Doctor-patient communication has evolved from a paternalistic model to one emphasizing mutual participation. Effective communication is important for accurate diagnosis, treatment adherence and patient satisfaction. It requires listening skills, managing expectations, and tailoring information to individual patients. While doctors value diagnostic skills most, patients prioritize listening. Shared decision-making is preferred but preferences vary between patients. Qualitative research is needed to fully understand patient satisfaction.
This presentation deals with principles of basic communication skills, importance of it for Doctors and medical students. It also addresses the basic elements Doctor patient communication skills, kalmazoo Consensus working model for Clinical interview, 5 A model guidelines for the behaviour changes.
A short sharing on doctor-patient communication to First year medical students in Universiti Malaysia Sarawak, to be supplemented with anecdotal accounts.
This presentation deals with principles of basic communication skills, importance of it for Doctors and medical students. It also addresses the basic elements Doctor patient communication skills, kalmazoo Consensus working model for Clinical interview, 5 A model guidelines for the behaviour changes.
A short sharing on doctor-patient communication to First year medical students in Universiti Malaysia Sarawak, to be supplemented with anecdotal accounts.
Definition of DPR
Why does DPR matter?
Parson's Ideal Doctor & Patient
Types of DPR
Importance of DPR
Elements of DPR
Key components of DPR
Communication between Doctor & Patient
Barriers in communication
Factors influencing DPR
How to improve DPR
Patient Education
IN THIS PRESENTATION I HAVE DESCRIBED ABOUT DOCTORS AND PATIENTS RELATIONSHIP . History of doctor-patient relationship. Models of doctor-patient relationship. Psychological types of doctors. Basic characters and skills of physician. Communication of doctors. Problems of contemporary healthcare system
The lecture is about the ethical guidelines in the doctor-patient relationship. this is the lecture for the beginners that is for first-year medical students.
Comunicación, alfabetización y empoderamiento del pacienteIgnacio Basagoiti
Presentación correspondiente a la jornada "Comunicant Salut" con motivo del número 100 de la revista "Viure en Salut", celebrada el 4 de diciembre de 2014
Definition of DPR
Why does DPR matter?
Parson's Ideal Doctor & Patient
Types of DPR
Importance of DPR
Elements of DPR
Key components of DPR
Communication between Doctor & Patient
Barriers in communication
Factors influencing DPR
How to improve DPR
Patient Education
IN THIS PRESENTATION I HAVE DESCRIBED ABOUT DOCTORS AND PATIENTS RELATIONSHIP . History of doctor-patient relationship. Models of doctor-patient relationship. Psychological types of doctors. Basic characters and skills of physician. Communication of doctors. Problems of contemporary healthcare system
The lecture is about the ethical guidelines in the doctor-patient relationship. this is the lecture for the beginners that is for first-year medical students.
Comunicación, alfabetización y empoderamiento del pacienteIgnacio Basagoiti
Presentación correspondiente a la jornada "Comunicant Salut" con motivo del número 100 de la revista "Viure en Salut", celebrada el 4 de diciembre de 2014
This slide corresponds with Wrench, McCroskey, and Richmond's (2008) Human Communication in Everyday Life: Explanations and Applications published by Allyn and Bacon.
Ten Distinguishing Ideas for Health Communication in the 21st Century renataschiavo
This presentation draws upon my book, Health Communication: From Theory to Practice, Second Edition, San Francisco: Jossey-Bass, an imprint of Wiley, 2013. It was given as part of a Sept. 10, 2014 Author's Night at the New York Academy of Medicine.
An Evaluation of the Challenges of Doctor- Patient Communicationinventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996). For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000). Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013). The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019). The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996).
For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000).
Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013).
The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019).
The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Patient-Centered Communication: A Useful Clinical ReviewZackary Berger
Patient-centered communication is important because of the 5 E's: ethics, emotions, efficiency, effectiveness, and equity. This talk was originally given October 1, 2014, at the Baltimore City Medical Society.
1
Management Of Care
Chamberlain University
NR452: Capstone
Professor Alison Colvin.
Date: November 23, 2022.
