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Informed consent reflects a patient’s right to decide whether to receive or refuse medical intervention. Ideally, the patient receives all the necessary information from a physician and, consciously, allows the treatment or refuses it. However, in routine practice, a doctor may influence the patient’s decision: both because of professional knowledge, and because of the very fact that a patient seeks medical help. It follows from this that voluntary basis of a patient’s consent can hardly be absolute, since a doctor often influences his decision to a greater or lesser degree. The article proposes criteria for assessing the admissibility of doctor’s influence on a patient when deciding whether to sign informed consent to medical intervention or to refuse it, using the example of cardiac surgery.

Objective This study aims to investigate factors influencing COVID-19 vaccination intention in the United States. Methods A cross-sectional survey was conducted with 800 respondents recruited from an online panel managed by a survey company. Path analysis was employed to examine the relationships between the study variables. Results First, perceived susceptibility to COVID-19 vaccine side effects was negatively associated with vaccination intention whereas perceived severity did not show any significant impact. Second, vaccine-related knowledge was not directly related to vaccination intention, but it had an indirect and positive effect on vaccination intention via decreasing perceived susceptibility. Third, doctor-patient communication strengthened the negative effect of vaccine knowledge on perceived susceptibility and severity. Conclusion The results of this study offer insights on how to increase people’s vaccination intention and reduce their psychological concerns when making COVID-19 vaccine-related decisions. Practice implications Government agencies should actively promote the effectiveness and importance of vaccination, while addressing concerns about vaccine safety in the public; Health initiatives also need to enhance the level of knowledge about COVID-19 vaccines through various media channels; Doctors can start the conversations about COVID-19 vaccination with their patients at the point of care and/or via online communication platforms.

Effective doctor-patient communication is key to addressing the signifi cant issue of nonadherence to hypertension treatment in Nepal. Common clinical messages about hypertension are evaluated utilizing the framework of the Common-Sense Model of Self-Regulation for their role in shaping the patient models that underlie nonadherent behavior. Clinical communications and practices are recommended: to respectfully elicit and address patient reliance on self-identifi ed symptoms; to accompany warnings of hypertension’s serious consequences with specifi c individual action-plans for durable effects; to emphasize the necessity of long-term continuous treatment without creating fears of dependence and withdrawal effects or burdensome monitoring and counseling; to inform of side-effects while presenting medication as nontoxic and necessary for the body’s maintenance of a healthy balance. By acknowledging the patient as an active agent engaged in self-regulation and by employing culturally consonant concepts (often Ayurvedic), we can encourage accurate patientillness and treatment representations that guide medication adherence.

The purpose of this study is to evaluate the doctors-patients communication style and their information seeking practiced among doctors under training or junior doctors in Malaysian hospital. Two types of communication styles evaluated are doctor centered and patient centered communication. Meanwhile, elements of information seeking practice evaluated are exploration of the reason for encounter, history taking, concrete solutions, structuring the interview, interpersonal skills and communicative skills. These six elements were categorized into interview skills and process skills. This information seeking skills have been derived from meta-analysis conducted by Stewart and Roter (1989). We combined the doctors-patients communication style and information seeking practice to develop a model based on four quadrants namely doctors-interview, doctors-process, patient-interview and patient-process. The subjects for this research are doctors under training or junior doctors in Malaysia. This explorative research distributed a set of questionnaires in order to collect data for analysis. The result show that the doctors under training or junior doctors tend to practice doctor-centered styles compare to patient-centered. Meanwhile, most of them demonstrate all the information seeking practice at a high level. Based on four quadrants developed by researcher, research shows that the doctors mostly categorized in doctor-centered communication style and interview information-seeking skills. We suggested that doctors should be more patient-oriented rather than doctor oriented. We also suggested the model that we developed can be used as a model of communication pattern of the doctors and can be used for future research.

The aim of this study was to assess the level of creativity and personality traits and their mutual influence on medical students using the DECAS and BWAS. We performed a prospective descriptive study on 119 medical students from Târgu Mureș, Romania between November 2020 and July 2021, who answered questions relating to the BWAS and DECAS scales to evaluate their creativity and personality traits. Our findings pointed out a reverse correlation between age and both the original and revised BWAS (r = −0.2037, p = 0.0263, r = −0.1931, p = 0.0354). In terms of extraversion, we found a significant positive correlation for both openness (r = 0.3032, p = 0.0008) and emotional stability (r = 0.2868, p = 0.0016) and a negative correlation between extraversion and agreeability (r = −0.2394, p = 0.0087). Regarding creativity, we found positive correlations between emotional stability and both the original and revised BWAS (r = 0.20, p = 0.0279, r = 0.20, p = 0.0245). Medical students’ creativity might be positively influenced by emotional stability and seems to decrease with age. Higher extraversion scores could be related to increased openness and emotional stability as well as decreased agreeability.

