共查询到20条相似文献,搜索用时 31 毫秒
1.
Debra L. Roter Lori H. Erby Ann Adams Christopher D. Buckingham Laura Vail Alba Realpe Susan Larson Judith A. Hall 《Patient education and counseling》2014
Objectives
To disentangle the effects of physician gender and patient-centered communication style on patients’ oral engagement in depression care.Methods
Physician gender, physician race and communication style (high patient-centered (HPC) and low patient-centered (LPC)) were manipulated and presented as videotaped actors within a computer simulated medical visit to assess effects on analogue patient (AP) verbal responsiveness and care ratings. 307 APs (56% female; 70% African American) were randomly assigned to conditions and instructed to verbally respond to depression-related questions and indicate willingness to continue care. Disclosures were coded using Roter Interaction Analysis System (RIAS).Results
Both male and female APs talked more overall and conveyed more psychosocial and emotional talk to HPC gender discordant doctors (all p < .05). APs were more willing to continue treatment with gender-discordant HPC physicians (p < .05). No effects were evident in the LPC condition.Conclusions
Findings highlight a role for physician gender when considering active patient engagement in patient-centered depression care. This pattern suggests that there may be largely under-appreciated and consequential effects associated with patient expectations in regard to physician gender that these differ by patient gender.Practice implications
High patient-centeredness increases active patient engagement in depression care especially in gender discordant dyads. 相似文献2.
Danielle Blanch-Hartigan Judith A. Hall Debra L. Roter Richard M. Frankel 《Patient education and counseling》2010
Objective
This research examines whether patient perceptions are equivalently associated with patient-centered behavior in male and female medical students, and tests the impact of a message emphasizing the importance of patient-centeredness on analogue patients’ perceptions of male and female medical students’ performance.Methods
Sixty-one medical students interacting with standardized patients (SPs) were viewed by 384 analogue patients (APs). APs were randomly assigned to receive a message emphasizing the value of patient-centeredness or of technical competence, or a neutral message, and then evaluated the medical students’ competence in the interactions. Students’ patient-centeredness was measured using the Four Habits Coding Scheme and Roter Interaction Analysis System.Results
APs in the neutral and technical competence conditions gave higher competence ratings to more patient-centered male students, but not to more patient-centered female students. However, APs who received the patient-centeredness message gave higher competence ratings to both male and female students who were higher in patient-centeredness.Conclusion
Making it clear that patient-centeredness is a dimension of physician competence eliminated a gender bias in evaluating performance.Practice implications
Because patient perceptions are often used in evaluations, gender biases must be understood and reduced so both male and female providers receive appropriate credit for their patient-centered behaviors. 相似文献3.
4.
Objectives
To assess differences in the importance ascribed to patient-centered care between various patient groups and demographic groups.Methods
Survey data collected using questionnaires were analyzed for patients that underwent hip or knee surgery (n = 214), patients suffering from rheumatoid arthritis (n = 343), spinal disk herniation (n = 145), breast abnormalities (n = 596) or congestive heart failure (n = 118). A composite for patient-centered care priorities was constructed (α = 0.82) and compared to the average importance over all healthcare aspects in the surveys.Results
All patient groups considered patient-centered care to be of above-average importance (p‘s < 0.001). Small but significant differences were observed: patient-centered care was more important for patients suffering from congestive heart failure (p < 0.001) and patients who were younger, female, well-educated and healthier (p‘s < 0.05). Patients who had undergone hip or knee surgery considered patient-centered care more important than patients with spinal disk herniation did (p < 0.05).Conclusion
Patient-centered care is important to all patient groups. Differential policies regarding patient-centered care for patient subgroups do not seem required.Practical implications
Given the importance attributed to patient-centered care, it is essential that elements of patient-centered care are included in surveys, indicators of quality of care, and the training of doctors and nurses. 相似文献5.
