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Discordance between physicians and patients’ health beliefs can impede health communication efforts. However, little research considers physicians’ perceptions of patient beliefs, despite the impor...

Background: The MAAS Global (Maastricht History-taking and Advice Scoring List ) is an internationally widely-used instrument in under- and postgraduate medical education. The focus is on the assessment of medical communication and clinical skills. The assessment tool, which has also been used in Germany since 2015, has a high-quality design (e.g. comprehensible structure, appropriate complexity), good psychometric properties and is very user-friendly. An update of MAAS Global, MAAS 2.0, was published in March 2021 with a new and greater focus on context and the formative.Method: The revised version of the MAAS 2.0 assessment sheet was translated into German with the authors' permission. Open questions were discussed with the revision process project manager. Results: The revision was carried out with a view to focusing on the patient's frame of reference, removing ambiguities identified previously while using MAAS Global, and closer alignment with the underlying Calgary-Cambridge model. Furthermore, the scale used for the evaluation was modified and now uses a formative evaluation range without grade-related classification. Conclusion: With the content reorientation of MAAS Global to MAAS 2.0, and the associated focus on frame of reference, context, the formative, the revision presented here sets new priorities for future evaluations in the context of under- and postgraduate medical education and the assessment of medical patient communication in general. Hintergrund: Der MAAS-Global (Maastricht history-taking and advise scoring list ) ist ein international vielfältig in der medizinischen Aus- und Weiterbildung eingesetztes Instrument. Schwerpunkte liegen auf der Beurteilung ärztlicher Kommunikations- sowie klinischer Fertigkeiten. Das seit 2015 auch in Deutschland angewandte Beurteilungsinstrument besitzt eine hohe Qualität in Design (u. a. nachvollziehbarer Aufbau, angemessene Komplexität), gute psychometrische Eigenschaften und eine hohe Benutzerfreundlichkeit. Seit März 2021 existiert eine Aktualisierung des MAAS-Global: der MAAS 2.0, mit einer inhaltlichen Neuausrichtung auf Kontext und einem höheren Fokus auf das Formative.Methode: Die überarbeitete Version des MAAS-2.0-Bewertungsbogens wurde nach Einholen der Erlaubnis der Autoren ins Deutsche übersetzt. Offene Fragen wurden mit dem Projektleiter des Überarbeitungsprozesses diskutiert. Ergebnisse: Die Überarbeitung erfolgte in Hinblick auf die Fokussierung auf den Bezugsrahmen des/der Patient*in, auf die Bereinigung von in der Vergangenheit ermittelten Unklarheiten bei der Bewertung mittels des MAAS-Globals sowie auf eine stärkere Angleichung an das zugrundeliegende Calgary-Cambridge-Modell. Des Weiteren erfuhr die zur Evaluation genutzte Skala eine Modifikation und nutzt nun eine formative Bewertungsreichweite ohne notenbezogene Einteilung. Schlussfolgerung: Mit der inhaltlichen Neuausrichtung vom MAAS-Global hin zum MAAS 2.0, und dem damit einhergehenden Fokus auf Bezugsrahmen, Kontext und das Formative, legt die hier vorgestellte Revision neue Schwerpunkte für zukünftige Evaluationen im Rahmen der Aus- und Weiterbildung und der Bewertung von Arzt-Patient-Kommunikation allgemein vor.

The relevance of the research derives from the necessity to analyze the influence of new non-human digital actants on the nature of doctor-patients communication. The authors prove that in modern society the digitalization of the healthcare system is proceeding at an accelerated pace and pushes individuals to monitor their health status regularly in background mode by using such digital actants as smartwatches with pre-installed medical applications. The active use of high-tech devices for self-diagnosis of health transforms the doctor-patient communication, making it hybrid and exerting ambivalent influence on the treatment process. On the one hand, individuals can collect health information continuously. However, on the other hand, the study reveals that smartwatches provide users with less accurate health information in comparison with the health information obtained via stationary medical equipment. The use of inaccurate information without the supervision of medical workers may lead to unforeseen consequences and health risks. The results of the content analysis of modern scientific research on the effectiveness of smart devices’ use in online health diagnostics indicate that formal and pragmatic trends take place in doctor-patient communication. In this regard, the authors prove that hybrid social communication in medicine needs a new vector of development in accordance with the principles of the proposed “humanistic turn”.