NEW TECHNOLOGIES HAVE FACILITATED DOCTOR–PATIENT EMAIL CONSULTATIONS (E-CONSULTATIONS). GUIDELINES FOR E-CONSULTATION USE IN DENMARK STATE THAT THEY SHOULD BE USED FOR SIMPLE, CONCRETE AND NON-URGENT QUERIES; HOWEVER, A SMALL-SCALE DANISH STUDY SUGGESTED THAT DOCTORS ENCOUNTER E-CONSULTATIONS THAT DO NOT MATCH THE GUIDELINES. THE PURPOSE OF THIS ARTICLE IS TO EXPLORE WHETHER E-CONSULTATIONS IN DENMARK REFLECT RECOMMENDATIONS THAT THEY SHOULD BE SIMPLE, SHORT, CONCRETE AND WELL DEFINED, AND IF NOT, WHAT FORMS OF COMPLEXITY ARE EVIDENT. WE INDUCTIVELY ANALYSED 1,671 E-CONSULTATIONS FROM 38 PATIENTS AGED 21–91 YEARS COMMUNICATING WITH 28 DOCTORS, 6 NURSES, 1 MEDICAL STUDENT AND 8 SECRETARIES. RESULTS SHOWED BOTH QUANTITATIVE COMPLEXITY IN TERMS OF NUMBER OF INTERACTION TURNS, COMMUNICATIVE PARTICIPANTS, AND QUESTIONS ASKED, AND QUALITATIVE COMPLEXITY RELATING TO PATIENTS’ PSYCHOSOCIAL CONTEXTS AND GPS’ BIOMEDICAL DISEASE PERSPECTIVE. THUS, DESPITE EXISTING GUIDELINES AND THE LEANNESS ASSOCIATED WITH THE EMAIL MEDIUM, MULTIPLE FORMS OF COMPLEXITY WERE EVIDENT. THIS MISMATCH HIGHLIGHTS THE NEED FOR THEORETICAL DEVELOPMENT AS WELL AS THE VALUE OF RE-EXAMINING EXISTING POLICIES AND GUIDELINES REGARDING EXPECTATIONS FOR E-CONSULTATION USE.

In today’s era of globalization, clinicians have to deal with a diverse patient population, coming from a varied range of cultural, linguistic, and socio-economic backgrounds. Modern-day medicine e...

Communication is the procedure of generation, transmission, or gathering of messages to oneself or another substance, for the most part by means of a commonly comprehended arrangement of signs. Communication skills are the tools that individuals use to evacuate boundaries and troubles to perform successful correspondence (are learnable, trainable, versatile simply like some other expertise). The objective was to assess the effectiveness of communication skills system among consultants, physicians, registrars and medical officers with their patients in different units of medicine and surgery. Methods: It was a descriptive-analytical study in OFTH August 2010. (241) participants by simple random sampling. All patients attend the OFTH for their appointment and agreed to be included in this study. Whereas the emergent and urgent were excluded. Data were collected using small groups discussion and pre-tested questionnaires. Results: Many doctors know some information about Doctor-Patient Communication Skills but, they didn't perform it because of, the high frequency of patients in referral clinics. Doctors spent 6 to 10 minutes with 179 patients (74.3%), 11to 15 minutes with 46 patients (19.1%), 1 to 5 minutes with 12 patients (5%), 16 to 20 minutes with 3 patients (1.2%) and more than 26 minutes with one patient (O.4%). Patients' satisfaction; 205 patients are satisfied represent (85.1%), 36 patients aren't satisfied represent (14.9%). Those who aren't satisfied; 25 patients (69%) because of a short duration of medical interview, 8 patients (22%) because doctors didn't mention the adverse effects of the drugs and 3 patients (9%) because doctors didn't mention the possible complications of operation. Conclusion: Doctor-patient communication skills were done by medical officers, registrars, physicians and consultants. They took a short time 6-10 minutes for medical interview (74.3%), they didn’t share information with their colleagues in the same unit by (46.5%) in 112 patients and didn’t involve other health care professionals in patients’ care by (62.7%) for 151 patients. Despite of that the patients’ satisfaction was (85.1%)

