1
|
Sanders ARJ, de Wit NJ, Zuithoff NPA, van Dulmen S. The effect of shared decision-making on recovery from non-chronic aspecific low back pain in primary care; a post-hoc analysis from the patient, physician and observer perspectives. BMC PRIMARY CARE 2022; 23:22. [PMID: 35172742 PMCID: PMC8809011 DOI: 10.1186/s12875-022-01624-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 12/15/2021] [Indexed: 12/02/2022]
Abstract
Background Although shared decision-making (SDM) is increasingly accepted in healthcare and has demonstrated merits for several psychological outcomes, the effect on recovery from somatic conditions is still subject to debate. The objective of this study is to measure the effect of SDM on recovery from non-chronic aspecific low back pain (LBP). Methods This study is a post-hoc analysis of data from a cluster-randomised trial that evaluated the effectiveness of SDM on recovery in patients with non-chronic aspecific LBP. In this analysis, we re-evaluate the impact of SDM from three perspectives: that of external observers, participating GPs and participating patients. Recovery was measured with the Visual Analogue Scale (VAS) for pain and with the Roland Morris Disability questionnaire (RMD) and defined as a VAS < 30 and an RMD < 4. Logistic regression was used to analyse the effect of SDM on recovery at 6 and 26 weeks. Results At 26 weeks, 105 (74%) of all 176 included patients had recovered. No significant effect of SDM on recovery at 6 or 26 weeks after the consultation was found when considering SDM from an observer perspective or a patient perspective. From a GP perspective SDM had a significant effect on recovery, but at 26 weeks only, and with the lowest probability of recovery observed at a medium level of GP-perceived SDM. Conclusions We found no evidence that SDM as perceived by the patient or by external observation improves recovery from non-chronic aspecific low back pain. The long-term recovery may be better for patients in whom the GP perceives SDM during their consultations. Further research should highlight the hierarchy and the relation between the perspectives, which is needed to come to an integral effect evaluation of SDM. Trial registration The Netherlands National Trial Register (NTR) number: NTR1960. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01624-y.
Collapse
Affiliation(s)
- Ariëtte R J Sanders
- Julius centre for health sciences and primary care, University medical centre Utrecht, P.O. box 85500, 3508, GA, Utrecht, the Netherlands.
| | - Niek J de Wit
- Julius centre for health sciences and primary care, University medical centre Utrecht, P.O. box 85500, 3508, GA, Utrecht, the Netherlands
| | - Nicolaas P A Zuithoff
- Julius centre for health sciences and primary care, University medical centre Utrecht, P.O. box 85500, 3508, GA, Utrecht, the Netherlands
| | - Sandra van Dulmen
- Nivel (Netherlands institute for health services research), P.O. Box 1568, 3500, BN, Utrecht, the Netherlands.,Department of primary and community care, Radboud university edical center, Radboud institute for health sciences, Nijmegen, The Netherlands
| |
Collapse
|
2
|
Shersher V, Haines TP, Williams C, Willoughby L, Sturgiss E, Weller C. Developing a Taxonomy of Communication Techniques and Aids Used By Healthcare Providers During Patient Consultations: Protocol for a Systematic Review. JMIR Res Protoc 2020; 9:e16801. [PMID: 32673277 PMCID: PMC7388054 DOI: 10.2196/16801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/06/2020] [Accepted: 04/09/2020] [Indexed: 11/13/2022] Open
Abstract
