and at ease. Furthermore, empathy makes them feel supported and enabled. A lack of empathy can result in avoiding a visit to the GP. CONCLUSION Empathy is perceived as an important attribute of patient-GP communication. Its presence results in feelings of satisfaction, relief and trust. Furthermore, it supports patients, resulting in new coping strategies. A lack of empathy causes feelings of frustration and disappointment and can lead to patients avoiding visiting their GP. PRACTICE IMPLICATIONS More explicit attention should be given to empathy during medical education in general and during vocational GP-training.
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Affiliation(s)
- Frans Derksen
- Department Primary and Community Care, Gender & Women's Health, Radboudumc, Nijmegen, The Netherlands.
| | - Tim C Olde Hartman
- Department Primary and Community Care, Radboudumc, Nijmegen, The Netherlands
| | - Annelies van Dijk
- Department Primary and Community Care, Gender & Women's Health, Radboudumc, Nijmegen, The Netherlands
| | - Annette Plouvier
- Department Primary and Community Care, Gender & Women's Health, Radboudumc, Nijmegen, The Netherlands
| | - Jozien Bensing
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University. NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Antoine Lagro-Janssen
- Department Primary and Community Care, Gender & Women's Health, Radboudumc, Nijmegen, The Netherlands
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From personal crisis care to convenience shopping: an interpretive description of the experiences of people with mental illness and addictions in community pharmacies. BMC Health Serv Res 2016; 16:569. [PMID: 27729051 PMCID: PMC5059973 DOI: 10.1186/s12913-016-1817-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The role of community pharmacists is changing globally with pharmacists engaging in more clinically-oriented roles, including in mental health care. Pharmacists' interventions have been shown to improve mental health related outcomes but various barriers can limit pharmacists in their care of patients. We aimed to explore the experiences of people with lived experience of mental illness and addictions in community pharmacies to generate findings to inform practice improvements. METHODS We used interpretive description methodology with analytic procedures of thematic analysis to explore the experiences of people with lived experience of mental illness and addictions with community pharmacy services. Participants were recruited through multiple mechanisms (e.g., paper and online advertisements), offered honorarium for their time, and given the option of a focus group or interview for participation in our study. Data were gathered during July to September of 2012. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed by two researchers. RESULTS We collected approximately nine hours of audio data from 18 individuals in two focus groups (n = 12) and six individual interviews. Fourteen participants were female and the average age was 41 years (range 24 to 57 years). Expectations, decision-making, and supports were identified as central themes underlying the community pharmacy experiences of people with lived experience of mental illness and addictions. Eight subthemes were identified including: relationships with pharmacy staff; patient's role in the pharmacist-patient relationship; crisis and triage; privacy and confidentiality; time; stigma and judgment; medication-related and other services; and transparency. CONCLUSIONS People with lived experience of mental illness and addictions demonstrate a high regard and respect for pharmacist's knowledge and abilities but hold conservative expectations of pharmacy health services shaped by experience, observations, and assumptions. To some extent, expectation management occurs with the recognition of the demands on pharmacists and constraints inherent to community pharmacy practice. Relationships with pharmacy staff are critical to people with lived experience and influence their decision-making. Research in the area of pharmacists' roles in crises and triage, especially in the area of suicide assessment and mitigation, is needed urgently.