Background: Communication is the way how a physician interacts with the patient; it should have nonverbal, verbal and para-verbal components. This study was designed for communication skill training on newly graduated medical and dental physicians and to compare the outcomes of training in terms of pretest and post-test results among experimental group and control groups. Materials & methods: It was a randomized, prospective, interventional study performed on newly graduated medical and dental physicians, recruited from four participating centres: Chittagong Medical College, Chattagram Maa-O-Shishu Hospital Medical College, Southern Medical College & Hospital and Chattagram International Dental College. Duration of study was from 1st January 2017 to 30th August 2017. After selecting 60 participants (experimental group: 50; control group: 10) by lottery method, informed consent was taken and all the participants of both groups appeared at a pre-test. Only experimental group attended the training program and both the groups appeared at post-test. Results: When pre-test and post-test values of experimental group was compared by t-test, the p values for proper introduction, verbal, non-verbal, para-verbal and total scores were 0.00, 0.00, 0.00, 0.00 and 0.00 respectively. During comparison post-test scores in experimental and control groups by ANCOVA, the p values for proper introduction, verbal, non-verbal, para-verbal and total scores were 0.00, 0.00, 0.00, 0.00 and 0.00 respectively. Conclusions: There was significant improvement in communication skill of physicians after receiving the training with no possibility of occurring those changes by chance. If appropriate, the results can be utilized to approach for formal introduction of communication skills training for pre-intern physicians. J MEDICINE JAN 2020; 21 (1) : 3-7

Research documents that many chronic non-malignant pain patients experience existential, spiritual and religious needs; however, research knowledge is missing on if and how physicians approach these needs. We conducted a systematic review to explore the extent to which physicians address these needs in their communication with chronic non-malignant pain patients and to explore the facilitators and challenges of this communication. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching Embase, Medline, Scopus and PsycINFO. The quality of the included articles was assessed based on design-specific screening tools. We included four of 2337 screened articles and found the quality to be good. Physicians’ communication about existential, spiritual and religious needs was given low priority and depended on the patients’ own initiative, except when clinicians were interested in holistic care. Patient dissatisfaction with the physician’s attention to these needs was related to higher pain and depression. Physicians’ challenges for addressing these needs were their tendency to prioritize physiological aspects and close further elaboration of existential needs when addressed by the patients. The main facilitator was the individual physician’s willingness to listen with openness and empathy to the patients’ existential concerns. A tentative conclusion is that physicians rarely meet the existential, spiritual and religious needs of their chronic non-malignant pain patients. This might be due to higher priority of physical aspects, lack of time and a lack of knowledge about the importance of and training in the ability to address these needs. Further research is needed on physicians’ communication about existential, spiritual and religious needs and on their training in here.

Abstract. This work investigates the German version of the Kalamazoo Communication Skills Assessment Form (KCSAFd) for three assessment methods: students' self-assessment (KCSAFd-self), assessment by standardised patients (KCSAFd-sPat) and video-assessment by trained raters (KCSAFd-video). Videotaped simulated patient consultations of N = 163 medical students from the first ( n = 97) and the final clinical years ( n = 66) were rated using the KCSAFd. Investigating the psychometric properties of the instrument, we found a two factor-construct with interpersonal and conversational competence. All methods showed good internal consistency and acceptable model fit values. Additionally, we found plausible relationships between the three methods and meaningful differences between the two groups of students.

Introduction: Treating patients and teaching medical students are parallel activities that occur at teaching hospitals. However, the relationship between these activities is poorly understood. There have been multiple calls for assessing the quality of medical education by examining publicly available clinical data but there is minimal evidence linking these variables. Method: In this proof-of-principle study, the authors examined publicly available Hospital Consumer Assessment of Healthcare Providers and Systems (H-CAHPS)Ⓡ data collected during Calendar Year 2013 to explore the relationship between patient evaluations of their hospital experience and medical student evaluations of the educational experience at that site. Results: Pearson product-moment correlation coefficients were calculated for multiple variables. Patient ratings of doctor-patient communication correlated with student ratings of organization (R=0.882, p=0.048), educational value (R=0.882, p=0.048), teaching (R=0.963, p=0.008), and evaluation and feedback (R=0.920, p=0.027). Conclusion: These findings provide preliminary evidence for a relationship between patient experiences and the quality of education at that site. Further studies linking clinical and education outcomes are needed to explore this relationship in more depth. The contributions of specific hospital locations, providers, or clerkships need to be evaluated. Studies examining these relationships have the potential to improve both patient care and medical education.