Management of Care
Management of care involves organizing, prioritizing, maintaining strict patient confidentiality, providing patient with efficient care, education to patient and families, risk stratification, coordination of care transition and medication management. Patient care management is provided to client by nurses and other health care professionals “Management of the critically injured patient is optimized by a coordinated team effort in an organized trauma system that allow for rapid assessment and initiation of life- preserving therapies. (Cantrell, E., & Doucet, J. 2018). Effective patient care management can impact patient heath more positively, when all healthcare professionals work together to provide quality care in promoting patient centered care. Adequate patient care can prevent readmission or admission, also can reduce distress, total cost of care, improve self-management, disease control and patient overall health.
Patient care is important to patient because its ensure that patient receive the needed possible care they deserve when in the hospital and out of the hospital, patient will feel their demand is understood and listened to if they health needs are met and understood by professionals that know how to manage their health care needs, health care management team member work together to ensure patient safety through effective communication and collaboration, advocating for patient by connecting patient to community and social services resources that will promote their health care needs can be beneficial to patient, environmental and home risk assessment, and effective facilitation of communication between members of the healthcare team.
Nurses play a role in managing a patient health, roles such as: Critical thinking skills, in this case the nurse can recognize any shift in patient health status which plays a significant role in decision making and patient centered care. Time management: delegation, prioritization such as knowing what to do first, what is important, and knowing what task is more important for the patient at a particular time. Patient education is also one of the many role’s nurses do to educate patient on what to expect during a procedure, or during recovery, also teachings on complications or adverse effects of a medication. Clinical reasoning and judgement which will promote quality of health through patient centered care that addresses patient specific health care needs. Holman, H. C., Williams, “et al”. (2019).
References
Cantrell, E., & Doucet, J. (2018). Initial Management of Life-Threatening Trauma.
DeckerMed Critical Care of the Surgical Patient.
https://doi.org/10.2310/7ccsp.2129
Holman, H. C., Williams, D., Johnson, J., Sommer, S., Ball, B. S., Lemon, T.,
& Assessment Technologies Institute. (2019). Nursing leadership
an.
This slide is part of a collection of slides, I have created for exam revision from Atypical Child development. The contents of the slide are based on several different research papers.
This slide is part of a collection of exam revision slides from Atypical Child Development. The slides have been created by me, and based on several different research papers. The slides were created for essay exam.
This slide is part of a collection of exam revision slides from Atypical Child Development. The slides have been created by me, and based on several different research papers. The slides were created for essay exam.
This slide is part of a collection of exam revision slides from Atypical Child Development. The slides have been created by me, and based on several different research papers. The slides were created for essay exam.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
2. Session outline
• Understanding how doctor-patient relationship /
communication has evolved
• Importance and benefits of good doctor-patient
communication
• Effects of bad doctor- patient relationship /
communication
• Improvements in communication
• Communication styles in Health context
• Importance and role of patient satisfaction
• Consultation styles
• Role of consultation in diabetes care
3. Evolution of doctor patient relation*
Model
Physician’s
role
Patient's role
Clinical
application of
the model
Prototype
model
Time period
Activity -
Passivity
Does
something to
the patient
Recipient
(unable to
respond to
inert)
Anaesthesia,
acute trauma,
coma,
delirium, etc.
Parent-
infant
Ancient Egypt
Greek
Enlightenment
Medieval
Europe
Guidance-
co-
operation
Tells patient
what to do
Co-operator
(obeys)
Acute
infectious
processes, etc.
Parent-
Child /
adolescent
French
Revolution
Mutual
participati
on
Helps patient
to help
himself
Participant in
“partnership”
uses expert
help
Most chronic
illness,
psychoanalysis
Adult -
Adult
1700s - today
4. Forms of doctor – patient relationship
Described four basic forms of patterns of control and
communication in doctor-patient relationships (think of the
table at the beginning):
1. Default: characterised by a lack of control on either side, not
ideal
2. Paternalism: characterised by dominant doctors and passive
patients
3. Consumerism: associated with the reverse, with it focusing
on patients rights and doctors obligations
4. Mutuality: characterised by shared decision making and is
often advocated as the best type of relationship
(Hall & Rotter, 1991)
6. Why is doctor-patient communication important?
• “Medicine is an art whose magic and creative ability have long been
recognized as residing in the interpersonal aspects of patient-physician
relationship.” (Hall et al, 1981)
• A doctor's communication and interpersonal skills encompass the
ability to gather information in order to facilitate accurate diagnosis,
counsel appropriately, give therapeutic instructions, and establish
caring relationships with patients (Duffy et al, 2004)
• The 3 main goals of current doctor-patient communication are
creating a good interpersonal relationship, facilitating exchange
of information, and including patients in decision making.