Erika Leemann Price Eliseo J. Pérez-Stable Dana Nickleach Monica López Leah S. Karliner 《Patient education and counseling》2012
Objective
To examine professional medical interpreters’ perspectives of in-person and remote interpreting modalities.Methods
Survey of interpreters at three medical centers assessing satisfaction with aspects of communication using each modality, and adequacy of videoconferencing medical interpretation (VMI) and telephonic interpretation for 21 common clinical scenarios in the hospital and ambulatory care settings.Results
52 interpreters completed the survey (73% response). All modalities were equally satisfactory for conveying information. Respondents favored in-person to telephonic interpretation for establishing rapport (95% versus 71%, p = .002) and for facilitating clinician understanding of patients’ social and cultural backgrounds (92% versus 69%, p = .002). Scenarios with substantial educational or psychosocial dimensions had no more than 70% of respondents rating telephonic interpretation as adequate (25–70%); for all of these scenarios, VMI represented an improvement (52–87%).Conclusion
From the interpreter perspective, telephonic interpretation is satisfactory for information exchange, but less so for interpersonal aspects of communication. In scenarios where telephonic interpretation does not suffice, particularly those with substantial educational or psychosocial components, VMI offers improved communication.Practice implications
Differences in interpreters’ perspectives of modalities based on communication needs and clinical scenario suggest mixed use of multiple modalities may be the best language access strategy. 相似文献6.
Maria K. Venetis Jeffrey D. Robinson Katie LaPlant Turkiewicz Mike Allen 《Patient education and counseling》2009
Objective
In the context of patients visiting cancer specialists, the objective is to test the association between both patient-centered communication (including Affective Behavior and Participation Behavior) and Instrumental Behavior and patients’ post-visit satisfaction with a variety of visit phenomena.Methods
Meta-analysis of 25 articles representing 10 distinct data sets.Results
Both patient-centered- and instrumental behavior are significantly, positively associated with satisfaction, with patient-centered communication having a relatively stronger association.Conclusion
There is an evidence base for the efficacy of patient-centered care.Practice implications
Cancer specialists need to train to improve their patient-centered communication. 相似文献7.
Objective
To show the effects of an in-service communication training for health care providers at a cancer ward, to improve the quality and quantity of the patient education, and patient satisfaction with the care received.Methods
A 3-year in-service communication training was held at a cancer ward. Pre- and post-data were collected about the quality and quantity of the communication of nurses, physicians and other health care providers (HCPs) towards patients and colleagues (n = 22) as well as the satisfaction of the patients with the quality of care (n = 90).Results
The communication training raised significantly the quality and quantity of the communication towards patients and with colleagues. Also patient satisfaction with the quality of care increased. However, the long-term implementation of the benefits was proved disappointing.Conclusion
In-service communication training is an important means for the long-term improvement of the quality of patient education at nursing departments in hospitals. Lasting implementation of the benefits however requires attention to organizational obstacles, budgetary conditions, leadership factors at the ward, and the application of an organizationally oriented theoretical framework.Practice implications
Improvement of patient education at nursing wards does not only require educational means, organizational facilities and professional training, but can be improved too by in-service communication training, which increases the quality of the patient-centered care. An organizational oriented change-strategy is needed to ensure the implementation produces lasting effects. 相似文献8.
Objective
To compare patients’ acupuncture use with physician's attitudes toward and history of referral for acupuncture.Methods
A questionnaire was administered to patients of the Atlanta Veterans Affairs Medical Center and the physicians whom they identified as most influencing their healthcare decisions. A total of 114 patients were matched with 33 physicians.Results
Physicians’ history of referral was not significantly related to patients’ acupuncture use. Physicians’ belief that acupuncture would increase patient satisfaction, however, was associated with higher rates of patient acupuncture use (p = 0.01). Qualitative analysis of an open-ended question that probed further into physicians’ attitudes regarding acupuncture revealed three key themes: lack of knowledge about the treatment; misperceptions regarding availability of acupuncture at VA; and lack of VA providers to meet demand.Conclusion
These results indicate that physicians’ referral patterns are not associated with patients’ acupuncture use. However, some evidence shows a link between patients’ acupuncture use and physicians’ beliefs that the treatment will increase patient satisfaction, showing that physician attitudes may have some influence on patients’ acupuncture use.Practice implications
In order to cultivate shared-decision making between patients and their physicians it will be important to address gaps in provider knowledge about acupuncture and its availability. 相似文献9.