Background Currently, there is no available standardized taxonomy of defined communication techniques and aids used by healthcare providers during patient consultations. It is challenging to identify communication techniques that contribute to effective healthcare provider and patient consultations and to replicate communication interventions in research. Objective The aim of this paper is to describe a protocol for the development and pilot of a taxonomy of communication techniques and aids used by healthcare providers during patient consultations. Methods A systematic review will be completed to identify eligible studies. Extracted techniques and aids will be organized into a preliminary taxonomy by a multidisciplinary team. The preliminary taxonomy will be piloted by two groups: research assistants trained in taxonomy application and healthcare providers and healthcare professional students not trained in taxonomy use. The pilot will use custom developed video footage of health provider and patient interactions. Interrater validity and interview feedback will be used to inform a Delphi panel of multidisciplinary healthcare providers and patient experts when they convene to finalize the preliminary taxonomy. Results This study was funded in November 2017 by the Monash University Interdisciplinary Research Seed Funding Scheme. Data collection commenced in March 2018, and data analysis is in progress. We expect the results to be published in 2021. Conclusions This is the first known attempt to develop a defined and standardized taxonomy of communication techniques and aids used by healthcare providers in patient consultations. The findings will be used to inform future research by providing a detailed taxonomy of healthcare providers’ communication techniques and standardized definitions. International Registered Report Identifier (IRRID) DERR1-10.2196/16801
Collapse
Affiliation(s)
- Violetta Shersher
- School of Primary and Allied Health, Monash University, Frankston, Australia
| | - Terry P Haines
- School of Primary and Allied Health, Monash University, Frankston, Australia
| | - Cylie Williams
- School of Primary and Allied Health, Monash University, Frankston, Australia
| | - Louisa Willoughby
- School of Languages, Literatures, Cultures and Linguistics, Monash University, Clayton, Victoria, Australia
| | - Elizabeth Sturgiss
- Department of General Practice, Monash University, Notting Hill, Victoria, Australia
| | - Carolina Weller
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Testing a Model of Consultation-based Reassurance and Back Pain Outcomes With Psychological Risk as Moderator: A Prospective Cohort Study. Clin J Pain 2019; 34:339-348. [PMID: 29509169 PMCID: PMC5844580 DOI: 10.1097/ajp.0000000000000541] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Reassurance is an essential part of treatment for low back pain (LBP), but evidence on effective methods to deliver reassurance remains scarce. The interaction between consultation-based reassurance and patients' psychological risk is unknown. Our objective was to investigate the relationship between consultation-based reassurance and clinical outcomes at follow-up, in people with and without psychological risk. METHODS We tested the associations between specific reassurance components (data gathering, relationship building, generic reassurance, and cognitive reassurance), patients' psychological risk (the presence of depression, anxiety, catastrophizing, or fear-avoidance), and postconsultation outcomes including, satisfaction and enablement, disability, pain, and mood at 3-month follow-up. RESULTS Adjusted linear regression models using data from patients who had recently consulted for LBP in primary care (n=142 in 43 practices) indicated that all reassurance components were strongly associated with increased satisfaction, whereas generic reassurance was significantly associated with postconsultation enablement. Generic reassurance was also associated with lower pain at 3 months, whereas cognitive reassurance was associated with increased pain. A significant interaction was observed between generic reassurance and psychological risk for depression at 3 months: high rates of generic reassurance were associated with lower depression in low-risk patients, but with higher rates of depression for high-risk groups. DISCUSSION The findings support the hypothesis that different components of reassurance are associated with specific outcomes, and that psychological risk moderates this relationship for depression. Clinicians reassuring behaviors might therefore have the potential to improve outcomes in people with LBP, especially for patients with higher psychological risk profiles.