Effective doctor-patient communication is determined by the
doctors' “bedside manner,” which patients judge as a major
indicator of their doctors' general competence (Platt & Keating,
2007)
7. Fallowfield (2002)
Effective communication is an important determinant
of:
-Accuracy and completeness of data collection about
symptoms and side effects
-Dictates the problems elicited
-Adherence to treatment
-Emotional and physical well-being
-Doctor and patient satisfaction
8. Benefits of doctor- patient communication
Patient Satisfaction, adherence, Health outcomes
• Good doctor-patient communication has the potential to help regulate patients'
emotions, facilitate comprehension of medical information, and allow for better
identification of patients' needs, perceptions, and expectations (Platt & Keating, 2007)
• Patients reporting good communication with their doctor are more likely to be
satisfied with their care, and especially to share pertinent information for accurate
diagnosis of their problems, follow advice, and adhere to the prescribed treatment
(Chen et al, 2007, Zolnierek & Dimatteo, 2009)
• Patients' agreement with the doctor about the nature of the treatment and need for
follow-up is strongly associated with their recovery (Stewart et al, 2000)
• Studies have shown correlations between a sense of control and the ability to
tolerate pain, recovery from illness, decreased tumour growth, and daily functioning.
Enhanced psychological adjustments and better mental health have also been
reported. Some studies have observed a decrease in length of hospital stay and
therefore the cost of individual medical visits and fewer referrals
• A more patient-centered encounter results in better patient as well as doctor
satisfaction. Satisfied patients are less likely to lodge formal complaints or initiate
malpractice complaints. Satisfied patients are advantageous for doctors in terms of
greater job satisfaction, less work-related stress, and reduced burnout.
(Stewart et al, 2000, Little et al,2001, Hemdon & Pollick, 2002,Roter et al, 2002, Maguire & Picheatly, 2002)
9. Factors that influence this relationship
1. The characteristics of the doctor (gender, level of
experience, personality)
2. The characteristics of the patient (gender, social
class, age, education, desire for information)
3. Differences between the two – in terms of social
class and education, attitudes, beliefs and
expectations
4. Situational factors – such as patient load, level of
aquaintance and the nature of the problem
(Endelman, 2000)
10. Problems with Doctor – patient communication
• Deterioration of Doctors’
communication skills
• Nondisclosure of information
• Doctors’ avoidance behaviour
• Discouragement of collaboration
• Resistance by patients
(Ha, Anat & Longnecker, 2010)
11. Recent shift in agenda
• After 1991 there was a shift in model of healthcare, the
Department of Health recognised that the patient
deserves information on their treatment
• Governments commitment to provide not only an NHS
offering high quality patient-centred care, but also to
ensure the patients voice was heard
• This included having any proposed treatment, including
any risks involved, clearly explained before decision –
taking into account the importance of communication
12. Possible improvements
Communication skills training
• Doctors should encourage patients to discuss their main concerns
without interruption or premature closure
• The appropriate use of open-ended questions, frequent summaries,
clarification and negotiation which are key factors which influence
the quality and quantity of information gathered
• Institutions should consider requiring and facilitating such skills
training with medical schools, hospitals and practices
• Encouraging Collaborative communication
• Conflict management (Feudtner, 2007, Lee et al, 2002)
• Health beliefs (Platt & Keating, 2007, Tongue et al, 2005)
13. What makes a good doctor?
• What do you think?
