Comparison of communication during home medical care between patients with intractable neurological disorders and those with malignant tumors

Abstract

Aim Home medical care is currently a topic of discussion in Japan. It is reported that the key to the success of home medical care is communication. The aim of the present study was to elucidate the characteristics of communication during home medical care of patients with intractable neurological diseases (IND patients) by comparing them with patients with malignant tumors, the representative common disease for home medical care. Methods A questionnaire survey was sent out in June and July 2011 to 295 families of patients who had previously received home medical care. The response rate was 83.8% (n = 227). Communication backgrounds were compared between those patients whose primary disease was either IND or malignant tumor. Results Analysis of responses from 104 families (IND, 30 and malignant tumors, 74). was undertaken The number of families that experienced “doctor‐patient communication without family” was 15% (n = 4) in the IND group and 35% (n = 24) in the malignant tumor group (P < 0.05). The number of families who had experienced “doctor‐family communication without patient” was 44% (n = 12) in the IND group and 83% (n = 54) in the malignant tumor group (P < 0.01). No statistically significant differences in doctors' stay duration were observed. Conclusion It is suggested that communication with the patient in the presence of their family is characteristic of communication during home medical care of IND patients, because this was observed to be more frequent than that for malignant tumor patients.

Comparison of Feedback From Families of Patients With Neuromuscular Disorders and Malignant Tumors on Communications Among Doctors, Patients, and Family Members in Home Medical Care Settings

“…The data sources for this study were medical records and completed questionnaires comprising 53 questions, among which questions designed for another study were also included. 4,6 Basic patient characteristics were obtained from the medical records, whereas information on patient and family backgrounds and the caregiving situation was extracted from the questionnaires. Details of the questions are as described in our previous paper.…”

“…4,6 Basic patient characteristics were obtained from the medical records, whereas information on patient and family backgrounds and the caregiving situation was extracted from the questionnaires. Details of the questions are as described in our previous paper.…”

“…4 These questions and survey items were selected through discussions among the authors about the findings of previous studies and qualitative results obtained from our previous surveys on communication methods during home medical care of patients with neuromuscular disorders. [4][5][6][7][11][12][13] The questionnaire included questions about the content of communications that had occurred during home medical care and desire for future DPC/DFC (the objective of this study): the specifics follow.…”

“…We also showed that, in the home medical care setting, significantly fewer patients with neuromuscular disorders than with malignant tumors (MT; common diseases that are representative of home medical care) participate in DFC and DPC and that tripartite communication between doctor, patient, and family is the standard practice. 6 In such tripartite communication, some patients find it difficult to communicate with their doctor about certain matters in the presence of the family; conversely, some family members have the same difficulty in the presence of the patient. However, from the point of view of patients’ autonomy and confidentiality, it is questionable practice to set up DFC without adequate consideration, or to fail to set up adequate DPC.…”