Patient-Clinician Communication

Slatore, Christopher G.; Cecere, Laura M.; Reinke, Lynn F.; Ganzini, Linda; Udris, Edmunds M.; Moss, Brianna R.; Bryson, Chris L.; Curtis, J. Randall; Au, David H.

doi:10.1378/chest.09-2328

Cited by 61 publications

(18 citation statements)

References 36 publications

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“…In general, the domains of ‘physician communication and competence’, ‘postoperative care’ and ‘treatment information’ had the strongest association with a more positive treatment outcome. This finding is in line with previous studies which reported that patient experience with the physician’s communication is the most important factor in the relationship with treatment outcome ( Black et al., 2014 ; Fremont et al., 2001 ; Slatore et al., 2010 ). In addition, our results show that a good experience with the treatment information provided was also strongly associated with patient-reported treatment effectiveness.…”

Section: Discussionsupporting

confidence: 93%

Better patients’ treatment experiences are associated with better postoperative results in Dupuytren’s disease

Poelstra

Selles

Slijper³

et al. 2018

J Hand Surg Eur Vol

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This prospective study investigates the extent to which a better experience with healthcare delivery is associated with better postoperative treatment outcomes after surgery for Dupuytren’s contracture. Patients undergoing limited fasciectomy or percutaneous needle fasciotomy for Dupuytren’s contractures completed the Michigan Hand Outcomes Questionnaire before and 3 months after surgery, together with a patient reported experience measure, while hand therapists assessed the straightness of the finger with a goniometer. Regression analyses were used to examine associations. We found that a better experience with healthcare delivery was associated with better patient-reported outcomes, while association with residual extension deficit was minimal. Strongest associations were seen with communication of the physician, postoperative care and information about the treatment. Experience with the treatment explained up to 12% of the variance in treatment outcome. These findings suggest that patient reported treatment outcomes in Dupuytren’s disease can be improved by improving the treatment context.Level of evidence: II

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Section: Discussionsupporting

confidence: 93%

Better patients’ treatment experiences are associated with better postoperative results in Dupuytren’s disease

Poelstra

Selles

Slijper³

et al. 2018

J Hand Surg Eur Vol

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“…For clinicians, a consistent area of concern is the desire among patients for improved care, which is consistent with findings from previous investigations that quality of communication and duration of the relationship between physician and patient affects health literacy and self-efficacy of patients. 41 Moreover, poor physician communication is a barrier to self-management, 35 and communication style has a major influence on making commitment to specific behavioural change goals and plans. 42 Further research is needed to determine the best cognitive-behavioural methods for encouraging COPD patients to convert their motivation to overcome losses and fears, and their need for information into the actual behaviour change that will help them manage their illness better.…”

Section: Discussionmentioning

confidence: 99%

A qualitative study of patients' goals and expectations for self-management of COPD

Wortz

Cade

Menard

et al. 2012

Primary Care Respiratory Journal

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Background Chronic obstructive pulmonary disease (COPD) is an illness that affects patients on multiple levels, both physically and psychologically. While there is a growing body of evidence for the efficacy of self-management among patients with COPD, little evidence is available on the optimal content and methods for delivering self-management support. Aims The purpose of this study was to address gaps in the literature on self-management support by examining patients’ responses to questions about goals, needs, and expectations regarding self-management using qualitative methods in a broadly representative sample of patients with moderate to severe COPD. By focusing on patients’ perceptions of their needs, we hoped to guide development of cognitive-behavioural interventions for self-management support. Methods Patients ≥45 years of age with a physician diagnosis of COPD were recruited as part of a larger randomised controlled trial designed to determine the effectiveness of a lifestyle behavioural intervention to increase physical activity. In-depth interviews were conducted at baseline data collection using 10 standardised open-ended questions tailored to examine factors relevant to self-management support including concerns, fears, learning needs, barriers, facilitators, and goals. All interviews were audio recorded and analysed using qualitative methods. Responses were coded by three raters into thematic categories. Results A sample of 47 interviews with patients of mean age 68.4 years, 53% male, 87% white were used in the analysis. The distribution of spirometric impairment based on percent predicted forced expiratory volume in 1 second (FEV1) was moderate (57.5%), severe (31.9%), and very severe (10.6%). In response to questions targeting needs and goals for care, three main themes (loss, fear, and desire for improved care) and seven associated sub-themes were identified. Because of breathlessness and fatigue as well as symptoms from conditions other than COPD, patients reported the loss of ability to participate in pleasurable and necessary activities of daily living and the desire to recover at least some of their functioning. They expressed problems with social isolation and uncertainty about their prognosis, as well as the hope to improve. In addition, fearful experiences associated with uncontrolled breathlessness and a wish for greater understanding and knowledge about treatment were major concerns. Conclusions These qualitative results suggest that the content of self-management support for patients with COPD should focus on addressing patients’ fears associated with the uncertainty, progression, and suffering of their disease, their expectations about overcoming or replacing losses, their needs for improved health literacy and their desire for improved care. These responses indicate areas where cognitive-behavioural intervention should focus in order to enhance patient self-efficacy, motivation, and behavioural change for improved self-management.

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“…Patient participation also benefits the patient in other ways including enhancing patient knowledge (Coulter and Ellins, 2007) and sense of control (Dudas et al, 2013, Hӧglund et al, 2010. Patient-centred approaches, inclusive of patient participation, also improve patient satisfaction (Dwamena et al, 2012) and perceived quality of care (Slatore, 2010, Weingart et al, 2011. Finally, involving patients in their care can improve condition (Coulter and Ellins, 2007), specifically patients' function in activities of daily living (Ekman et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Patient participation in nursing care on medical wards: An integrative review

Tobiano

Marshall

Bucknall

et al. 2015

International Journal of Nursing Studies

139

132

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On medical wards, patients and nurses desire, perceive or enact patient participation passively. Challenging factors for patient participation include patients' willingness, nurses' approach and confusion around expectations and roles. Information-sharing was identified as an activity that promotes patient participation, suggesting nurses encourage active communication with patients in practice. Involving patients in assessment and care planning may also enhance patient participation. For education, enhancing nurses' understanding of the attributes of patient participation, as well as patient-centred care approaches may be beneficial for medical ward nurses. From here, researchers need to examine ways to overcome the barriers to patient participation; further nurse participants and observational data is required on medical wards.

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Patient-Clinician Communication

Abstract: Communication between patients and clinicians is associated with quality of care and confidence in dealing with breathing problems, and this association may change over time. Attention to specific communication strategies may lead to improvements in the care of patients with COPD.

Cited by 61 publications

References 36 publications

Better patients’ treatment experiences are associated with better postoperative results in Dupuytren’s disease

Better patients’ treatment experiences are associated with better postoperative results in Dupuytren’s disease

A qualitative study of patients' goals and expectations for self-management of COPD

Patient participation in nursing care on medical wards: An integrative review

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