Doctors and patients have different
perspectives on what factors they see as
being most important in doctor – patient
communication
Paling (2004)
• Asked doctors and patients to describe
what makes a good doctor
• The doctors stated that ‘diagnostic
ability’ was the most important quality
of a good doctor whereas the patient
said that ‘listening’ was the most
important aspect – which doctors
rated as being the least important
14. What makes a good doctor (cont’d)
• How well the doctor communicates with the patients
and shows a caring attitude
• Exploring medical or technical procedures in an easy to
understand way
• Listening and taking time to ask questions
• In contrast, the aspects most highly rated by doctors
were number of years in practice and whether they had
attended a well known medical school
(Delamothe, 1998)
15. Specifically considers communication in the context of health. The
model emphasises the way in which a series of factors can impact
on the interactions in healthcare settings based on three elements:
1. RELATIONSHIPS: The model illustrates the four major types of
relationships that exist in healthcare settings;
a) Professional – Professional
b) Professional – Client
c) Professional – Clients significant others
d) Client – Significant others
2. TRANSACTIONS: health transactions include both verbal and non
verbal health communications as well as the content and
relationship dimensions of messages
3. HEALTHCARE CONTEXTS: the settings in which health
communication occurs Both health professionals and clients bring
unique characteristics, beliefs, values and perceptions to the
healthcare setting which effect how they interact
(Northouse & Northouse,1998)
Model of health communication
16. • Looked at key communication skills and how to acquire them
discussing the importance of good communication skills in medical
care and the maxamising impact it can have on treatment adherence
• They conducted a clinical review using original research studies into
doctor-patient communication
They noted the key tasks in communication that good doctors should
be able to:
• Elicit the main problem and the patients perception of the main
problem
• Understand the physical, emotional and social impact of the patients
problem and its impact on the patient and their family
• Tailor information to what the patient wants to know, checking their
understanding
• Determine how much the patient wants to participate in decision
making (when treatment options are available) and discuss treatment
options so that the patient understands the implications
Maguire and Pitceathly (2002)
17. Results in
• Patients not disclosing problems as belief nothing can be done, do not want
to appear a burden to doctor, desire not to seem pathetic or ungreatful,
concern that problem is not legitimate enough to mention, worry that fear
will be confirmed
Effective teaching methods
• The opportunity to practice key skills and receive constructive feedback of
performance is essential
• Provide evidence of current deficiencies in communication, reasons for
them and the consequences for doctors and patients
• Offer an evidence base for the skills needed to overcome these deficiences
• Demonstrate the skills to be learned and elicit reactions to these
• Provide an opportunity to practice the skills under controlled and safe
conditions
• Give constructive feedback on performance and reflect on the reasons for
any blocking behaviour
18. What are the common mistakes?
• Not introducing themselves
• Not asking for clarification from patient
• Not allowing or encouraging patients to ask questions
• Not asking questions about patients feelings
• Not providing information in a form that patients can use
Use of medical Jargon (language)
Although healthcare providers can potentially switch from medical to
everyday language, they tend to over-rely on medical jargon which
often patients have difficulty understanding
They found that patients only understood 36% of the terms that were
commonly used by health professionals
The use of technical language is particularly problematic as studies
have shown that the use of more technical messages is associated with
less cognitive satisfaction, comprehension and recall
Leading to patient dissatisfaction
(Hadlow & Pitts, 1991, Jackson, 1992, Davis and Fallowfield, 1994)
19. Bad communication
Bad communication and consequent
patient dissatisfaction can result in:
Patient lack of engagement
Patient refusal to follow
recommended health behaviours
Failure to adhere
Psychological damage
Physical harm
(Korsek et al.,1968)
20. Predictors of patient satisfaction
• The amount of information given, technical and interpersonal
competence, partnership building, immediate and positive non verbal
behaviour, social conversation, positive talk, less negative talk (Hall, Roter
& Katz, 1988)
• Patients are more likely to be satisfied if their treatment choice is
accepted and dissatisfied when their choice is rejected (Amyx et al., 2000)
• Meeting idealised expectations of care is important determinant of patient
satisfaction (McKinley, 2002)
• Expectations are important determinants of satisfaction
The three main types of expectations (Zeithaml & Bitner, 1999)