Wendy W.T. Lam Marie Kwok Miranda Chan Wai Ka Hung Marcus Ying Amy Or Ava Kwong Dacita Suen Sungwon Yoon Richard Fielding 《Patient education and counseling》2014
Objective
To assess the extent to which breast surgical consultations used shared decision making (SDM), identify factors associated with use of SDM, and assess if using SDM increases decision-making satisfaction.Methods
Two hundred and eighty-three video-recorded diagnostic-treatment decision consultations between breast surgeons and women with breast cancer were assessed using the Decision Analysis System for Oncology (DAS-O) coding system designed for assessing SDM behaviors. Women completed a questionnaire at pre-consultation, one-week post-consultation and one-month post-surgery. Patient outcomes included decision conflict, patient satisfaction with medical consultation, and decision regret.Results
Overall, the level of SDM behaviors was low. The extent of SDM behavior within consultation was related to greater consultation duration (p < 0.001), more than one treatment being offered (p < 0.001), and fewer questions raised by patients/companions (p < 0.05). While use of SDM consultation did not influence post-consultation decision conflict, it increased satisfaction with information given and explained, patients’ feelings of trust and confidence in their surgeons, and reduced post-surgical decision regret.Conclusion
These breast surgical consultations mostly adopted informed treatment decision-making approaches. Using SDM improved patient consultation and decision satisfaction.Practice implications
The study findings highlight a need to reinforce the importance of SDM in consultations among breast surgeons. 相似文献10.
DL Roter R Wexler P Naragon B Forrest J Dees A Almodovar J Wood 《Patient education and counseling》2012,88(3):406-413
Objective
The objective was to evaluate parallel patient and physician computer-mediated communication skill training on participants’ report of skill use and patient satisfaction.Methods
Separate patient and clinician web-tools comprised of over 500, 10-s video clips demonstrating patient-centered skills in various ways. Four clinician members of the American Academy of Family Physicians National Research Network participated by enrolling 194 patients into a randomized patient trial and 29 physicians into a non-randomized clinician trial of respective interventions. All participants completed baseline and follow-up self-report measures of visit communication and satisfaction.Results
Intervention patients reported using more skills than controls in five of six skill areas, including identification of problems/concerns, information exchange, treatment adherence, shared decision-making and interpersonal rapport (all p < .05); post intervention, physicians reported using more skills in the same 5 areas (all p < .01). Intervention group patients reported higher levels of satisfaction than controls in five of six domains (all p < .05).Conclusion
Communication skill training delivered in a computer mediated format had a positive and parallel impact on both patient and clinician reported use of patient-centered communication and in patient satisfaction.Practice Implications
Computer-mediated interventions are cost and time effective thereby increasing patient and clinician willingness to undertake training. 相似文献11.
Objective
Review of studies published in the last 10 years about women seeking gynecological- or obstetrical care and physician's gender in relation to patient preferences, differences in communication style and patient satisfaction.Methods
Studies were identified by searching the online databases PubMed, PsycINFO, Embase and the Cochrane Library. The search strategies ‘gender’; ‘obstetrics’ and ‘gynecology’ were combined with ‘communication’; ‘physician–patient relations’; ‘patient preference’ and ‘patient satisfaction’.Results
After screening title and abstract, evaluating full text and quality assessment, 9 articles were included in this review. Most patients preferred a female rather than a male gynecologist–obstetrician. This was partly explained by a more patient-centered communication style used by female gynecologists–obstetricians. Also experience and clinical competence were important factors in choosing a gynecologist–obstetrician. It was not clear whether patient's age or ethnicity influenced patients gender preference. Patient satisfaction increased when gynecologists–obstetricians used a patient-centered communication style.Conclusion
Preference for a female gynecologist–obstetrician might be explained by a more patient-centered communication style used by female gynecologists–obstetricians. Using a patient-centered communication style increases patient satisfaction.Practice implications
To increase patient satisfaction, gynecologists–obstetricians should learn to integrate patient-centered communication style into the consultation. 相似文献12.