Most ophthalmic physicians are not formally trained for breaking the news of having sight threatening diseases, requiring lifelong therapy. This study aims to ascertain physician practices and patients’ experiences regarding delivery of bad news. An online, anonymous questionnaire was sent to 400 ophthalmologists practising glaucoma to gather information as to how they deliver bad news to their patients. A parallel survey was also conducted amongst 100 established glaucoma patients to know whether how their doctor had delivered the diagnosis of glaucoma to them. After this, resident doctors were trained in SPIKES strategy and the patient survey was repeated in 100 new patients. Two hundred and eighteen out of 400 ophthalmologists responded to our survey resulting in a survey yield of 54.5%. About 56.5% ophthalmologists dealt with disclosing the diagnosis >20 times a month; 70% of responders always discussed about the true severity of disease up-front. Only 8.70% respondents had formal training for breaking the bad news. Results of first phase of patient survey revealed that nearly one-third of patients (27%), felt that their doctor used incomprehensible medical terminology and 42% patients said that their doctor downplayed their diagnosis. Only 12% provided information to their patients about reliable sources to gather additional information. After the resident doctors were trained in SPIKES strategy, the second phase of patient survey had marked positive change in the way information was delivered. The current study shows that despite years of clinical experience, many ophthalmologists face difficulty in delivering bad news for a sight threatening disease such as glaucoma. Therefore, SPIKES strategy or a similar protocol must be taught to practising ophthalmologists at all levels, to alleviate worries of patients suffering from chronic, visually debilitating diseases.

The relevance of the research derives from the necessity to analyze new risks of online self-diagnosis of health conditions amidst the increase in the number of Internet requests for diagnosis and treatment of Covid-19 and identification of the first coronavirus symptoms. Tensions in society are growing due to the fact that the pace of epidemic is accelerating and the number of people infected with coronavirus is growing every day, encouraging individuals to self-diagnose in the internet, as hospital hotlines are overloaded, and doctors’ visiting hours are reduced due to a large flow of the infected. Moreover, the article examines the risks that online self-treatment entails without professional supervision and control. The analysis of modern research on what pushes individuals to online treatment and self-medication is presented in the article. The author reviews statistical data on the actual number of Yandex search queries regarding the diagnosis and treatment of coronavirus infection. At the end of the article, the author determines both the processes in the field of medicine that can be automated and the processes with a low technical potential for digitalization.

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.

Objectives: Medical knowledge has increased by leaps and bounds over the past century, but our teaching-learning methods remain archaic, lecturing being one of the oldest. This study was conducted to assess the change in knowledge following a conventional lecture and that following a video-based lecture using a medical television (TV) serial. Material and Methods: The students were divided into two groups based on their registration numbers. To one group, a video-based lecture using appropriate clips from a medical TV serial was administered while the other group was taught the same topic using conventional teaching-learning method of a lecture. A pre-test and a post-test were conducted and the change in the results compared. Results: The mean pre-test scores were higher in the successively senior batches of students as compared to the junior batches in both groups. The post-test scores were significantly higher in both the conventional lecture and the video group. Surprisingly, the mean post-test scores in the conventional lecture group were significantly higher than that of video-based lecture group. Students preferred the video-based lecture more than the conventional lecture. Conclusion: Both teaching learning methods have their own advantages. The conventional lecture uses an outcome-oriented session while the video-based sessions do not. The soft skills like breaking bad news, doctor patient communication skills etc which we never teach in conventional lectures can be learnt using these video-based sessions. Thus, we need a blended approach here as well, utilising the strengths of each of the teaching learning methods so that our students can achieve the laid down competencies.

