Which medical interview skills are associated with patients' verbal indications of undisclosed feelings of anxiety and depressive feelings?

Effect of Communication Skills Training Using the Calgary-Cambridge Model on Interviewing Skills among Midwifery Students: A Randomized Controlled Trial

Background

An effective interview can strengthen the clinician-patient relationship and improve treatment outcomes. We aimed to assess the effect of communication skills training using the Calgary-Cambridge model on interviewing skills among midwifery students.

Materials and Methods

In this randomized controlled trial, 30 midwifery students of Golestan University of Medical Sciences were selected using the convenience sampling method and randomly assigned through minimization into the intervention (n = 15) and control (n = 15) groups in 2018. The routine interventions were administered for the control group, and four sessions of communication skills training based on the Calgary-Cambridge model was performed in small groups for the intervention group. Evan and colleague's History-taking Rating Scale was used before and four weeks after the intervention. Data were analyzed using paired and independent-sample t and Mann-Whitney U tests at the significance level of less than 0.05.

Results

The mean (SD) scores of interviewing skill before and after the intervention was 33.71 (7.34) and 54.50 (8.16), respectively, in the intervention group (t₁₃= 9.26, p < 0.001) and 33.64 (6.02) and 33.93 (5.39) in the control group, respectively (p = 0.85). The difference between the two groups was significant (t₂₆= 7.86, p < 0.001).

Conclusions

Communication skills training based on the Calgary-Cambridge model can be used as an effective method to improve interviewing skills among midwifery students.

Development and feasibility of the use of an assessment tool measuring treatment efficacy in patients with trimethylaminuria: A mixed methods study

Trimethylaminuria (TMAU) is a rare metabolic condition characterised by an unpleasant smell resembling rotting fish. Currently, the only measure of treatment efficacy is urine trimethylamine levels which do not always reflect the patient's experience of symptoms. A literature review did not find a specific tool to assess treatment efficacy from the patient's perspective. The aim of this study was to develop an assessment tool to provide a quantitative measure of treatment efficacy in patients diagnosed with TMAU before and after treatment and assess its acceptability (feasibility of use and face and content validity) to people living with TMAU. Mixed methods; a modified, four-round Delphi by email and semi-structured interviews conducted after clinical appointments. Delphi; Eight individuals living with TMAU from the TMAU forum, six medical consultants, and four dieticians in Metabolic Medicine in four National Health Service hospitals in England. Semi-structured interviews; three patients with TMAU in two National Health Service hospitals, United Kingdom. The assessment tool contains 27 items distributed across four domains; Odour characteristics with 6 items, mental well-being with 13 items, social well-being with 5 items, and healthcare professionals support with 3 items. Semi-structured interviews; views on the content and design of the tool. The co-produced tool was successfully developed and considered acceptable to people living with TMAU. While further testing is needed to evaluate the validity and reliability of the assessment tool, the tool may serve as a prompt for questioning for clinicians diagnosing and treating TMAU.

Challenges and opportunities in establishing a collaborative multisite observational study of chronic diseases and lifestyle factors among adults in Puerto Rico

Background

Prevalence of chronic diseases and unhealthy lifestyle behaviors among the adult population of Puerto Rico (PR) is high; however, few epidemiological studies have been conducted to address these. We aimed to document the methods and operation of establishing a multisite cross-sectional study of chronic diseases and risk factors in PR, in partnership with academic, community, clinical, and research institutions.

Methods

The Puerto Rico Assessment of Diet, Lifestyle and Diseases (PRADLAD) documented lifestyle and health characteristics of adults living in PR, with the goal of informing future epidemiological and intervention projects, as well as public health, policy, and clinical efforts to help improve the population’s health. The study was conducted in three primary care clinics in the San Juan, PR metropolitan area. Eligible volunteers were 30–75y, living in PR for at least 10 months of the previous year, and able to answer interviewer-administered questionnaires without assistance. Questions were recorded electronically by trained interviewers, and included socio-demographic characteristics, lifestyle behaviors, self-reported medically-diagnosed diseases, and psychosocial factors. Waist and hip circumferences were measured following standardized protocols. A subset of participants answered a validated food frequency questionnaire, a legumes questionnaire, and had medical record data abstracted. Process and outcome evaluation indicators were assessed.

Results

The study screened 403 participants in 5 months. Of these, 396 (98%) were eligible and 380 (94%) had reliable and complete information. A subset of 242 participants had valid dietary data, and 236 had medical record data. The mean time to complete an interview was 1.5 h. Participants were generally cooperative and research collaborators were fully engaged. Having multiple sites helped enhance recruitment and sociodemographic representation. Diagnosed conditions were prevalent across sites. Challenges in data monitoring, interviewer training, and scheduling were identified and corrected, and should be addressed in future studies.

Conclusions

Epidemiological studies in PR can be successfully implemented in partnership with multiple institutions. Effective recruitment and implementation requires concerted planning and continued involvement from partners, frequent quality control, brief interviews, reasonable incentives, and thorough training/re-training of culturally-sensitive interviewers. Further studies are feasible and needed to help address highly prevalent chronic conditions in PR.