Mariëtte N. Verkissen Nicole P.M. Ezendam Mirjam P. Fransen Marie-Louise Essink-Bot Mieke J. Aarts Kim A.H. Nicolaije M. Caroline Vos Olga Husson 《Patient education and counseling》2014
Objective
To assess the association of subjective health literacy (HL) and education with perceived information provision and satisfaction.Methods
Women (N = 548) diagnosed with an ovarian or borderline ovarian tumor between 2000 and 2010, registered in the Eindhoven Cancer Registry, received a questionnaire including subjective HL, educational level, perceived information provision, and satisfaction with the information received. Multiple linear and logistic regression analyses were performed, controlled for potential confounders.Results
Fifty percent of the women responded (N = 275). Thirteen percent had low and 41% had medium subjective HL. Women with low HL reported less perceived information provision about medical tests, and were less satisfied with the information received compared to women with high HL. Low educated women reported that they received more information about their disease compared to highly educated women.Conclusion
Low subjective HL among women with ovarian tumors is associated with less perceived information provision about medical tests and lower information satisfaction, whereas low education is associated with more perceived information provision about the disease.Practice implications
HL should not be overlooked as a contributing factor to patients’ perceived information provision and satisfaction. Health care providers may need training about recognizing low HL. 相似文献13.
Christoph Kowalski Anika Nitzsche Fueloep Scheibler Petra Steffen Ute-Susann Albert Holger Pfaff 《Patient education and counseling》2009
Objective
To examine whether patients’ perception of a hospital's organizational climate has an impact on their trust in physicians after accounting for physicians’ communication behaviors as perceived by the patients and patient characteristics.Methods
Patients undergoing treatment in breast centers in the German state of North Rhein-Westphalia in 2006 were asked to complete a standardized postal questionnaire. Disease characteristics were then added by the medical personnel. Multiple linear regressions were performed.Results
80.5% of the patients responded to the survey. 37% of the variance in patients’ trust in physicians can be explained by the variables included in our final model (N = 2226; R2 adj. = 0.372; p < 0.001). Breast cancer patients’ trust in their physicians is strongly associated with their perception of a hospital's organizational climate. The impact of their perception of physicians’ communication behaviors persists after introducing hospital organizational characteristics. Perceived physician accessibility shows the strongest association with trust.Conclusions
A trusting physician–patient relationship among breast cancer patients is associated with both the perceived quality of the hospital organizational climate and perceived physicians’ communication behaviors.Practice implications
With regard to clinical organization, efforts should be put into improving the organizational climate and making physicians more accessible to patients. 相似文献14.
Objective
The aim of this study was to investigate – for the first time in Greece – patients’ attitudes toward patient-centered care, by identifying the impact of socio-demographic factors, health condition, social support and religious beliefs.Methods
454 Hospitalized patients were interviewed on the first day of their scheduled admission, answering demographic questions and the following questionnaires: Patient–Practitioner Orientation Scale (PPOS), Autonomy Preference Index (API), Short Form SF-12v2 Health Survey, God Locus of Health Control (GLHC) and Perceived Available Support (PAS).Results
Mean PPOS and API scores were: PPOS Sharing 3.4 (sd = 0.69), Caring 3.99 (sd = 0.76), API Information-Seeking 88.32 (sd = 9.35) and Decision-Making 51.19 (sd = 9.27). Higher desire for information was associated with younger age, more years of education, weaker spiritual faith in healing and worse subjective health status. Higher expectations for caring physicians were correlated with older age, more years of education, higher perceived social support and weaker spiritual faith in healing.Conclusion
Age, years of education, health status, social support and religious beliefs are determinants of patient-centered attitudes.Practice implications
Patients expect to be informed, although they do not equally want to be involved in decision-making. Religious faith and perceived social support should be taken into consideration to further understand patients’ needs. 相似文献15.
16.
Sofie Rosenlund Lau Søren Troels Christensen Jesper T. Andreasen 《Patient education and counseling》2013
Objectives
To investigate patients’ preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone.Methods
A survey was conducted using an adapted version of the Patient-Practitioner Orientation Scale (PPOS) as a structured interview guide. The study population was drawn from the population of all adults attending for treatment or treatment for their children.Results
144 patients were included in the analysis. Factors, such as doctor's friendly approach, the interpersonal relationship and information-sharing were all scored high (patient-centered) on the PPOS. Factors associated with shared-decision making had a lower (doctor-centered) score. A high educational level was associated with a more patient-centered scoring, an association that was most pronounced in the female population.Conclusion
The results provide an insight into the patients’ preferences for PCC. Patients expressed a patient-centered attitude toward certain areas of PCC, while other areas were less expressed. More research is needed in order to fully qualify the applicability of PCC in resource-poor settings.Practice implications
Stakeholders and healthcare professionals should aim to strengthen healthcare practice by focusing on PCC in the medical encounter while taking into considerations the patients’ awareness and preferences for PCC. 相似文献17.
