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Harsi ELMEL, Izel O, Benksim A, Cherkaoui M. Factors influencing older adults' satisfaction with caregivers' communication. Dement Neuropsychol 2023; 17:e20230069. [PMID: 38053648 PMCID: PMC10695440 DOI: 10.1590/1980-5764-dn-2023-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/28/2023] [Accepted: 09/20/2023] [Indexed: 12/07/2023] Open
Abstract
Effective communication skills are crucial for caregivers to provide quality care and meet the unique needs of patients of all ages. However, older patients have specific communication requirements, and their satisfaction depends on several factors. Objective This study aimed to evaluate the level of satisfaction among older adults in Marrakech, Morocco, regarding the communication skills of their caregivers, and to identify the factors influencing this satisfaction. Methods This is a cross-sectional study conducted between March and July 2022 among 204 people aged 60 years and older who presented to the Mouhamed VI University Hospital of Marrakech, Morocco, for various care services. The older adults' satisfaction with caregivers' communication was assessed by the American Board of Internal Medicine (ABIM) patient satisfaction questionnaire. Sociodemographic and clinical characteristics of the participants were collected through interview and consultation of medical records. Multiple linear regression was used to determine potential factors influencing the total satisfaction score. Results The total satisfaction score of older adults with caregiver' communication was 2.55±0.95 and the mean scores of the lowest subscales were answering questions, greeting and listening. Analysis revealed that having visual disorders (B=-0.276±0.12; p=0.029) and receiving affective touch from caregivers (B=0.745±0.12; p=0.001) were the main factors associated with older adults' satisfaction with caregiver' communication. Conclusion Older people are not sufficiently satisfied with caregivers' communication skills, especially those with vision problems and those who have not received affective touch from caregivers. Caregivers need to be aware of the specific needs of older patients and use appropriate communication techniques.
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Affiliation(s)
- EL Mahjoub EL Harsi
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech 40000, Morocco
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Nursing Care Department, Marrakech 40000, Morocco
| | - Ouafa Izel
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Nursing Care Department, Marrakech 40000, Morocco
| | - Abdelhafid Benksim
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech 40000, Morocco
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Nursing Care Department, Marrakech 40000, Morocco
| | - Mohamed Cherkaoui
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech 40000, Morocco
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Communication skills utilized by physicians in the pediatric outpatient setting. BMC Health Serv Res 2022; 22:993. [PMID: 35927741 PMCID: PMC9354305 DOI: 10.1186/s12913-022-08385-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Effective communication has been shown to increase patient satisfaction. The objective of this study was to describe communication strategies employed by physicians, and determine if physician communication strategies affect caregiver perception of quality or satisfaction with physician communication in a pediatric ambulatory setting. Methods This observational study was conducted at the Children’s Hospital of Philadelphia and consisted of video recordings of visits that were reviewed by research assistants for physician utilized communication strategies. Caregivers completed surveys on their preferred physician communication qualities, perception of communication quality, and satisfaction with communication. Correlation was performed between types of communication strategy and caregiver satisfaction with communication or perceived quality of communication. T-tests were run to see if there was a significant difference in patient perceived communication and satisfaction scores based on the communication strategies utilized during visits. Results There were five universally used communication strategies across the 84 clinic visits recorded, including: eye contact, good posture, speaking concisely, providing thorough explanations, and providing summary of next steps. The average number of communication strategies used was 15.95 (σ = 1.50) with physicians using at least 16 of the 18 communication strategies in 62% of the clinic visits. There was no correlation between the number of communication strategies physicians utilized and either the caregiver perception of communication quality score (CPCQ) or communication satisfaction (CS) score. Caregivers who preferred an authoritative approach but perceived a collaborative approach reported lower average CPCQ and CS scores compared to caregivers who had their communication expectations met. Discussion There are numerous tools designed to help the physician facilitate an effective working relationship with the patient. In our study, the universally used verbal communication strategies are generally recognized as components of an effective communication repertoire. Another part of effective communication is meeting communication expectations with the CS scores suggesting that caregivers felt their communication needs were being met. Dedicating clinical time to understanding this need may help improve the overall clinical experience. Conclusion Physicians utilize many of the suggested communication strategies to help facilitate an effective clinical encounter. Further studies on caregiver communication requirements and meeting caregiver communication expectations are needed.