Collapse
|
4
|
Self-limiting Conditions: A Holistic Approach. Holist Nurs Pract 2017; 32:1-2. [PMID: 29210871 DOI: 10.1097/hnp.0000000000000249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
5
|
van Osch M, van Dulmen S, van Vliet L, Bensing J. Specifying the effects of physician's communication on patients' outcomes: A randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2017; 100:1482-1489. [PMID: 28318845 DOI: 10.1016/j.pec.2017.03.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/03/2017] [Accepted: 03/04/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To experimentally test the effects of physician's affect-oriented communication and inducing expectations on outcomes in patients with menstrual pain. METHODS Using a 2×2 RCT design, four videotaped simulated medical consultations were used, depicting a physician and a patient with menstrual pain. In the videos, two elements of physician's communication were manipulated: (1) affect-oriented communication (positive: warm, emphatic; versus negative: cold, formal), and (2) outcome expectation induction (positive versus uncertain). Participants (293 women with menstrual pain), acting as analogue patients, viewed one of the four videos. Pre- and post video participants' outcomes (anxiety, mood, self-efficacy, outcome expectations, and satisfaction) were assessed. RESULTS Positive affect-oriented communication reduced anxiety (p<0.001), negative mood (p=0.001), and increased satisfaction (p<0.001) compared to negative affect-oriented communication. Positive expectations increased feelings of self-efficacy (p<0.001) and outcome expectancies (p<0.001), compared to uncertain expectations, but did not reduce anxiety. The combination of positive affect-oriented communication and a positive expectation reduced anxiety (p=0.02), increased outcome expectancies (p=0.01) and satisfaction (p=0.001). CONCLUSION Being empathic and inducing positive expectations have distinct and combined effects, demonstrating that both are needed to influence patients' outcomes for the best. PRACTICE IMPLICATIONS Continued medical training is needed to harness placebo-effects of medical communication into practice.
Collapse
Affiliation(s)
- Mara van Osch
- NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands
| | - Sandra van Dulmen
- NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Faculty of Health Science, University College of Southeast Norway, PO Box 7053, NO-3007 Drammen, Norway.
| | - Liesbeth van Vliet
- NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands
| | - Jozien Bensing
- NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands
| |
Collapse
|
6
|
Maurice-Szamburski A, Michel P, Loundou A, Auquier P. Validation of the generic medical interview satisfaction scale: the G-MISS questionnaire. Health Qual Life Outcomes 2017; 15:36. [PMID: 28196503 PMCID: PMC5310066 DOI: 10.1186/s12955-017-0608-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/01/2017] [Indexed: 11/13/2022] Open
Abstract
Background Patients have about seven medical consultations a year. Despite the importance of medical interviews in the healthcare process, there is no generic instrument to assess patients’ experiences in general practices, medical specialties, and surgical specialties. The main objective was to validate a questionnaire assessing patients’ experiences with medical consultations in various practices. Method The G-MISS study was a prospective multi-center trial that enrolled patients from May to July 2016. A total of 2055 patients were included from general practices, medical specialties, and surgical specialties. Patients filled out a questionnaire assessing various aspects of their experience and satisfaction within 1 week after their medical interview. The validation process relied on item response theory. Internal validity was examined using exploratory factorial analysis. The statistical model used the root mean square error of approximation, confirmatory fit index, and standard root mean square residual as fit indices. Scalability and reliability were assessed with the Rasch model and Cronbach’s alpha coefficients, respectively. Scale properties across the three subgroups were explored with differential item functioning. Results The G-MISS final questionnaire contained 16 items, structured in three dimensions of patients’ experiences: “Relief”, “Communication”, and “Compliance”. A global index of patients’ experiences was computed as the mean of the dimension scores. All fit indices from the statistical model were satisfactory (RMSEA = 0.03, CFI = 0.98, SRMR = 0.06). The overall scalability had a good fit to the Rasch model. Each dimension was reliable, with Cronbach’s alpha ranging from 0.73 to 0.86. Differential item functioning across the three consultation settings was negligible. Patients undergoing medical or surgical specialties reported higher scores in the “Relief” dimension compared with general practice (83.0 ± 11.6 or 82.4 ± 11.6 vs. 73.2 ± 16.7; P < .001). A consultation shorter than 5 min correlated with low patient satisfaction in “Relief” and “Communication” and in the global index, P < .001. Conclusions The G-MISS questionnaire is a valid and reliable questionnaire for assessing patients’ experiences after consultations with general practitioners, medical specialists, and surgical specialists. The multidimensional structure relies on item response theory and assesses different aspects of patients’ experiences that could be useful in clinical practice and research settings.