Background. The benefits of effective communication include good working relationships and increased patient satisfaction. Effective communication can improve patient understanding of treatment, improve compliance, and lead to better health. Aim. This literature review was conducted to gather knowledge and concepts related to doctor-patient communication and how they affect patient satisfaction and perceived quality of medical services in primary care. Method. Various electronic databases were used to search for articles, including PubMed, Cochrane, Scopus and Google Scholar. The headings of related articles were selected, which were narrowed down before annotating the articles concerned. Results. All the reviewed articles showed that the community was positively related to patient satisfaction and perceived quality of medical services; in both extended and developing countries. Communication creates trust that helps an independent physician to provide the best care. Conduct more visits, visit patients, encourage follow-up questions after visits, actively listen to patients and begin conversations, you can significantly improve the level of communication, level of trust and level of help. Joint decision making leads to better management and better chances of adherence to treatment. Conclusion. Evidence suggests that a patient-centered approach with effective communication skills and trust leads to better management and increased patient satisfaction. This is associated with better adherence to treatment, better health outcomes and better perception of the quality of medical services.

Background: Non-adherence to medication increases patient’s risk of morbidity, mortality and economic wastage of scare medical resources. This study was conducted to assess the role of doctor-patient communication and duration of consultation, as tools to improve adherence to hypertension treatment. Methods: Data of this cross-sectional study were collected by face to face interview and document review at Combined Military Hospital (CMH), Dhaka among 253 conveniently recruited hypertensive patients attending outpatient department during July 2016 to June 2017. Mean-age of the respondents was 49.2 (±10.4) years, mostly married male (54.9% male, 95.3% married). Mean consultation duration experienced by the respondents was 5.3 (± 1.3) minutes. Among the participants, 63.64% experienced effective communication, 66% were adherent and 34% were non-adherent to medication. Among the respondents with effective communication, 92.5% were adherent to medication. On the contrary, among the respondents with ineffective communication, 80.4% were non-adherent. Results: Duration of consultation had significant association with adherence to hypertension treatment (p

Summary Background Because effective communication skills are crucial for every physician, this study evaluated students’ competence to take a sufficient medical history. This ability was measured via reports from the students’ supervising and training physicians. Methods A total of 24 physicians from several different departments were interviewed‚ and a stratification of medical specialties was performed due to the current supply-relevant number of medical doctors in the country. A qualitative content analysis was then performed. Results The analysis revealed the students’ lack of expertise and ability to take a structured and complete medical history. Additionally, the lack of students’ engagement was criticized by the training physicians. An insufficiency of student supervision was also shown as only half of the departments have a fixed supervisor for the students during the internship. Conclusion The data showed the need for a refinement of the training of communicative skills at university and the practical training at hospitals.

Introduction The primary care visit is an important opportunity to discuss and modify diabetes management. Objective To gain insight into doctor-patient communication during primary care visits among English and Spanish speaking patients with type 2 diabetes and suboptimal glycemic control (HbA1c > 7%). Methods We conducted a quantitative content analysis of audiotaped primary care visits in 2 patient cohorts. In Study 1 (31 English-speaking patients), we examined factors associated with management changes, and in Study 2 (20 Spanish-speaking patients and their Spanish-speaking providers), we examined the association of question asking with HbA1c control. This study was conducted between November 2017 and January 2020 across 8 primary care practices within Kaiser Permanente Northern California. Results In Study 1, the only factor significantly associated with a diabetes management change was patient identification of diabetes as a priority prior to the visit (91.7% had a management change vs 52.6% of patients who did not identify diabetes as a priority; p = 0.02). In Study 2, patients with poorer glycemic control (HbA1c ≥ 10.0) asked significantly fewer questions (3.4 ± 1.8 vs 10.7 ± 6.9 questions per 15 minutes; p = 0.004). Overall, despite receiving primary care from language-concordant providers, Spanish-speaking Study 2 patients asked fewer questions than English-speaking Study 1 patients (4.5 ± 2.9 vs 7.5 ± 3.7 questions per 15 minutes, respectively; p = 0.004). Conclusion Our results highlight 2 potential strategies (preparing patients for their visits through identifying priorities and learning how to ask more questions during visits) for improving diabetes primary care.