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Lee T, Rosario H, Cifuentes E, Cui J, Lin EC, Miller VA, Lin HC. Review of interruptions in a pediatric subspecialty outpatient clinic. PLoS One 2021; 16:e0254528. [PMID: 34324552 PMCID: PMC8320932 DOI: 10.1371/journal.pone.0254528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/29/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The objective of this study was to describe interruptions in the pediatric ambulatory setting and to assess their impact on perceived physician communication, patient satisfaction and recall of provided physician instructions. METHODS An observational study was performed at the Children's Hospital of Philadelphia, Pediatric Gastroenterology clinic. Participation consisted of video recording the clinic visit and the caregiver completed post-visit surveys on communication and satisfaction. Video recordings were coded for interruptions, which were divided into 3 main categories: Visit Associated, Pediatric Associated, and Unanticipated. An interruption rate was calculated and correlated with the following outcome variables to assess the impact of interruptions: caregiver satisfaction, caregiver perception on the quality of physician communication, and caregiver instruction recall. RESULTS There were 675 interruptions noted in the 81 clinic visits, with an average of 7.96 (σ = 7.68) interruptions per visit. Six visits had no interruptions. The Patient was the most frequent interrupter. Significantly higher interruption rates occurred in clinic visits with younger patients (<7 years old) with most of the interruptions being Pediatric Associated interruptions. There was minimal correlation between the clinic visit interruption rate and caregiver satisfaction with the communication, caregiver perception of quality of communication, or caregiver instruction recall rate. CONCLUSION The effect of interruptions on the pediatric visit remains unclear. Interruptions may be part of the communication process to ensure alignment of the patient's agenda. Additional studies are needed to help determine the impact of interruptions and guide medical education on patient communication.
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Affiliation(s)
- Tyler Lee
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Hinette Rosario
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Elizabeth Cifuentes
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Jiawei Cui
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Emery C. Lin
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Victoria A. Miller
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Henry C. Lin
- Division of Pediatric Gastroenterology, Doernbecher Children’s Hospital, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States of America
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Roshal JA, Chefitz D, Terregino CA, Petrova A. Comparison of self and simulated patient assessments of first-year medical students' Interpersonal and Communication Skills (ICS) during Objective Structured Clinical Examinations (OSCE). BMC MEDICAL EDUCATION 2021; 21:107. [PMID: 33596892 PMCID: PMC7887830 DOI: 10.1186/s12909-021-02540-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/04/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND Interpersonal and communication skills (ICS) are important core competencies in medical education and certification. In this study, we identified self- and simulated patient (SP)-reported ratings of US first-year medical students' ICS and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE). METHODS OSCE participants, including 172 first-year medical students and 15 SPs were asked to evaluate the students' ICS using the American Board of Internal Medicine-Patient-Satisfaction Questionnaire (ABIM-PSQ), electronically and via paper, respectively. Self- and SP-reported ratings of students' ICS were presented as the median on a 5-point Likert-scale and as three categories defined as "good," "very good," and "inadequate." RESULTS SPs assessed all 172 students in the OSCE, while 43.6% of students assessed their own performance. The majority of students and SPs evaluated the students' ICS as very good. 23.3% of SPs and 5.3% of students rated the medical students' ability to encourage patient question-asking and answer questions as inadequate (P < 0.002). Neither age nor gender influenced the medical students' self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs was more likely to assign lower scores on all survey questions. CONCLUSIONS In the present study, self- and SP-reported ratings of first-year medical students' ICS were mainly "very good" with no influence of students' age or gender. Older age and female gender among the SPs were associated with a reduction in SP-reported ratings of students' ICS.