Background Communication skills are fundamental to successful medical practice and can greatly impact patient satisfaction, compliance and outcomes. This study evaluated knowledge and practice of doctor- patient communication among the urban family physicians based on main items of Calgary Cambridge Observation Guides. Method This cross-sectional study was conducted from July to September, 2019, in a 400 randomly selected sample of family physicians of Shiraz, Fars province. The data collection tool was a self-administered, second-part questionnaire developed by the researchers. Participants were asked about their age, gender, practice setting, and years of work experience and if they received any formal training in doctor- patient communication. Data were analyzed using SPSS (Version 16, SPSS Inc., Chicago, IL, USA). A p-value of less than 0.05 was considered statistically significant. Results The study participants included 204 male and 196 female family physicians with a mean age of 46.7 ± 7.7 years. The mean communication skills knowledge score was 41.5 (SD: ± 2.8) indicating a high level of knowledge. The mean score for practices was 38.7 (SD: ± 3.4), implying a moderate level of practice. Based on Bloom’s scale, nearly 80% of family physicians had good knowledge about doctor-patient communication skills, however, 55% of participants reported moderate to poor level of practice in this regard. Results of multivariate regression analysis suggest that higher levels of related knowledge, having higher age or longer work experience, and working in the public sector can predict better practice scores (P Conclusion There is a potential gap between knowledge and self-reported practices toward communication skills among a sample of Iranian family physicians. They have fundamental weakness in the most important evidence-based items of doctor- patient communication. Considering significant role of family physicians in prevention and control of non-communicable diseases (NCDs) as an emerging challenge of our country, the topic of communication skills should be inserted as a top educational priority of family physicians.

Objective This project developed an innovative methodology for visualising consultation structure by categorising doctor-patient talk into the phases proposed by an established educational model of clinical communication. Method Consultation phases were identified from verbatim transcripts using the tasks and process skills of the Calgary-Cambridge Guide to the Medical Interview. Seventy-eight simulated consultations from a ‘History-taking’ station of a postgraduate examination for physicians were analysed by two independent raters. Transcripts were converted into diagrams comprising up to six phases: Initiating, Gathering information, Summary, Explanation, Planning and Closing. Results The dominant phases were Gathering information, Planning and Explanation (66 %, 10 % and 12 % of talk respectively). While consultations broadly followed the expected chronological sequence, less than a third (23/78) contained all six phases, with Closing and Summary most frequently absent. Half of consultations (40/78) did not include phases in the predicted order, with intertwined phases commonly observed. Conclusions In this standardised setting, doctors created variable consultation structures, typically omitting phases involving consolidation and agreement of plans going forward. Practice implications The method enables visualisation and comparison of consultation structure. The findings pose questions about the alignment of practice with educational guidance and the opportunities afforded to patients to actively engage in consultations.

Current widespread facemask usage profoundly impacts clinical practice and healthcare education where communicational dimensions are essential to the care and teaching processes. As part of a larger study, 208 medical and nursing students were randomly assigned to a masked vs unmasked version of the standardized facial emotion recognition task DANVA2. A significantly higher number of errors existed in the masked vs unmasked condition. Differences for happy, sad, and angry faces, but not for fearful faces, existed between conditions. Misinterpretation of facial emotions can severely affect doctor-patient and inter-professional communication in healthcare. Teaching communication in medical education must adapt to the current universal use of facemasks in professional settings.

Purpose This study aims to explore the information-seeking behavior of female patients engaged in doctor shopping. An investigation was conducted on the following aspects: the reasons for doctor-shopping behavior (DSB), patients’ information needs and sources, patients’ use of the obtained information and the degree of satisfaction with the information collected. Design/methodology/approach In-depth interviews were conducted in this study. In total, 30 female participants who lived or worked in the Taipei metropolitan area, Taiwan, were recruited. Findings Dissatisfaction with treatment, confirmation of illness conditions, inconvenient treatment locations and hours and dissatisfaction with doctor’s attitude were the main reasons for DSB. Family members, friends, the internet and mass media were sources of information for participants when they sought second and successive doctors. In most cases, the degree of satisfaction toward the obtained information increased after each visit to a doctor during the doctor-shopping journey. However, not all participants shared information with doctors. The participants suggested that detailed explanations provided by doctors and better communication with doctors may reduce the occurrence of doctor shopping. Originality/value The findings of this study help medical personnel better understand DSB. The findings revealed the significance of information to patients and indicated that the information collected during doctor shopping is beneficial for patients.