Introduction: Communication is an important aspect of the medical profession. Doctor-patient communication plays a significant role in health care delivery. This study aims to find outpatient department patient satisfaction in doctor-patient communication in a tertiary care hospital in Kathmandu, Nepal. Methods: A descriptive cross-sectional study was conducted in the outpatient department of a tertiary care hospital in Kathmandu, Nepal in the month of August 2019. Validated questionnaire of Patient Satisfaction Questionnaire, consisting of 80 items, originally developed by Willis H. Ware and his colleagues were used and distributed to the patient in the outpatient department of the hospital. Their satisfaction level for doctor-patient communication was assessed on a five-point scale. The questionnaire was distributed randomly to the patient attending the hospital outpatient department during one month period. Results: Out of the total participants, 420 (96%) at 95% CI (95.07–96.93) respondents reported that they were satisfied regarding communication with their doctors. Among the patients, 109 (24.0%) visited the department of medicine followed by obstetrics and gynaecology 85 (19.4%). Conclusions: The majority of participants were found to be satisfied with the doctor-patient communication. While this study has shown that the communication in the doctor-patient relationship was seen to be satisfactory, this might not show the generalized picture of the country. We should also think of ways to further improve the communication in our hospitals.

Phil Whitaker revisits the model of “ideas, concerns, and expectations” founded by his GP mentor and wonders what doctor-patient communication means in the internet age and life after the pandemic

Objective Communication skills diminish with time and must be applied and updated frequently. Due to various professional constraints, the dentists may not be able to attend training programs to sharpen their skills. During patient interactions, dentists may face difficult situations which they may be unable to handle and, consequently, make them overreact. Therefore, there is a need to provide a platform to freely discuss their feelings, ideas, and take opinion from peers. Methods Training in communication skills customized for dealing with complete denture patients was conducted for the prosthodontic postgraduates. Based on feedback obtained, it was decided to have periodic meetings and the concept of Practice-Oriented–Peer Review for Prosthodontics (PrO-PReP) was introduced. This novel concept is a combination of the Relationship building, exploring Reactions, exploring Content, and Coaching (R2C2) model of residency education and the Balint method. The meetings were scheduled every one or two months based on the available caseload of the patients treated by the postgraduates. Results The thematic analysis of the postgraduates’ self-reflection during the sessions and the video recorded observations (assessed using the Kalamazoo scale) revealed that these sessions were effective in positively engaging the postgraduates to discuss their experiences, reflect on their performances, practice their newly gained skills, and learn from peer sharing. Conclusion The postgraduates felt that they have changed in their working style and were more confident to manage patients. They found such sessions very useful for being updated with the already-learned skills.

Ethnomethodology research has systematically investigated discursive practices of categorisation, looking at the various ways by which social actors ascribe both themselves and others to identity categories to accomplish various kinds of social actions. Drawing on a data corpus of oncological visits collected in an Italian hospital, involving both native and non-native patients, the present work analyses how participants in these intercultural medical encounters invoke and make relevant social identity categories by the marking of collective pronouns in their talk. Our results showed that whilst institutional identities (e.g. those of the doctors, the local hospital or the Tumour Board) prevailed, categorial formulations related to cultural or linguistic identities were rarely displayed in interactions with non-native patients. Conversational participants made very little of their linguistical or cultural background and when they did so, their cultural and linguistic identities were deployed for rhetorical and pragmatical aims, such as testing and negotiating common knowledge and epistemic authority. This study shows how even speakers’ minimal lexical choices, such as marked pronouns, impact the negotiation of meanings and activities in life-saving sites such as oncological visits.

The Methodological Guide to the Discipline Romanian as a foreign language for medical students Didactic assistance for optimizing doctor-patient communication is structured in 3 chapters: the first chapter includes conceptual milestones of competency-based education, data on the concept of competences and their role in modern education; the second chapter analyzes the concept of interpersonal communication versus linguistic competence including general considerations on the communication competence between linguistic knowledge and performance as an integral part of the competence formation process of doctor-patient interpersonal communication looked through the prism of medical terminology knowledge; the third chapter highlights pragmatic hypostases of formation/development of doctor-patient communication competence focused on Romanian medical language, as well, are presented practical reasonings for optimizing doctor-patient communication competence focused on specialized language and methodological recommendations for formation/development of doctor-patient communication competence within the Discipline Romanian as a foreign language for medical students. To attain the established objectives, the formation/development of doctor-patient interpersonal communication competence within the Discipline Romanian as a foreign language for medical students, we focused on the innovative teaching and creative learning of some curricular content and on contextualized use of a number of communication methods and techniques based on the development of critical and creative thinking such as: Ciorchinele; Mosaic; SINELG; Glottodrama, Cinquain, Project, etc. According to therapeutic and ethical perspectives, the modern doctor should be able to create and maintain correct relationship with patients, their relatives, as well as in relationship with colleagues and society, etc. The modern doctor is able to effectively use communication techniques, request and provide information, correctly apply active listening, explanation, silence, paraphrasing, empathy, acceptance, etc. Physicians should receive adequate training that meets the patients’ current needs and is based on their holistic approach.

