Physician gender,physician patient-centered behavior,and patient satisfaction: A study in three practice settings within a hospital

Objective

To compare male and female physicians on patient-centeredness and patients’ satisfaction in three practice settings within a hospital; to test whether satisfaction is more strongly predicted by patient-centeredness in male than female physicians.

Methods

Encounters between physicians (N = 71) and patients (N = 497) in a hospital were videotaped and patients’ satisfaction was measured. Patient-centeredness was measured by trained coders.

Results

In the outpatient setting, female physicians were somewhat more patient-centered than male physicians; patient satisfaction did not differ. In the inpatient and emergency room settings, female physicians were notably more patient-centered than male physicians; satisfaction paralleled these differences. Nevertheless, there was some, though mixed, evidence that patient-centeredness predicted satisfaction more strongly in male than female physicians, suggesting that patients valued patient-centered behavior more in male than female physicians.

Conclusion

Even though satisfaction mirrored the different behavior styles of male and female physicians in the inpatient and emergency room settings, in all settings male physicians got somewhat more credit for being patient-centered than female physicians did.

Practice implications

If female physicians do not consistently receive credit for high patient-centeredness in the eyes of patients, this could lead female physicians to reduce their patient-centered behavior.     

Information system end-user satisfaction and continuance intention: A unified modeling approach

ContextPermanent evaluation of end-user satisfaction and continuance intention is a critical issue at each phase of a clinical information system (CIS) project, but most validation studies are concerned with the pre- or early post-adoption phases.ObjectiveThe purpose of this study was twofold: to validate at the Pompidou University Hospital (HEGP) an information technology late post-adoption model built from four validated models and to propose a unified metamodel of evaluation that could be adapted to each context or deployment phase of a CIS project.MethodsFive dimensions, i.e., CIS quality (CISQ), perceived usefulness (PU), confirmation of expectations (CE), user satisfaction (SAT), and continuance intention (CI) were selected to constitute the CI evaluation model. The validity of the model was tested using the combined answers to four surveys performed between 2011 and 2015, i.e., more than ten years after the opening of HEGP in July 2000. Structural equation modeling was used to test the eight model-associated hypotheses.ResultsThe multi-professional study group of 571 responders consisted of 158 doctors, 282 nurses, and 131 secretaries. The evaluation model accounted for 84% of variance of satisfaction and 53% of CI variance for the period 2011–2015 and for 92% and 69% for the period 2014–2015. In very late post adoption, CISQ appears to be the major determinant of satisfaction and CI. Combining the results obtained at various phases of CIS deployment, a Unified Model of Information System Continuance (UMISC) is proposed.ConclusionIn a meaningful CIS use situation at HEGP, this study confirms the importance of CISQ in explaining satisfaction and CI. The proposed UMISC model that can be adapted to each phase of CIS deployment could facilitate the necessary efforts of permanent CIS acceptance and continuance evaluation.     

A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity,face validity,and test-retest reliability

Objective

To describe the development and evaluation of the content and face validity and test-retest reliability of a disease-specific questionnaire that measures patient-reported outcomes and experiences for the Swedish National Diabetes Register for adult patients who have type 1 or type 2 diabetes.

Neuroticism,symptom reports,and Type A behavior: Interpretive cautions for the Framingham scale

The Framingham Type A Scale (FTAS) is one of three primary measures of Type A behavior. Unlike the structured interview (SI) and Jenkins Activity Survey (JAS), the FTAS is correlated with neuroticism. Further, neuroticism and FTAS scores predict angina-like chest pain complaints but not more definitive coronary heart disease (CHD) end points. Thus, the FTAS may be unique among Type A measures in its susceptibility to the neuroticism-symptom reporting confound. The present study examined associations of the SI, JAS, and FTAS with neuroticism and symptom reporting in two independent samples of undergraduate males. Unlike the SI and JAS, the FTAS was correlated with neuroticism and symptom reporting. Further, the correlations of FTAS scores and symptoms were due to shared variance with neuroticism. The findings are discussed in terms of a possible alternative interpretation of the Framingham Study and the need to consider neuroticism in studies of personality and health.     

Impact of the mental health and dynamic referral for oncology (MHADRO) program on oncology patient outcomes,health care utilization,and health provider behaviors: A multi-site randomized control trial

ObjectiveThe MHADRO assesses psychosocial and medical needs, provides tailored feedback reports, and connects patients to mental health providers. This study examined the MHADRO’s effect on patient outcomes, health care utilization, and oncology provider documentation and behaviors.Methods836 patients were part of a multi-site RCT and assessments were conducted at baseline, 2, 6 and 12 months.ResultsThe intervention group engaged in less emergency calls to providers. There were no differences in psychosocial outcomes at follow up assessments. Providers of patients in the intervention group were more likely to: document psychosocial symptoms and history; refer to psychosocial services; encourage support groups; seek psychological evaluations during visits. Patients who agreed to a mental health referral had decreased hospitalizations, increased mental health care interactions, and stronger ratings of counseling potential benefits. This group also reported increased psychosocial distress at all follow-up assessments.ConclusionThe MHADRO may increase access to mental health care, lessen utilization, and improve providers’ management of psychosocial needs, but does not appear to impact overall functioning over time.Practice ImplicationsProviders are encouraged to consider incorporating programs, like the MHADRO, into patient care as they may have the potential to impact screening and management of patients’ psychosocial needs.