Objective
To Examine physician eye contact (EC), patient understanding and adherence.Methods
Secondary analysis of National Institute of Aging videotapes (N = 52) of physician–elder patients in two visit types: (1) routine (n = 20); (2) anxiety-provoking (n = 32) was conducted. Self-reports of understanding and adherence were used. History-taking segments were qualitatively and quantitatively analyzed for relationships between EC, understanding and adherence.Results
Qualitative analysis showed: (1) two salient EC elements – frequency, type (brief or sustained) – and verbal synchronicity were commonly invoked; (2) conjoint unfolding of three communication elements – “looking, listening and talking” – may be salient for patient outcomes; (3) despite differing EC patterns in routine and anxiety provoking visits, statistical analyses showed patient understanding and adherence ratings were similar in the sample population comprising two visit types; no significant correlations between EC elements and understanding and adherence were found.Conclusions
Salience of EC for patient-centered communication is shown in prior research. Present findings broaden the significance of EC by including verbal synchronicity. Methodological limitations may account for no significant correlations between EC and patient outcomes.Practice implications
Using suggested framework for operationalizing EC elements, including verbally synchronous communication, may facilitate patient-centeredness and have positive implications for patient understanding and adherence. 相似文献18.
Lourdes S. Martinez J. Sanford Schwartz Derek Freres Taressa Fraze Robert C. Hornik 《Patient education and counseling》2009
Objective
Examine how patient–clinician information engagement (PCIE) may operate through feeling informed to influence patients’ treatment decision satisfaction (TDS).Methods
Randomly drawn sample (N = 2013) from Pennsylvania Cancer Registry, comprised of breast, prostate and colon cancer patients completed mail surveys in the Fall of 2006 (response rate = 64%) and Fall of 2007. Of 2013 baseline respondents, 85% agreed to participate in follow-up survey (N = 1703). Of those who agreed, 76% (N = 1293) completed follow-up surveys. The sample was split between males and females. The majority of participants were White, over the age of 50, married, and with a high school degree. Most reported having been diagnosed with in situ and local cancer.Results
PCIE was related to concurrent TDS (β = .06) and feeling informed (β = .15), after confounder adjustments. A mediation analysis was consistent with PCIE affecting TDS through feeling informed. Baseline PCIE predicted feeling informed (β = .04) measured 1 year later, after adjustments for baseline feeling informed and other confounders. Feeling informed was related to concurrent TDS (β = .35) after confounder adjustment and follow-up TDS (β = .13) after baseline TDS and confounder adjustment.Conclusion
Results suggest PCIE affects TDS in part through patients’ feeling informed.Practice implications
PCIE may be important in determining patients’ level of feeling informed and TDS. 相似文献19.
Pål Gulbrandsen Bård Fossli Jensen Arnstein Finset Danielle Blanch-Hartigan 《Patient education and counseling》2013
Objective
To examine the long term impact of a communication skills intervention on physicians’ communication self-efficacy and the relationship between reported self-efficacy and actual performance.Methods
62 hospital physicians were exposed to a 20-h communication skills course according to the Four Habits patient-centered approach in a crossover randomized trial. Encounters with real patients before and after the intervention (mean 154 days) were videotaped, for evaluation of performance using the Four Habits Coding Scheme. Participants completed a questionnaire about communication skills self-efficacy before the course, immediately after the course, and at 3 years follow-up. Change in self-efficacy and the correlations between performance and self-efficacy at baseline and follow-up were assessed.Results
Communication skills self-efficacy was not correlated to performance at baseline (r = −0.16; p = 0.22). The association changed significantly (p = 0.01) and was positive at follow-up (r = 0.336, p = 0.042). The self-efficacy increased significantly (effect size d = 0.27). High performance after the course and low self-efficacy before the course were associated with larger increase in communication skills self-efficacy.Conclusion
A communication skills course led to improved communication skills self-efficacy more than 3 years later, and introduced a positive association between communication skills self-efficacy and performance not present at baseline.Practice implications
Communication skills training enhances physicians’ insight in own performance. 相似文献20.
Distinct communication patterns during genetic counseling for late-onset Alzheimer's risk assessment
Barbara Lerner J. Scott Roberts Michael Shwartz Debra L. Roter Robert C. Green Jack A. Clark 《Patient education and counseling》2014