Hypertenze a dyslipidemie jsou kardiovaskularni (KV) rizikove faktory, ktere se casto vyskytuji spolecně. A to již u relativně mladých osob. Je doloženo, že casna simultanni kompenzace těchto rizikových faktorů nasobi přinos pro pacienta. Zejmena u mladsich jedinců ale naražime na nizkou adherenci k lecbě KV rizikových faktorů. Dodržovani doporucených farmakologických i nefarmakologických intervenci může zvýsit spravna komunikace mezi lekařem a pacientem, např. vysvětleni KV rizika pacientovi pomoci cevniho věku. Důležitým nastrojem na zvýseni adherence je i jednoduchý režim farmakoterapie, který umožňuji fixni kombinace. Inspiraci mohou být modelove přiklady komunikace mezi lekařem a pacientem s hypertenzi a dyslipidemii.

The fact that general practitioner (GP) or psychiatrist understands the psychosocial effects of prescribing on the doctor-patient relationship is as important, if not more so, than knowing pharmacology. Any prescription of drugs modifies the doctor-patient relationship. Drugs, especially psychotropic drugs, act on symptoms and change thoughts, feelings, and behaviors; they can create both physical and psychological dependency; they can discourage a deep search for real solutions, both on the part of the doctor and the patient; they can affect the doctor’s access to the patient and the problem will be out of their reach. Psychotropic drugs can make the effect of the doctor in himself as a drug more difficult, favor an insignificant or problematic or little human relational context, where the GP/psychiatrist does not delve into the true meaning of the symptoms, and the patient tends not to get involved, to make an emotional withdrawal, to be passive before the prescribed drug, and can result in the chronification and structuring of functional symptoms that become organic, with lack of cooperation of the doctor and the patient, and paradoxically with over-compliance or therapeutic discontinuity and the lack of pharmacological adherence, absences to appointments or delays or cancellations of visits, and the denial of responsibility of both the doctor and the patient.

Objective To explore socioeconomic status (SES) differences in patterns of doctor-patient communication within head and neck cancer clinics and why such differences exist. Methods Thirty-six head and neck cancer review appointments with five Physicians were observed and audio-taped, along with follow-up interviews involving 32 patients. Data were analysed using Thematic Analysis, and compared by patient SES (education, occupation and Indices of Multiple Deprivation). Results Three main themes were identified: (a) Physicians used more humour and small talk in their consultations with high SES patients; (b) Low SES patients were more passive in their participation, engaged in less agenda setting and information-seeking, and framed their clinical experience differently; (c) Low SES patients had different preferences for involvement, defining involvement differently to high SES patients and were seen to take a more stoical approach. Conclusion Low SES patients take a more passive role in medical consultations, engage in less relational talk and are less likely to raise concerns, but were satisfied with this. Physicians may adapt their communication behaviour in response to low SES patients' expectations and preferences. Practice implications A question prompt list may help low SES patients to raise concerns during their consultations. This may reduce inequalities in communication and health.

The effect of clinical practice directly affects the clinical ability and professional quality of graduates, lack of interest in practice, lack of doctor-patient communication skills and conflict with other clinical training doctors arecommon problems in current practice. This article through to the clinical medical undergraduate interns in practice there is lack of interest, in the process of doctor-patient communication skills and conflict with other clinical training for doctors and other issues were discussed, and through the reform of teaching methods, strengthen the teaching supervision and organize training of doctor-patient communication, in order to improve the clinical interns learning autonomy, strengthen the doctor-patient communication skills, to further improve the quality of medical personnel training to provide help.

The aim of the article is to present Marshall Bertrand Rosenberg’s concept of non-violent communication (NVC) and usefulness in the doctor-patient relationship. M. B. Rosenberg’s concept of NVC was based on the assumption that a person’s natural ability is empathy directed towards other people and towards themselves. However, our culture suppresses these natural abilities. The language offers many expressions that block natural compassion because they are overfilled with moral judgments, judging comparisons, punishments, arousing feelings of guilt or shame. The author of NVC proposes a four-phase model of empathic non-violent and non-manipulative communication, which is the basis for changes in the thought process: observing without judging, recognising, relating the feelings currently experienced to needs (values) and formulating concrete requests instead of demands.