Collapse
Affiliation(s)
- Axel Maurice-Szamburski
- Laboratoire Universitaire EA 3279, Santé Publique et Maladies Chroniques, 27 boulevard Jean Moulin, Marseille, 13005, France.
| | - Pierre Michel
- Laboratoire Universitaire EA 3279, Santé Publique et Maladies Chroniques, 27 boulevard Jean Moulin, Marseille, 13005, France
| | - Anderson Loundou
- Unité d'aide méthodologique, Direction de la Recherche Clinique, AP-HM, Marseille, France
| | - Pascal Auquier
- Laboratoire Universitaire EA 3279, Santé Publique et Maladies Chroniques, 27 boulevard Jean Moulin, Marseille, 13005, France
| | | |
Collapse
|
7
|
DiLiberto DD, Staedke SG, Nankya F, Maiteki-Sebuguzi C, Taaka L, Nayiga S, Kamya MR, Haaland A, Chandler CIR. Behind the scenes of the PRIME intervention: designing a complex intervention to improve malaria care at public health centres in Uganda. Glob Health Action 2015; 8:29067. [PMID: 26498744 PMCID: PMC4620687 DOI: 10.3402/gha.v8.29067] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/20/2015] [Accepted: 09/22/2015] [Indexed: 12/30/2022] Open
Abstract
Background In Uganda, health system challenges limit access to good quality healthcare and contribute to slow progress on malaria control. We developed a complex intervention (PRIME), which was designed to improve quality of care for malaria at public health centres. Objective Responding to calls for increased transparency, we describe the PRIME intervention's design process, rationale, and final content and reflect on the choices and challenges encountered during the design of this complex intervention. Design To develop the intervention, we followed a multistep approach, including the following: 1) formative research to identify intervention target areas and objectives; 2) prioritization of intervention components; 3) review of relevant evidence; 4) development of intervention components; 5) piloting and refinement of workshop modules; and 6) consolidation of the PRIME intervention theories of change to articulate why and how the intervention was hypothesized to produce desired outcomes. We aimed to develop an intervention that was evidence-based, grounded in theory, and appropriate for the study context; could be evaluated within a randomized controlled trial; and had the potential to be scaled up sustainably. Results The process of developing the PRIME intervention package was lengthy and dynamic. The final intervention package consisted of four components: 1) training in fever case management and use of rapid diagnostic tests for malaria (mRDTs); 2) workshops in health centre management; 3) workshops in patient-centred services; and 4) provision of mRDTs and antimalarials when stocks ran low. Conclusions The slow and iterative process of intervention design contrasted with the continually shifting study context. We highlight the considerations and choices made at each design stage, discussing elements we included and why, as well as those that were ultimately excluded. Reflection on and reporting of ‘behind the scenes’ accounts of intervention design may improve the design, assessment, and generalizability of complex interventions and their evaluations.