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Affiliation(s)
- Joshua A Roshal
- Rutgers Robert Wood Johnson Medical School, Medical Education Building, MEB 202, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Dalya Chefitz
- Rutgers Robert Wood Johnson Medical School, Medical Education Building, MEB 202, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Carol A Terregino
- Rutgers Robert Wood Johnson Medical School, Medical Education Building, MEB 202, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Anna Petrova
- Rutgers Robert Wood Johnson Medical School, Medical Education Building, MEB 202, 125 Paterson Street, New Brunswick, NJ, 08901, USA.
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Lee T, Cui J, Rosario H, Hilmara D, Samuelson K, Lin EC, Miller VA, Lin HC. Assessment of caregiver expectations of physician communication in a pediatric setting. BMC Health Serv Res 2020; 20:408. [PMID: 32393244 PMCID: PMC7212563 DOI: 10.1186/s12913-020-05262-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In pediatrics, communication often occurs through an intermediary such as a caregiver. The goal of this study is to assess caregiver communication expectations and determine if meeting expectations influences caregiver satisfaction or instruction retention. METHODS A survey study was performed at the Children's Hospital of Philadelphia. Before the visit, caregivers completed a survey on communication expectations, Caregiver Expected Kalamazoo Essential Elements Communication Checklist (Caregiver Expected KEECC). After the visit, caregivers were surveyed on their perception of physician communication (Caregiver Perceived KEECC) and satisfaction. Caregivers were contacted 1 week after the clinic visit to assess instruction retention. Meeting of caregiver expectation was calculated by the difference between Caregiver Expected and Caregiver Perceived KEECC scores. RESULTS 112 caregivers participated in the study. There was no significant difference in Caregiver Expected KEECC versus Caregiver Perceived KEECC score (4.39 vs 4.56). Caregiver communication expectations were exceeded in 51.5% of the visits. Communication expectations were exceeded more among caregivers with at a college education (p < 0.01) and more among White caregivers (p < 0.01). The average caregiver satisfaction score with the clinic visit was 4.67. Higher satisfaction scores were observed in caregivers who had their communication expectations met or exceeded (p < 0.01). Caregivers with communication expectations exceeded had higher percentage recall of physician instructions (p < 0.01). CONCLUSIONS Caregiver communication expectations may be influenced by demographic factors. Communication expectation affects visit outcomes including caregiver satisfaction and instruction retention. Therefore, physicians need to be cognizant of caregiver communication expectations, which can impact quality of the healthcare experience.
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Affiliation(s)
- Tyler Lee
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Julie Cui
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Hinette Rosario
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Didja Hilmara
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Kate Samuelson
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Emery C. Lin
- Department of Medicine, College of Medicine Drexel University, Philadelphia, PA USA
| | - Victoria A. Miller
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Henry C. Lin
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
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Pelletier D, Green-Demers I, Collerette P, Heberer M. Modeling the communication-satisfaction relationship in hospital patients. SAGE Open Med 2019; 7:2050312119847924. [PMID: 31069079 PMCID: PMC6492352 DOI: 10.1177/2050312119847924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/02/2019] [Indexed: 01/14/2023] Open
Abstract
Objectives: Although it has long been known that communication with medical professionals
presents a strong relationship with patient satisfaction, research on this
topic has been hindered by conceptual and methodological issues (e.g.