Contains fulltext : 251428.pdf (Publisher’s version ) (Open Access) OBJECTIVES: To gain insight into (1) the unfulfilled instrumental and affective needs of Turkish-Dutch and Moroccan-Dutch older cancer patients/survivors, (2) the barriers perceived by healthcare professionals in fulfilling these needs, and (3) how the Health Communicator, a multilingual eHealth tool, can support the fulfillment of patients'/survivors' needs, and decrease professionals' barriers. DESIGN: We conducted a pre-implementation study of the Health Communicator using semi-structured interviews with Turkish-Dutch (n = 10; mean age = 69.10) and Moroccan-Dutch (n = 9; mean age = 69.33) older cancer patients/survivors, and held two focus groups with general practitioners (GPs; n = 7; mean age 45.14) and oncology nurses (ONs; n = 5; mean age = 49.60). Topic list consisted of questions related to needs and perceived barriers. Analysis was based on grounded theory. The acceptance of the Health Communicator was inquired by questions based on the concepts of the Technology Acceptance Model, and analyzed deductively. RESULTS: Patients/survivors reported unfulfilled needs concerning: (1) information about cancer (treatment), (2) information about the healthcare system, (3) possibilities regarding psychosocial support, and (4) doctor-patient relationship. Among professionals, the main perceived barriers were: (1) patients'/survivors' low health literacy and language barrier, (2) cultural taboo, (3) lack of insight into patients' instrumental needs, and (4) patients'/survivors' lack of trust in Dutch healthcare. Both patients/survivors and professionals thought that implementing the Health Communicator could be effective in fulfilling most of the needs and decreasing the barriers. However, a majority of the patients/survivors were hesitant regarding the use of it, because they found it too difficult to use. Professionals showed a positive intention towards using the Health Communicator. CONCLUSIONS: To enhance patient participation among older migrant cancer patients/survivors, the Health Communicator is, under certain conditions, a promising tool for fulfilling patients'/survivors' unfulfilled instrumental and affective needs and for bridging barriers perceived by professionals.

The paper explores how the politeness marker tetszik is used in Hungarian and how its functions are evaluated by the participants of doctor-patient communication. The possible functions of tetszik are investigated on the basis of questionnaires filled in by 50 patients and 50 GPs. Data about the social meanings of tetszik are presented with regard to the following: proportions of the use of tetszik in doctor-patient communication; metapragmatic evaluations and attitudes to the use of tetszik by doctors and patients; probable strategies underlying its use. Based on the data, we conclude that the use of the politeness marker tetszik is prototypically respectful while conveying familiarity and friendliness, with the age, gender, and relative status of the interlocutors also taken into consideration.

Absztrakt: Bevezetés: A koronavírus-járvány okozta veszélyhelyzet idején a Szegedi Tudományegyetemen a negyedéves orvostanhallgatók Orvos-beteg kommunikációs gyakorlata is online történt. A gyakorlat a videóanalízis módszerén alapul, szimulált páciensek bevonásával történik, kiemelt hangsúlyt fektetve a személyközi interakciókra, így az online megvalósítás rendkívül nagy kihívást jelentett. Célkitűzés: Az online Orvos-beteg kommunikációs gyakorlattal kapcsolatos tapasztalataink bemutatása. A hagyományos, személyes jelenléten alapuló és az online gyakorlatok összehasonlítása. Az online gyakorlatokkal kapcsolatos hallgatói értékelések elemzése. Módszer: Az online megvalósításhoz a Zoom ingyenes változatát használtuk. A gyakorlatok ötfős kiscsoportokban egy oktató családorvos vezetésével és egy szimulált páciens részvételével zajlottak. Valamennyi hallgató részt vett egy szituációban, amit rögzítettünk. A felvételek megtekintését közös elemzés, értékelés követte. A hallgatók anonim online kérdőív segítségével értékelték a kurzust. Az adatokat leíró statisztikai módszerekkel, a szöveges válaszokat kvalitatív módon elemeztük. Eredmények: A kérdőívet a hallgatók 74,4%-a, 64 fő töltötte ki. Valamennyi kérdés esetén a hallgatók többsége (78,1–100%) jó (4) vagy kiváló (5) értékelést adott. A legmagasabb átlagpontszámot (4,95 ± 0,21) a gyakorlati oktatók szakmai felkészültsége, míg a legalacsonyabbat az elméleti rész témaválasztása (4,06 ± 1,02) kapta. A szöveges értékelések alapján a hallgatók többsége elégedett a kurzussal, örömmel vennének rajta többször részt, a személyes megvalósítást azonban előnyben részesítenék az online formával szemben. Következtetések: Az online gyakorlat megvalósítása sikeres volt, sok szempontból megfelelően helyettesítette a hagyományos formát. A hallgatói értékelés nem volt rosszabb az előző évek eredményeinél. A személyes kontaktus hiánya limitáló tényező, ezért az online gyakorlat nem tekinthető a személyes kommunikációs tréning alternatívájának, hanem olyan önálló képzési forma, amely jelentősen hozzájárulhat a hatékony, modern oktatáshoz. Orv Hetil. 2020; 161(33): 1355–1362.