Collapse
Affiliation(s)
- Deborah D DiLiberto
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK;
| | - Sarah G Staedke
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - Lilian Taaka
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Susan Nayiga
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Moses R Kamya
- Infectious Diseases Research Collaboration, Kampala, Uganda.,School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ane Haaland
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Clare I R Chandler
- Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
8
|
Boerebach BC, Scheepers RA, van der Leeuw RM, Heineman MJ, Arah OA, Lombarts KM. The impact of clinicians' personality and their interpersonal behaviors on the quality of patient care: a systematic review. Int J Qual Health Care 2014; 26:426-81. [DOI: 10.1093/intqhc/mzu055] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
9
|
Giroldi E, Veldhuijzen W, Mannaerts A, van der Weijden T, Bareman F, van der Vleuten C. "Doctor, please tell me it's nothing serious": an exploration of patients' worrying and reassuring cognitions using stimulated recall interviews. BMC FAMILY PRACTICE 2014; 15:73. [PMID: 24762333 PMCID: PMC4008437 DOI: 10.1186/1471-2296-15-73] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 04/17/2014] [Indexed: 11/16/2022]
Abstract
Background Many patients who consult their GP are worried about their health, but there is little empirical data on strategies for effective reassurance. To gain a better understanding of mechanisms for effective patient reassurance, we explored cognitions underlying patients’ worries, cognitions underlying reassurance and factors supporting patients’ reassuring cognitions. Methods In a qualitative study, we conducted stimulated recall interviews with 21 patients of 12 different GPs shortly after their consultation. We selected consultations in which the GPs aimed to reassure worried patients and used their videotaped consultation as a stimulus for the interview. The interviews were analysed with thematic coding and by writing interpretive summaries. Results Patients expressed four different core cognitions underlying their concerns: ‘I have a serious illness’, ‘my health problem will have adverse physical effects’, ‘my treatment will have adverse effects’ and ‘my health problem will negatively impact my life’. Patients mentioned a range of person-specific and context-specific cognitions as reasons for these core cognitions. Patients described five core reassuring cognitions: ‘I trust my doctor’s expertise’, ‘I have a trusting and supporting relationship with my doctor’, ‘I do not have a serious disease’, ‘my health problem is harmless’ and ‘my health problem will disappear.’ Factors expressed as reasons for these reassuring cognitions were GPs’ actions during the consultation as well as patients’ pre-existing cognitions about their GP, the doctor-patient relationship and previous events. Patients’ worrying cognitions were counterbalanced by specific reassuring cognitions, i.e. worrying and reassuring cognitions seemed to be interrelated. Conclusions Patients described a wide range of worrying cognitions, some of which were not expressed during the consultation. Gaining a thorough understanding of the specific cognitions and tailoring reassuring strategies to them should be an effective way of achieving reassurance. The identified reassuring cognitions can guide doctors in applying these strategies in their daily practice.
Collapse
Affiliation(s)
- Esther Giroldi
- Department of Family Medicine, Maastricht University, School for Public Health and Primary Care (CAPHRI), P,O, Box 616, Maastricht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
10
|
Cognitive and affective reassurance and patient outcomes in primary care: A systematic review. Pain 2013; 154:2407-2416. [DOI: 10.1016/j.pain.2013.07.019] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 07/12/2013] [Accepted: 07/15/2013] [Indexed: 12/19/2022]
|
11
|
Leach CMJ, Mandy A, Hankins M, Bottomley LM, Cross V, Fawkes CA, Fiske A, Moore AP. Patients' expectations of private osteopathic care in the UK: a national survey of patients. Altern Ther Health Med 2013; 13:122. [PMID: 23721054 PMCID: PMC3679882 DOI: 10.1186/1472-6882-13-122] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 05/22/2013] [Indexed: 11/16/2022]
Abstract
Background Patients’ expectations of osteopathic care have been little researched. The aim of this study was to quantify the most important expectations of patients in private UK osteopathic practices, and the extent to which those expectations were met or unmet. Methods The study involved development and application of a questionnaire about patients’ expectations of osteopathic care. The questionnaire drew on an extensive review of the literature and the findings of a prior qualitative study involving focus groups exploring the expectations of osteopathic patients. A questionnaire survey of osteopathic patients in the UK was then conducted. Patients were recruited from a random sample of 800 registered osteopaths in private practice across the UK. Patients were asked to complete the questionnaire which asked about 51 aspects of expectation, and post it to the researchers for analysis. The main outcome measures were the patients-perceived level of expectation as assessed by the percentage of positive responses for each aspect of expectation, and unmet expectation as computed from the proportion responding that their expectation “did not happen”. Results 1649 sets of patient data were included in the analysis. Thirty five (69%) of the 51 aspects of expectation were prevalent, with listening, respect and information-giving ranking highest. Only 11 expectations were unmet, the most often unmet were to be made aware that there was a complaints procedure, to find it difficult to pay for osteopathic treatment, and perceiving a lack of communication between the osteopath and their GP. Conclusions The findings reflected the complexity of providing osteopathic care and meeting patients’ expectations. The results provided a generally positive message about private osteopathic practice. The study identified certain gaps between expectations and delivery of care, which can be used to improve the quality of care. The questionnaire is a resource for future research.