single-item measures, inclusion of idiosyncratic patient characteristics,
etc.). Using a more comprehensive and integrated approach, this study had
two objectives: to document the multidimensional structure of the Picker
Patient Experience–15, and to test a patient communication/satisfaction
model that organizes its dimensions in a conceptually logical array of
relationships. First, the factorial structure of the Picker Patient
Experience–15 was hypothesized to comprise five dimensions: communication
with patient, with family, addressing fears/concerns, preparation for
discharge, and patient satisfaction. Second, the hypothesized model included
positive relationships between all four communications dimensions, on the
one hand, and patient satisfaction, on the other. Within communication
dimensions, communication with patient was hypothesized to be the incipient
factor for other dimensions, and thus to be positively associated with the
other three forms of communication. Methods: This research is based on a single time point design, which relied on
administrative and questionnaire data. The study was conducted at a large
University Hospital in Switzerland. The sample included 54,686 patients who
received inpatient treatment, excluding those who were cared for in the
intensive and intermediate care units. Patients filled out, over a 5-year
period, the Picker Patient Experience questionnaire (PPE-15) after discharge
(overall response rate of 41%). Results: The proposed five-factor structure of the Picker Patient Experience–15 was
successfully supported by the results of a confirmatory factor analysis.
Moreover, the hypothesized network of associations between communication and
satisfaction latent constructs was substantiated using structural equation
modeling. With the exception of the association between preparation for
discharge and patient satisfaction, the hypothesized model was fully
corroborated. Conclusion: A more in-depth understanding of patient satisfaction can be achieved when it
is studied as a multifaceted phenomenon.
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Affiliation(s)
- Daniel Pelletier
- Department of Management, University of Quebec in Outaouais, Gatineau, QC, Canada
| | | | - Pierre Collerette
- Department of Management, University of Quebec in Outaouais, Gatineau, QC, Canada
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Radziej K, Loechner J, Engerer C, Niglio de Figueiredo M, Freund J, Sattel H, Bachmann C, Berberat PO, Dinkel A, Wuensch A. How to assess communication skills? Development of the rating scale ComOn Check. MEDICAL EDUCATION ONLINE 2017; 22:1392823. [PMID: 29141516 PMCID: PMC7011842 DOI: 10.1080/10872981.2017.1392823] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/09/2017] [Indexed: 05/30/2023]
Abstract
BACKGROUND Good communication is a core competency for all physicians. Thus, medical students require adequate preparation in communication skills. For research purposes, as well as for evaluation in teaching, there is a clear need for reliable assessment tools. We analyzed the shortcomings of existing instruments and saw a need for a new rating scale. The aim of this publication is to describe the development process for, and evaluation of, a new rating scale. METHODS First, we developed the rating scale in 10 steps. Then, two raters evaluated the newly developed rating scale by rating 135 videotaped consultations of medical students with standardized patients. Additionally, standardized patients evaluated students' performance, which was used as an outside criterion to validate ratings. RESULTS Our rating scale comprises six domains with 13 specific items evaluated on a five-point Likert scale: initiating conversation, patient's perception, structure of conversation, patient's emotions, end of conversation, and general communication skills. Item-total correlation coefficients between the checklist items ranged from 0.15 to 0.78. Subscale consistency was calculated for domains comprised of more than one item and Cronbach's α ≥ 0.77, indicating acceptable consistency. Standardized patients' global evaluation correlated moderately with overall expert ratings (Spearman's ρ = .40, p < .001). CONCLUSION Our rating scale is a reliable and applicable assessment tool. The rating scale focuses on the evaluation of general communication skills and can be applied in research as well as in evaluations, such as objective structured clinical examinations (OSCE). ABBREVIATIONS CST: Communication skills training; ICC: Intra-class correlation coefficient; OSCE: Objective structured clinical examination; SP: Standardized patients; SD: Standard deviation; M: Mean.
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Affiliation(s)
- K. Radziej
- Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - J. Loechner
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Ludwig-Maximilians-Universität, Munich, Germany
| | - C. Engerer
- TUM Medical Education Center, TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of General, Visceral, and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Niglio de Figueiredo
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Clinic of Dermatology and Venereology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J. Freund
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H. Sattel
- Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - C. Bachmann
- Institute of Medical Education, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - P. O. Berberat
- TUM Medical Education Center, TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - A. Dinkel
- Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - A. Wuensch
- TUM Medical Education Center, TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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