ObjectiveThe quality of physician–patient interaction can have a significant impact on medication adherence. Little is known about this relationship in patients with lupus nephritis.MethodsA cross-sectional, quantitative study. Data collected included demographics, current medication, systemic lupus erythematosus disease activity index, medication adherence, beliefs about medicines, shared decision-making, patient–doctor depth of relationship, patient–doctor quality of relationship, interpersonal trust in a physician and illness perceptions.ResultsNinety-eight patients with lupus nephritis completed the questionnaires. Logistic regression indicated that medication adherence was significantly predicted by (a) interpersonal trust in a physician (B = 0.85, Wald 3.94, 95% confidence interval (CI) 1.01, 5.44; P = 0.05); (b) timeline cyclical (B = –0.89, Wald 4.95, 95% CI 0.19, 0.90; P ConclusionThe findings highlighted two key elements: (a) the importance of trust in relation to medication adherence; and (b) a good understanding of patients’ illness is linked to a better relationship with their doctor and greater participation in shared decision-making which is associated with increased trust. Tailored psycho-educational interventions could contribute to improving the patient–doctor relationship quality, trust and increased shared decision-making, which, in turn, might improve medication adherence in patients with lupus nephritis.

The script of parenting shifts when parents learn of their child’s Down syndrome diagnosis. To build a theory of the diagnostic experience and early family sense-making process, we interviewed 33 parents and nine grandparents living in the United States who learned prenatally or neonatally of their child’s diagnosis. The core category of rescuing hope for the future encompassed the social process of sense-making over time as parents managed their sorrow, shock, and grief and amassed meaningful messages that anchored them as they looked toward the future. Application of the theory to practice underscores the import of early professional support offered to parents at key points in the sense-making process: Early as they disclose the news of the diagnosis to family and friends, and later close friends and kin assimilate meaningful messages about what the diagnosis means as they recalibrate expectations for a hopeful future.

The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.

Background: Lack of awareness about the life-limiting nature of renal failure is a significant barrier to palliative care for older adults with end-stage renal disease. Objective: To train nephrologists to use the best case/worst case (BC/WC) communication tool to improve shared decision making about dialysis initiation for older patients with limited life expectancy. Design: This is a pre-/postinterventional pilot study. Setting/Subjects: There were 16 nephrologists and 30 patients of age 70 years and older with estimated glomerular filtration rate (eGFR)

Background: Electronic Health Records (EHR) can help create patient ownership of information, enhance patient-centered collaborative advising, and increase advice utilization through increases in t...

The present study investigated the patients’ lexicons in unfolding migrant worker-domestic doctor interactions at a free-of-charge medical center for migrants (Center B) against those at a large general hospital (Hospital A) and those at another small free-of-charge hospital (Hospital C). In so doing, the focus was on the patients’ lexicons at Center B against those at the other institutions. Overall, the data at Center B consisted of approximately 80 consultations that the researcher himself participant-observed and audiorecorded at the three institutions over a span of two years. A qualitative investigation of the patients’ lexicons at Center B demonstrated that the patients who visited Center B initiated far more advanced scientific terminologies. Also, they adopted more nominalized forms, The lexical content and form appeared to result from the fact that the migrant patients were advanced degree seekers in agriculture, engineering, and science. Thus, the patients’ lexicons at Center B illustrated that the finding of the previous studies which argued that the patients at free-of-charge clinics were mostly unskilled laborers were oversimplistic and even stereotyping. The present study proposes a more critical applied linguistic study of migrant patient-domestic doctor consultations.