Collapse
|
12
|
Weiland A, Van de Kraats RE, Blankenstein AH, Van Saase JLCM, Van der Molen HT, Bramer WM, Van Dulmen AM, Arends LR. Encounters between medical specialists and patients with medically unexplained physical symptoms; influences of communication on patient outcomes and use of health care: a literature overview. PERSPECTIVES ON MEDICAL EDUCATION 2012; 1:192-206. [PMID: 23205344 PMCID: PMC3508274 DOI: 10.1007/s40037-012-0025-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Medically unexplained physical symptoms (MUPS) burden patients and health services due to large quantities of consultations and medical interventions. The aim of this study is to determine which elements of communication in non-psychiatric specialist MUPS care influence health outcomes. Systematic search in PubMed, PsycINFO and Embase. Data extraction comprising study design, patient characteristics, number of patients, communication strategies, outcome measures and results. Elements of doctor-patient communication were framed according to symptoms, health anxiety, satisfaction, daily functioning and use of health care. Eight included studies. Two studies described the effect of communication on patient outcome in physical symptoms, three studies on health anxiety and patient satisfaction and one study on daily functioning. Two studies contained research on use of health care. Qualitative synthesis of findings was conducted. Communication matters in non-psychiatric MUPS specialist care. Perceiving patients' expectations correctly enables specialists to influence patients' cognitions, to reduce patients' anxiety and improve patients' satisfaction. Patients report less symptoms and health anxiety when symptoms are properly explained. Positive interaction and feedback reduces use of health care and improves coping. Development of communication skills focused on MUPS patients should be part of postgraduate education for medical specialists.
Collapse
Affiliation(s)
- Anne Weiland
- Department of Internal Medicine, Erasmus MC, University Medical Center, 2040, 3000 CA, Rotterdam, the Netherlands.
- Faculty of Social Sciences, Institute of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | | | - Annette H Blankenstein
- Department of General Practice & Elderly Care Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Jan L C M Van Saase
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Henk T Van der Molen
- Faculty of Social Sciences, Institute of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Alexandra M Van Dulmen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
- Department of Health Science, Buskerud University College, Drammen, Norway
| | - Lidia R Arends
- Faculty of Social Sciences, Institute of Psychology and Institute of Pedagogy, Erasmus University, Rotterdam, the Netherlands
- Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
13
|
van Dulmen S, Schellevis F, Fassaert T, van der Jagt L, Schellevis F. De relatie tussen positieve communicatiestrategieën en het beloop van alledaagse klachten. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s12445-010-0117-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Abstract
RATIONALE When entering a consulting room a person becomes a patient with double needs, that is, the need to feel known and understood and the need to know and understand, also referred to as affective and instrumental needs, respectively. The fulfilment of these needs highly depends on the communication skills of both doctor and patient, which help to bridge the inherent distance that exists between these two persons. There is ample evidence that this bridge becomes stronger the more the communication is tailored to the person behind the patient. Besides, such tailored communication may also prove to be effective for reaching favourable health outcomes. METHODS Descriptive study focusing on the value of tailored communication in promoting person-centred instrumental and affective health outcomes. RESULTS Research shows that tailored communication contributes to health outcomes known to be crucial for recovery and quality of life, that is, information recall, medication adherence, reassurance and need fulfilment. CONCLUSION There is empirical evidence for the value of tailored communication for person-centred outcomes. Communicating in a purposeful way while at the same time respecting patients' values and feelings should therefore become the standard in health care practice.
Collapse
Affiliation(s)
- Sandra van Dulmen
- NIVEL (Netherlands Institute for Health Services Research), NIVEL, Nijmegen, The Netherlands.
| |
Collapse
|