Background Despite evidence on the positive impact of trust in a doctor-patient relationship on health outcomes, there are limited studies conducted in Pacific Island Countries including Fiji. This study was conducted to assess the current level of patient trust in doctors and investigate its determinants in Fiji. Method: A random sample of 410 participants attending the outpatient services completed the self-administered structured questionnaire. The response rate was 91% (N=375) and data was analyzed using descriptive statistics and analytic analysis using logistic regression. Result: Mean age of participants was 38years (±15yrs). The majority of patients had partial trust in their doctors compared to full trust (61.6% vs 38.4%). More than half of the participants perceived doctor’s communication behavior as fair rather than good (53.6% vs 45.6%). Those over 50 years (OR 1.96; p=0.007, 95% CI: 1.198–3.226) and those who perceived doctors’ communication behavior as good (OR 8.48; p=0.0001, 95% CI: 5.257–13.709) were significantly more likely to have full trust in the doctors. Conclusion: This study reveals that age and communication are determinants of trust in Fiji. In view of the current perception of the doctors’ communication behavior, Fiji’s Ministry of Health and Medical Services should implement policies to give equal importance to the communication skills of the doctors together with their clinical skills and enforce it in the medical schools.

Background. The diagnosis or even the suspicion of a disease on their children has an emotional impact on their parents and generates a need to acquire relevant knowledge and skills in a short period of time. For a range of motives, these parents will sometimes face communicative and cognitive barriers in their communication with the professionals that care for their children. These barriers can have a negative effect on knowledge acquisition, treatment adherence and, more generally, affect their relationship with clinicians. To overcome these barriers, we developed JUNTS framework following three steps: carrying out 10 semi-structured interviews with parents of child’s affected by a rare disease. Secondly, we carried out interviews with health professionals and patient’s organization staff. The third and last steep was to organize a meeting of the whole research team and patient’s association staff of Spanish Federation of Rare Disease and list a set of design trends that could help parents to solve the main communicational and linguistic barriers.Results. The JUNTS Framework presented here helps parents manage the communicative situations they find themselves in the relationship with health professionals, by exploiting a polyphonic design that includes different levels of involvement. One of the characteristics that makes this approach particularly unique is that parents and representatives of patient-support associations work jointly with health professionals, psychologists and language experts in designing the contents of a parents-support application. The Framework exploits a modular structure centred around a series of short challenges with different types of user involvement (visual, textual and hypertextual). For optimal adherence and to ensure patients complete the whole route through the support material, elements of persuasive design have been integrated.Conclusions. In this paper, we outline how the JUNTS framework has been designed and used to develop the web app COMjuntos based in JUNTS framework. This web app facilitates medical communication and has been specifically designed to help parents who have a child with a rare disease empower themselves in the main communicative situations with health professionals. The JUNTS framework can be adapted to any other type of chronic disease or condition.

Introduction Use of computers for doctor-patient communication is increasing. Considering effective doctor-patient communication is important for good health outcomes. This study helps to determine the level of acceptance of telemedicine in general public and factors associated with it. Methods: This survey with cross-sectional analysis comprised a brief survey with 15 questions. The survey was distributed in public places to determine the opinions of the general public. Results Randomly selected 125 participants completed the questionnaire. Synchronous telemedicine was favored by young people (82% in the 18-34 age group vs 37.5% of participants aged >55 years; p55 vs. 51.3% in the age group 35-53 years vs. 71% in age group 18-34 years). Receiving video education for specific health concerns was favored by those who used a computer frequently (94.6% who used a computer more than two hours a month vs 77% who used a computer less than two hours a month; p =0.02). Conclusion Telemedicine is generally favored, but physicians should be mindful about older people as they may not feel comfortable. Step by step guidance should be provided especially to senior citizens for telemedicine and portal use.