At the beginning of the 21st century, the interdisciplinary model for treating patients suffering from chronic pain has been adopted by a growing number of health centers. There is not, however, enough research examining how patients treated in clinics guided by this philosophy experience their condition and treatment. The purpose of this study is, therefore, to gain a closer understanding of the experience of these chronic pain patients. Semistructured interviews were conducted with 15 men and women aged 24 to 54 years who have suffered from chronic pain for over a year. The interviews were analyzed using the interpretative phenomenological analysis method. According to our analysis, participants experience themselves as trapped within endless pain that blurs their sense of identity and autonomy and isolates them from their environment. Participants expressed their desire for a close and caring relationship with their doctors as a way of relieving their sense of isolation. Based on our analysis, we suggest a patient-centered model for guiding doctors caring for chronic pain patients, which highlights the patients’ social and emotional experiences in addition to their medical condition.

Screen media guidelines for children set by medical organizations (e.g., the American Academy of Pediatrics) play a significant role in public discourse regarding media and parenting. Physician med...

Purpose The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the role of doctor-patient communication as a critical contingent variable in the psychological contract violation of patient’s antisocial behaviour relationship. Design/methodology/approach The data were collected from 483 hospitalized patients distributed in Shanxi province, China by using a self-administered survey. Findings The results indicated that psychological contract violation is positively associated with patient antisocial behaviour via patient trust. Moreover, the study found that doctor-patient communication moderates the mediated effects of psychological contract violation on patient’s antisocial behaviour through patient trust; that is, the mediated effect on antisocial behaviour is weaker when both doctor and patients have more communication. Research limitations/implications Due to a cross-sectional design in nature, the causal relationship cannot be developed based on the results. Despite the limitation, the present study provides insights for improving doctor-patient relationship by emphasizing the importance of increasing patient trust and doctor-patient communication. Practical implications To improve the quality of doctor-patient relationship, this study addresses the significance of properly showing understandings and care to regain mutual trust and reducing the likelihood of patient’s antisocial behaviour. Social implications The research findings have implications for both the health system and medical schools in China to reinforce the professional ethics and improve their medical humanities as the main concerns to generate a more sustainable doctor–patient relationship. Originality/value This study includes patient trust as a mediator and doctor-patient communication as a moderator to investigate the moderated mediation relationship among patients and medical professionals. By further examining the doctor-patient relationship, the results may not only help improve the efficient implementation of medical practices but also support the institutes and develop medical professionals for more positive doctor-patient relationships.

This study demonstrates that patients view their Electronic Health Records (EHR) significantly more with a dedicated second screen during outpatient primary care visits without any decrease in mutu...

Doctor-patient communication is a type of institutional communication which distinct linguistic features can significantly affect patient satisfaction and treatment outcome. A medical encounter has a clearly defined structure that has been shifting from clinician-centred to patient-centred. Therefore, it is of utter importance for prospective doctors and dentists to be aware of the role of language when communicating with their patients. Given the fact that working in a medical/dental practice has become increasingly international, the paper focuses on the role of the English language. New communicative models and environments such as Computer-Mediated Medical Communication (CMMC) and Video Interaction Guidance (VIG) are also presented.

Objective Listing more than one option for treatment, termed “option-listing” (OL) is one way to facilitate shared decision-making. We seek to evaluate how oncologists do option-listing in clinical encounters across disease contexts. Method We coded and transcribed 90 video-recorded interactions between 5 oncologist participants and a convenience sample of 82 patients at 2 large clinics in the western U.S. We used conversation analytic (CA) methods to examine patterns of behavior when oncologists provided more than one treatment option to patients. Results In early-stage disease, OL provides patients with options while at the same time constraining those options through expression of physician bias. This effect disappears when cancer is at an advanced stage. In this context, OL is presented without physician preference and demonstrates recission of medical authority. Conclusion In early-stage contexts, OL functions as a way for physicians to array available options to patients while also communicating their expertise. In advanced-stage contexts, OL functions as a way to minimize treatment options and highlight dwindling possibilities. Practice implications OL is one way to implement shared decision-making, but it can also be used to facilitate a realization that treatment choices are diminishing and disease is progressing beyond a cure.

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