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Gray J, Cadieux A, Sweeney B, Beck AR, Edgar S, Eneli I, Getzoff Testa E, Paguio K, Santos M, Ward WL. Medical neglect and pediatric obesity: Insights from tertiary care obesity treatment programs. CHILDRENS HEALTH CARE 2016. [DOI: 10.1080/02739615.2016.1163488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Jane Gray
- Dell Children’s Medical Center, Texas Center for the Prevention and Treatment of Childhood Obesity, Austin, TX
- Department of Educational Psychology, The University of Texas at Austin, Austin, TX
| | - Adelle Cadieux
- Healthy Weight Center, Helen DeVos Children’s Hospital, Grand Rapids, MI
| | - Brooke Sweeney
- Weight Management Program, Children’s Mercy Kansas City, Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO
| | - Amy R. Beck
- Weight Management Program, Children’s Mercy Kansas City, Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO
| | - Susan Edgar
- Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital, Columbus, OH
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital, Columbus, OH
| | - Elizabeth Getzoff Testa
- Department of Psychology, Mt. Washington Pediatric Hospital/Weigh Smart Program, Baltimore, MD
| | - Kristi Paguio
- Healthy Weight Center, Helen DeVos Children’s Hospital, Grand Rapids, MI
- Spectrum Health Medical Group, Grand Rapids, MI
| | - Melissa Santos
- Connecticut Children’s Medical Center, Hartford Hospital, Hartford, CT
- The Institute of Living, University of Connecticut School of Medicine, Hartford, CT
| | - Wendy L. Ward
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
- Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, AR
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Mazzi MA, Rimondini M, Boerma WGW, Zimmermann C, Bensing JM. How patients would like to improve medical consultations: Insights from a multicentre European study. PATIENT EDUCATION AND COUNSELING 2016; 99:51-60. [PMID: 26337005 DOI: 10.1016/j.pec.2015.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 08/05/2015] [Accepted: 08/06/2015] [Indexed: 05/10/2023]
Abstract
OBJECTIVE In a previous qualitative study (GULiVer-I), a series of lay-people derived recommendations ('tips') was listed for doctor and patient on 'How to make medical consultation more effective from the patient's perspective'. This work (GULiVer-II) aims to find evidence whether these tips can be generally applied, by using a quantitative approach, which is grounded in the previous qualitative study. METHODS The study design is based on a sequential mixed method approach. 798 patients, representing United Kingdom, Italy, Belgium and the Netherlands, were invited to assess on four point Likert scales the importance of the GULiVer-I tips listed in the 'Patient Consultation Values questionnaire'. RESULTS All tips for the doctor and the patient were considered as (very) important by the majority of the participants. Doctors' and patients' contributions to communicate honestly, treatment and time management were considered as equally important (65, 71 and 58% respectively); whereas the contribution of doctors to the course and content of the consultation was seen as more important than that of patients. CONCLUSIONS The relevance of GULiVer-I tips is confirmed, but tips for doctors were assessed as more important than those for patients. PRACTICE IMPLICATIONS Doctors and patients should pay attention to these "tips" in order to have an effective medical consultation.
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Affiliation(s)
- Maria Angela Mazzi
- Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Italy.
| | - Michela Rimondini
- Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Italy
| | - Wienke G W Boerma
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Christa Zimmermann
- Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Italy
| | - Jozien M Bensing
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Department of Psychology, University of Utrecht, The Netherlands
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González-de Paz L, Kostov B, López-Pina JA, Solans-Julián P, Navarro-Rubio MD, Sisó-Almirall A. A Rasch analysis of patients' opinions of primary health care professionals' ethical behaviour with respect to communication issues. Fam Pract 2015; 32:237-43. [PMID: 25381008 DOI: 10.1093/fampra/cmu073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients' opinions are crucial in assessing the effectiveness of the ethical theories which underlie the care relationship between patients and primary health care professionals. OBJECTIVES To study the ethical behaviour of primary health care professionals with respect to communication issues according to patients' opinions. METHODS Cross-sectional study using a self-administered questionnaire in patients from a network of 15 urban primary health centres. Participants were patients attended at the centres when the study was conducted. We used a Rasch analysis to verify the structure of the 17 questionnaire items, and to calculate interval level measures for patients and items. We analysed differences according to patient subgroups using analysis of variance tests and differences between the endorsement of each item. RESULTS We analysed 1013 (70.34%) of questionnaires. Data fit to the Rasch model was achieved after collapsing two categories and eliminating five items. Items with the lowest degree of endorsement were related to the management of differences in conflictive situations between patients and health care professionals. We found significant differences (P < 0.001) in patients' opinions according to the degree of confidence in professionals and their educational level. CONCLUSIONS Patients opined that empathy and traditional communication skills were respected by family physicians and nurses. However, opinions on endorsement were lower when patients disagreed with health care professionals. The differences found between patient subgroups demonstrated the importance of trust and confidence between patients and professionals.