This chapter provides a framework for the issue of patient adherence to treatment in the context of the doctor-patient relationship and shows how communication between the doctor and the patient can have a profound impact. A consequence of the model of the doctor-patient relationship is that any problems with adherence are assumed to be due to the patient. The conceptualisation of adherence is important, as it underpins any attempt to address the problem of non-adherence. The problem of non-adherence has wider implications for the doctor-patient relationship than simply that the patient obtain the benefits of treatment. The consequence of defining both the doctor-patient relationship and adherence in this way is that the issue of non-adherence becomes a forbidden subject, which both parties are uncomfortable about discussing. Meichenbaum and Turk suggested the concept of adherence, rather than “compliance”, implies “a more active, voluntary collaborative involvemen in a mutually acceptable course of behaviour to produce a desired preventative or therapeutic result.”

Effective communication is a cornerstone of a healthy doctor–patient relationship in almost any clinical setting. As physicians, we find that our empathetic communication is of paramount importance to our patients and may even be therapeutic to some. A significant proportion of this communication is non-verbal.1 Usage of personal protective equipment is undoubtedly necessary for prevention of spread of infection from patients to healthcare workers and vice versa. However, the masks, goggles and other headgear make it impossible to even maintain eye contact with patients, let alone effective communication. The spacesuit-like attire creates a rift between the doctor …

To assess doctors' communication skills in mainland China using the SEGUE Framework.A survey on doctors' communication skills with doctors (n = 1361) and patients (n = 1757) from 14 provinces in eastern, central and western China was conducted.The doctors' self-evaluation scores were higher than patients' evaluations (p.001). The scores of female doctors were higher than males (p = .022). Both doctors' self-evaluations and patients' evaluations indicated that the scores of doctors in tertiary hospitals were higher than those in primary hospitals.Doctors' communication skills don't match patients' needs. Female doctors are more empathetic and patient than male doctors and consequently have better communication skills. Doctors in tertiary hospitals have better communication skills because tertiary hospitals provide more training opportunities in communication skills and have better medical services and management.This study confirms the applicability of the SEGUE Framework to doctors and patients in mainland China. The effectiveness of cultivating doctors' communication skills should be evaluated through feedback from the perspective of both doctors and patients. Medical institutes need to prioritize patients' needs and provide training in doctors' communication skills to address the discrepancy in the perceptions of doctors and patients.

The use of Complementary and Alternative Medicine (CAM) is increasing and a considerable number of patients forgo biomedicine, employing these non-conventional modalities as an alternative to orthodox cancer treatment. CAM use and motivations vary according to how and to what ends it is being used. Values, such as a preference for “natural” cures and lay theories of illness causation play a pivotal role in choice of therapy. These, in turn, affect and are affected by the manner in which the patient encounters and interprets information. CAM use may signify a point of tension in the doctor-patient relationship, as both parties are frequently reluctant to discuss the issue, albeit non-conventional modalities may pose threats to patient safety and thus warrant open communication. Extensive research in this particular area of medical communication is scarce, even more so concerning patients who forgo biomedical treatment completely. The following contains practical recommendations for communicating with patients at risk of declining conventional cancer treatment.

Background: To cultivate the doctor-patient communication ability of medical students as the core and explore the new model of clinical communication ability training and evaluation for graduate students majoring in tumour radiotherapy and its application value.Methods: From January 2018 to June 2019, 60 postgraduates who were interned in the Department of Tumour Radiotherapy in our hospital were selected as the subjects, who were randomly divided into the experimental group (30) and control group (30). The experimental group adopted the Case Based Learning(CBL) teaching mode of introducing doctor-patient communication skills training, and the control group adopted the traditional CBL teaching method. After the teaching, the two groups of students were evaluated, measured and gave feedback on the effect of the teaching through the combination of examination and patient satisfaction questionnaire. The data were statistically analysed by SPSS19.0 software.Results: The doctor-patient communication skills assessment scale score of the experimental group was better than that of the control group, and the difference was statistically significant (PConclusion: The CBL teaching mode of introducing doctor-patient communication skills training for postgraduates of tumour radiotherapy can increase doctor-patient communication ability and improve patient satisfaction.