1. Expectations about desired service
2. Expectations about adequate service
3. Predicted services
Fulfillment theory
• Expectancy is determined by relationship between the importance of an
outcome and the perceived possibilities of achieving the outcome, this
expectancy is the most important determinant of patient satisfaction (Linder-Pelz,
1982)
21. Measuring patient satisfaction
The consultation satisfaction questionnaire (Baker, 1997)
• developed a questionnaire with a model to measure patient
satisfaction within practices and consultations
• The model used indicates how satisfaction should be measured,
satisfaction was regarded as an attitude
• Note that qualitative research is needed alongside questionnaires as
self reports do not always provide accurate picture
Dougall et al. (2000)
• Emphasised the importance of qualitative research
• Conducted a pilot patient satisfaction study of cancer service using a
combination of participant observation, in dept interviews and
questionnaire methods
• difficult to define what satisfaction is therefore difficult to measure,
when patients fill out satisfaction questionnaires responses show high
level of satisfaction - failing to elicit patients true satisfaction levels
• In depth qualitative interviews reveal a different picture than that
conveyed through questionnaire methods
22. The consultation
The key goals of the consultation are to exchange
relevant information and make decisions alongside
relationship building
The 6 key dimensions for a good consultation;
1. Having a good knowledge of research or medical
information and being able to communicate this to the
patient
2. Achieving a good relationship with the patient
3. Establishing the nature of patients medical problem
4. Gaining an understanding of patients understanding
5. Engaging the patient in decision making process
6. Managing time
(Ford, Schofield & Hope, 2003)
23. Consultation styles
• Professional-centred approach The doctor keeps control of the
consulation, ask direct, closed questions in order to gain information
and refer to medical facts, makes decision and patient passively accepts
• Patient-centred consultation The doctor identifies and works with the
patients agenda as well as their own, doctor actively listens,
professional and encouraging communication, listening to patients
views and understanding of health, patient is an active participant in
the process
• Shared decision making clinicians and patients share best available
evidence for decision making and both must agree, all about involving
the patient and checking their understanding and ideas as well as
taking into account affective components - gaining increasing
prominence in health care policy (Coulter, 1999, 2001)
• Evidence based patient choice (EBPC) newly emerging templates for
medical encounters that advocate evidence-informed choice and
shared decision making
24. What consultation style leads to satisfaction for patients?
Lee et al (2002) looked at decision making preferences of 999
women with early stage breast cancer and 141 stem cell
transplant patients, they found shared decision making to the
most preferred style at 44% and 40%
Little et al (2001) conducted a questionnaire study of 865
participants looking at their preference for a patient-centred
approach, found before entering the room patients had a strong
preference for a patient-centred approach and this preference
was most prevelant in vulnerable groups (low SES or bad health)
• Although patients should be offered the chance to and be
encouraged to take part in shared decision making there is
suggestion that active participation is not uniformly desired
and this preference should be respected
25. Diabetes care
10 ‘commandments’ of effective communication in the diabetes clinic (Alzaid,
2014)
1. Recognize the importance of patient empowerment as being fundamental to
diabetes management.
2. Use appropriate words and language when talking to patients with diabetes
3. Allow collaborative care and shared decision making and “strike a deal” with
the patient at each therapeutic juncture encountered.
4. Be practical and seek realistic goals. Focus on the achievable.
5. Be non-judgmental
6. Consider cultural issues, religious beliefs, and personal values of the patient.
7. Reward effort, not just outcome.
8. Stay tuned to the patient's feelings and pick up the clues early.
9.Use visual tools as much as possible: make a simple drawing or show the
patient a relevant graph or picture to facilitate understanding and enhance
motivation.
10. Does your patient comprehend and remember the instructions given at the
clinic?
26. Summary
• For an ideal consultation, doctors
realistically need to figure out and
tailor their approach with each
different patient depending on their
preference
• Successful and unsuccessful communication has a major impact
on adherence to treatment and patient satisfaction
• For effective doctor patient communication there must be
mutual respect and an exchanging of ideas - not just one sided
• Doctors and patients perhaps value different aspects which can
lead to confusion about what is an ideal doctor and consultation
• Patient satisfaction and consultation preference can be
influenced by demographic variables