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Affiliation(s)
- Luis González-de Paz
- Transverse Group for Research in Primary Care, IDIBAPS, Barcelona, School of Medicine and Health Sciences, Universitat Internacional de Catalunya. Sant Cugat del Vallés,
| | - Belchin Kostov
- Transverse Group for Research in Primary Care, IDIBAPS, Barcelona
| | - Jose A López-Pina
- Department of Basic Psychology and Methodology. University of Murcia, Murcia
| | - Pilar Solans-Julián
- Institut Català de la Salut. Àmbit d'Atenció Primària Barcelona Ciutat. Barcelona and
| | - M Dolors Navarro-Rubio
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya. Sant Cugat del Vallés
| | - Antoni Sisó-Almirall
- Transverse Group for Research in Primary Care, IDIBAPS, Barcelona, University of Barcelona School of Medicine (Hospital Clinic), Barcelona, Spain
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Expectations towards medical personnel – a study with infertility clinic patients. HEALTH PSYCHOLOGY REPORT 2014. [DOI: 10.5114/hpr.2014.45197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
<b>Background</b><br />
Contacts with medical personnel are important for patients’ experiences. The role of physicians’ psychosocial competence was noted in Polish studies, but systematic analyses of infertile patients’ expectations have not been conducted. This study was designed to learn about patients’ views on relationships with medical personnel. It was assumed that: 1) staff involvement in infertility treatment would be reflected in expectations towards persons in different roles, 2) expectations might be related to patients’ gender, duration of infertility, and type of treatment, 3) expectations of couples would be related.<br />
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<b>Participants and procedure</b><br />
Fifty-one married couples filled in a purposely designed questionnaire. Items related to information, attitudes and support were divided into three sections – expectations towards physicians, other medical personnel, psychologists – and were scored on a scale of 1 to 5 points.<br />
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<b>Results</b><br />
No gender effect of duration of treatment, type of infertility or treatment method on expectations was found. Partners expected the same level of information from physicians and the same level of emotional support from psychologists. Other expectations were consistently higher in women. There was a clear division of expectations towards different groups of personnel – the expectation to make the best medical choices was assigned to physicians, while the expectation to provide a supportive relationship and coping skills was assigned to psychologists, but all were expected to respect patients’ privacy, choices and decisions.<br />
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<b>Conclusions</b><br />
The findings indicate the division of expectations towards different groups of personnel, with the tendency of women to articulate their expectations more clearly and strongly, but towards the same aspects of staff functioning as men do.
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Van Damme-Ostapowicz K, Krajewska-Kułak E, Nwosu PJC, Kułak W, Sobolewski M, Olszański R. Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria. BMC Health Serv Res 2014; 14:202. [PMID: 24885562 PMCID: PMC4045946 DOI: 10.1186/1472-6963-14-202] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 04/25/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health condition is one of the basic factors affecting satisfaction with life, and the level of illness acceptance. The purpose of the study was to analyse the level of illness acceptance, the level of satisfaction with life among malaria patients, and the level of trust placed in the physician and the nurse. METHODS The study employs the method of diagnostic survey based on standardised AIS and SWLS scales, as well as Anderson and Dedrick's PPTS and PNTS scales. RESULTS The average AIS level was 12 points, while the average level of SwL at the SWLS scale was 16.5 points. The average level of trust in the physician and the nurse amounted to 50.6 points and 51.4 points, respectively. The correlation between the level of illness acceptance and self-evaluated satisfaction with life was statistically significant, with R = 0.56. The marital status influenced the level of illness acceptance with p < 0.05 and the level of satisfaction with life with p < 0.05. The employment status affected the level of satisfaction with life with p < 0.05 and the level of illness acceptance with p < 0.05. CONCLUSIONS The majority of malaria patients did not accept their illness, while the level of satisfaction with life was low. The majority of respondents trusted their physician and nurse. There is a statistically significant correlation between the level of illness acceptance and the self-evaluated satisfaction with life. The marital status had a statistically significant effect on the acceptance of illness and the satisfaction with life. The individuals who had a job demonstrated higher levels of quality of life and illness acceptance.
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Kajamaa A, Hilli A. Clients' initiatives and caregivers' responses in the organizational dynamics of care delivery. QUALITATIVE HEALTH RESEARCH 2014; 24:18-32. [PMID: 24265102 DOI: 10.1177/1049732313514138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Our aim with this article is to develop a typology for the analysis of client-caregiver encounters in health care. We first observed client-caregiver interactions in the homes of home care clients and during the care processes of surgical patients. We then conducted a data-driven analysis to identify the clients' initiatives and the degree of engagement in the responses they received. The clients shaped their care by commenting on, questioning, ensuring, and enriching their care. The responses from the caregivers consisted of neutral acceptance, disregard, and shared expansive development of the clients' initiatives. The typology developed from these will be a tool to widen our understanding of the complex interactions in care delivery and of the different conceptualizations of care that actors hold. In future studies this typology will help in the analysis of the organizational dynamics of health care delivery.