Objective: To evaluate the communicative ability of doctor-patient education for postgraduates majoring in oncology radiotherapy, and to discuss the training mode and effect. Methods: From January 1, 2018 to June 1, 2019, clinical interns of oncology radiotherapy in our hospital (all graduate students) were selected as the research subjects and randomly divided into two groups. A total of 60 cancer radiotherapy interns were randomly divided into experimental group (30 persons) and control group (30 persons); CBL teaching model (introducing training of doctor-patient communication skills) is adopted in experimental group, and traditional CBL teaching model is used in control group. After the end of the teaching, the two groups’ teaching effects are evaluated through the combination of examinations and questionnaires. SPSS 19.0 was applied to do statistical analysis, t test and Wilcoxon were used. Results: SEGUE baseline score of experimental group for doctorpatient communication skills is better than that of SEGUE in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The CBL teaching model which introduces training of doctor-patient communication skills in the practical process in cancer radiotherapy division is conducive to develop practitioners’ good doctor-patient communication and interaction skills.

Background Little attention is given to the process and impact of poor communicaton on the doctor-patent relationship. Objective The paper aims to employ Theory of Conditionals to help shed light on the experience from a patient perspective. Methods Doesnt really apply as this was inductive research i.e. based on other research in the area. Results Doesnt really apply except that The Theory of Conditionals enables us to understand the points of mis-communication as well as reasons behind misunderstandings across the medical consultation. Conclusions A number of recommmednations are made to support GPs to reduce the impact of this problem on the medical consultation.

Pain compels patients to visit doctors and is an inevitable topic of discussion between doctors and patients. The objective of the study was to investigate Chinese pain descriptors and explore their characteristics among 93 medical personnel in Beijing. This study used a questionnaire to collect Chinese pain descriptors used by medical personnel with more than two years of clinical experience. By qualitative analysis, 68 types of pain descriptors were identified from 801 descriptors and classified into 6 domains: sensory, affective, intensity, cause, physical effect, and temporal. Sensory pain descriptors were mentioned most frequently by the medical personnel (70.8%), whereas affective pain descriptors were mentioned least frequently (1.2%). The result revealed that medical personnel in Beijing seldom used affective descriptors, indicating that they tried to avoid their personal emotions when expressing pain. Based on the pain descriptors used by Chinese medical personnel, this study designed a visual pain assessment tool.

Objectives: Recognising patient cues indicating worry is essential for successful reassurance. To obtain more insight into the variety and nature of patient cues that may arise in practice, this study explores doctors' reflections on patient cues they recognise during consultations.Methods: We performed a qualitative study during which GPs participated in stimulated recall interviews, using their own video-recorded consultations to enhance reflection. First, we reanalysed an existing dataset of 15 interviews during which GPs elaborated on the doctor-patient interaction. Additionally, 12 GPs were interviewed specifically about recognising patients' cues.Results: GPs described four categories of patient cues that indicate worry. GPs recognised worry based on non-verbal cues such as visible bodily reactions, and verbal cues that can be further categorised by type of worry (e.g. about serious disease). Moreover, GPs described behavioural cues, e.g. the patient bringing a list of symptoms. Lastly, GPs recognise worry based on prior knowledge about the patient.Conclusions: GPs reflections have given insight into a wide variety of non-verbal -, verbal -, behavioural- and foreknowledge-based cues.Practice implications: The identified cues can guide other clinicians in recognising worries and inform medical communication training and future research on the effectiveness of recognising cues and patient reassurance. (c) 2019 Published by Elsevier B.V.

The nature of doctor–patient communication is determined foremost by the nature of the physician–patient relationship. As the nature of the doctor–patient relationship (DPR) has evolved, so has the nature of and need for communication.

Proper doctor-patient communication produces therapeutic benefit on the patient. The arts and tips of communication skill can change the feelings of a patient forever. Good communication skill should have verbal, non-verbal and para-verbal components. Unfortunately, many postgraduate doctors of our country cannot satisfy the demand of their patients due to lack of training on communication skills. In this paper, a model for communication skill training has been proposed for newly graduated doctors which includes formal lecture, video demonstration, role play and evaluation by creating different scenarios. The selected time for communication skill training would be the time gap between publication of result of final professional MBBS and starting the internship training. With increasing demand of creating more communicative physicians, implementation and further recommendations on communication skill training for new graduates are encouraged.Bangladesh Journal of Medical Education Vol.9(2) 2018: 32-36

Purpose The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. Design/methodology/approach The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC. Findings The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor–patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients’ overall ratings of hospitals. Research limitations/implications More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse. Practical implications When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program’s efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use. Originality/value The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.