Importance of patient centered communication in Lifestyle Diseases


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  • Even though I don't fully agree with Rekha Gupta's view, a practical solution need to be found out to implement this in India.Proper communication is a part and parcel of patient's care. We may need to change the paradigm shift from paternalistic relationship to one with mutuality. Communication skills need to be introduced in all health care professional courses so that we can work together. a small step make a big change.
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  • @rekhaCDE In my opinion its so useful and best possible approach.
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  • Do you think this possible in Indian settings that too in a small town or rural area. The doctor is surrounded with 100's of patient. He gives merely 3-5 mins. to a patient. Can a doctor counsel a patient and look into the barriers /psychological issues of a patient.

    I being a counselor for Diabetes as well as for HIV and AIDS I know it takes almost 30-45 mins. to make a patient comfortable and see to his barriers and make him understand ur concern and his outlook.

    I have seen how patients improve on their Blood sugar no's. They are very thankful too.

    I think more and more qualified counselor should be employed in all the areas and the doctors ,counselor's and patient should work as a team for a better outcome esp. in life style diseases.

    The team should consist of DOCTOR+ COUNSELOR + PATIENT.
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Importance of patient centered communication in Lifestyle Diseases

  1. 1. Importance of Patient-Centered Communication in Lifestyle DiseasesDr Ritu Awasthi-Shukla
  2. 2. Disease Transition Communicable Non Communicable Diseases Diseases (Lifestyle Diseases)
  3. 3. Communicable Diseases Tuberculosis, Malaria, Cholera, Influenza, Measles, Polio etc Transmitted from one person to another through a causative agent directly or indirectly Prevalent among lower stratum of the society Line of treatment and management is simple and easy to follow Acute diseases
  4. 4. Non Communicable Diseases Lifestyle Diseases Changes to the way people live have created new environmental and behavioral risk factors, leading to a rise in lifestyle diseases start slowly and often asymptomatically but last longer Type 2 diabetes, Cardiovascular Diseases, Hypertension, Stroke Management of lifestyle disease requires change in living pattern, attitude and mindset
  5. 5.  Improved quality of living and awareness are the only prerequisite of overcoming these diseases “The diabetic who knows the most, lives the longest”- Elliott P. Joslin, 1929
  6. 6. What Doctors say about patient….. People are not ready to listen and change so it‟s difficult to bring about positive changes Patient hide useful information on the first visit It is easier to change the mindset of the people when somebody has suffered in the family.
  7. 7. What Patients want from Doctors Make the patient aware that majority of the diseases are preventable and this prevention costs only a minimum of expenditure, if compared to the cost incurred on the treatment. Awareness of right treatment options for the patient. In addition to prescribing medicines to the patients, Doctors should also give some time to educate the patients and attendants about the causes of various diseases and what measures should be taken to prevent the common ailments which can be serious at times if neglected
  8. 8.  A study published in JAMA found that 72% of the doctors interrupted the patient‟s opening statement after an average of 23 seconds Patients who were allowed to state their concerns without interruption spoke for only an average of 6 more seconds
  9. 9. Patients are at fault too….. Patients described as “frustrating” by doctors do not trust or agree with the doctor present too many problems for one visit do not follow instructions are demanding or controlling
  10. 10. Traditional Model Linear/ Unidirectional Communication Biomedical approach to addressing medical problems ”Prescription followed” ”weight loss” “Healthy Diet” Symptomatic Treatment “Patient as diseases/ organ”
  11. 11. Why is it important? Compliance with the medical treatment Improves Patient‟s satisfaction Improved health and emotional status of the patient Improves Doctor‟s satisfaction Reduces Malpractices (Stewart and Roter)
  12. 12. Barriers to effectivecommunication There may be many barriers to effective physician-patient communication. Patients may feel that they are wasting the physicians valuable time; omit details of their history which they deem unimportant; be embarrassed to mention things they think will place them in an unfavorable light; not understand medical terminology; believe the physician has not really listened and, therefore, does not have the information needed to make good treatment decisions
  13. 13. Culture and D-P Communication How illness is discussed and treated in a culture Myths and misconceptions already prevalent in the society Poor Language skills
  14. 14. Types of doctor–patient relationship*Patient Control Doctor’s Control Low HighLow Default PaternalismHigh Consumerist Mutuality *Stewert and Roter
  15. 15. Default relationship Patients adopt a passive role even when the doctor reduces some of his or her control, with the consultation therefore lacking sufficient direction
  16. 16. Paternalistic Relationship Doctor is dominant and acts as a „parent‟ figure who decides what he or she believes to be in the patient‟s best interest Patient Submissive
  17. 17. Consumerist Relationship the patient taking the active role and the doctor adopting a fairly passive role, acceding to the patient‟s requests for a second opinion, referral to hospital, a sick note, and so on
  18. 18. Relationship of mutuality active involvement of patients as equal partners in the consultation meeting between experts‟, in which both parties participate and engage in an exchange of ideas and sharing of belief system The doctor brings his or her clinical skills and knowledge Patients bring their expertise in terms of their experiences and explanations of their illness, and knowledge of their particular social circumstances, attitudes to risk, values and preferences
  19. 19. Changing Role of Doctor Patient-Centered Communication Biopsychosocial approach Facilitator/ Listener Behavior Change Expert Negotiating small changes “Patient as person”
  20. 20. Collective Role of Doctor andPatient Shared decision making Patient preferences should be sought out and validated Doctor and Patient engage in a reciprocal relationship
  21. 21. “While the doctor focuses on illness, the patient may be more interested in wellness.” Athena du Pre
  22. 22. Thank you