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Abstract
PURPOSE OF REVIEW This article revises the main conclusions from recent reviews and research, about the different dimensions that shape the patient-physician relationship, delineating specific areas of intervention that would reinforce the quality of this interaction. RECENT FINDINGS The selected articles reflect the permanent interest that exists about this topic. Within the most promissory findings significant associations were found from statistical as well as clinical standpoints. These associated verbal and non-verbal communication skills, as well as the empathizing ability of the physician, with clinical results of the patients, were measured with subjective parameters (e.g. patient satisfaction) and especially objective ones (e.g. physiological markers). Nevertheless, the results are still not robust and cannot be translatable. SUMMARY The implications of these studies are at a conceptual and instrumental level. A better precision of the dimensions and variables that define the patient-physician relationship will permit the design of educational strategies and training that will empower the physician for an interaction with his patients of greater technical and relational efficiency.
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Mrduljaš Đujić N, Žitnik E, Pavelin L, Bačić D, Boljat M, Vrdoljak D, Pavličević I, Dvornik AR, Marušić A, Marušić M. Writing letters to patients as an educational tool for medical students. BMC MEDICAL EDUCATION 2013; 13:114. [PMID: 23971879 PMCID: PMC3765343 DOI: 10.1186/1472-6920-13-114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 08/21/2013] [Indexed: 05/28/2023]
Abstract
BACKGROUND Despite rapid growth and development of medical technology, personal relationship between the patient and physician remains the basis of high quality treatment. The aim of our study was to develop, implement and evaluate patient therapeutic letters written by students as a tool in teaching family medicine. METHODS The study included all 6th year students attending their rounds in family medicine, structured into two 10-day cycles, one in urban offices and one in offices on the Adriatic islands (rural). After receiving detailed instructions, students wrote letters to two patients after a consultation in the office. The letters were audited by patients and 3 family medicine experts who used a grading instrument (scale 0 - poor, 1 - medium, 2 - good) for 1) adequacy and clarity of description of patients' disease/state, 2) knowledge, 3) adequacy of recommendations, 4) courtesy and respect and 5) language and style. Patients and experts were also asked to underline phrases they thought would be difficult to understand; the underlined text was subjected to content analysis. RESULTS Both the patients and the experts gave high scores for the value and quality of the letters in terms of the description of the problem, adequacy of recommendations given, and courtesy and respect (mean (±standard deviation) 5.65 ± 0.79 for patients vs. 4.87 ± 0.79 for experts out of maximum score of 6). Family medicine experts were stricter than patients in their evaluation of the content of the letters (adequacy and clarity of disease description (P < 0.001) and adequacy of recommendations (P < 0.001). Both the patients and the experts seemed to like longer letters as the length of the letter showed significant positive correlation with the quality summary score (correlation r = 0.492 vs. r = 0.338, respectively, P < 0.010). Overlapping of the text underlined as difficult to understand by patients and experts was found in 10 (11.6%) out of 86 letters. The highest overlap (20 terms) was found for the category "Technical terms unclear to a lay reader". CONCLUSIONS Writing of a letter to their first patients may be a useful tool for students to personally experience the practice of medicine and establish better partnership with patients in health care.
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Affiliation(s)
- Nataša Mrduljaš Đujić
- Department of Family Medicine, University of Split School of Medicine, Šoltanska 2, Split 21000, Croatia
| | - Edi Žitnik
- ‘Mi’ Association and ‘Kajo Dadic’ Foundation Split, Split, Croatia
| | - Ljubica Pavelin
- Department of Family Medicine, University of Split School of Medicine, Šoltanska 2, Split 21000, Croatia
| | - Dubravka Bačić
- Department of Family Medicine, University of Split School of Medicine, Šoltanska 2, Split 21000, Croatia
| | - Mia Boljat
- Department of Family Medicine, University of Split School of Medicine, Šoltanska 2, Split 21000, Croatia
| | - Davorka Vrdoljak
- Department of Family Medicine, University of Split School of Medicine, Šoltanska 2, Split 21000, Croatia
| | - Ivančica Pavličević
- Department of Family Medicine, University of Split School of Medicine, Šoltanska 2, Split 21000, Croatia
| | | | - Ana Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Matko Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
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