Patient-physician interaction in general practice and health inequalities in a multidisciplinary study: design, methods and feasibility in the French INTERMEDE study

Kelly-Irving, Michelle; Rolland, Christine; Afrité, Anissa; Cases, Chantal; Dourgnon, Paul; Pascal, Jean; Lang, Thierry

doi:10.1186/1472-6963-9-66

Cited by 14 publications

(10 citation statements)

References 13 publications

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“…This is in accordance with the general educational guidelines of what is generally considered as good doctor-patient communication: doctors need to be competent, have to know their job, while adopting a patient-centered style (Roter and Hall 2006). At the same time, this result contrasts with what physicians tend to do, namely using a more dominant communication style when dealing with patients from lower educational backgrounds (Verlinde et al 2012;Smith et al 2009;Kelly-Irving et al 2009). This means that doctors often adapt their communication style based only on ingrained prejudices, and therefore, in the opposite direction.…”

Section: Discussionmentioning

confidence: 80%

Quality of doctor–patient communication through the eyes of the patient: variation according to the patient’s educational level

Aelbrecht

Rimondini

Bensing

et al. 2014

Adv in Health Sci Educ

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Good doctor-patient communication may lead to better compliance, higher patient satisfaction, and finally, better health. Although the social variance in how physicians and patients communicate is clearly demonstrated, little is known about what patients with different educational attainments actually prefer in doctor-patient communication. In this study we describe patients' perspective in doctor-patient communication according to their educational level, and to what extent these perspectives lean towards the expert opinion on doctor-patient communication. In a multi-center study (Belgium, The Netherlands, UK and Italy), focus group discussions were organised using videotaped medical consultations. A mixed methods approach was used to analyse the data. Firstly, a difference in perspective in communication style was found between the lower educated participants versus the middle and higher educated participants. Secondly, lower educated participants referred positively most to aspects related to the affective/emotional area of the medical consultation, followed by the task-oriented/problem-focused area. Middle and higher educated participants positively referred most to the task-oriented/problem-focused area. The competency of the physician was an important category of communication for all participants, independent of social background. The results indicate that the preferences of lower educated participants lean more towards the expert opinion in doctor-patient communication than the middle and higher educated participants. Patients' educational level seems to influence their perspective on communication style and should be taken into account by physicians. Further quantitative research is needed to confirm these results.

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Section: Discussionmentioning

confidence: 80%

Quality of doctor–patient communication through the eyes of the patient: variation according to the patient’s educational level

Aelbrecht

Rimondini

Bensing

et al. 2014

Adv in Health Sci Educ

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“…Research has shown that communication, as an interactional process involving both doctors and patients, is key to understanding the quality of care patients receive [1,2,5-7,13]. Communicating and exchanging information are key to diagnosis and treatment [3,14-17].…”

Section: Introductionmentioning

confidence: 99%

Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics

Desjarlais-deKlerk

Wallace

2013

BMC Health Serv Res

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BackgroundLocation of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada.MethodsWe analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either instrumental or socioemotional. Instrumental communication refers to “cure-oriented interactions” and tends to be more task-oriented focusing on the patient’s health concerns and reason for the appointment. In contrast, socioemotional communication refers to more “care-oriented interactions” that may make the patient feel comfortable, relieve patient anxiety and build a trusting relationship.ResultsThe physicians in small, rural towns appear to know their patients and their families on a more personal level and outside of their office, and engage in more socioemotional communications compared to those practicing in suburban clinics in a large urban centre. Knowing patients outside the clinic seems to change the nature of the doctor-patient interaction, and, in turn, the doctor-patient relationship itself. Interactions between urban doctors and their patients had a mixture of instrumental and socioemotional communications, while interactions between rural doctors and their patients tended to be highly interpersonal, often involving considerable socioemotional communication and relationship-building.ConclusionsDespite the different ways that doctors and patients communicate with each other in the two settings, rural and urban doctors spend approximately the same amount of time with their patients. Thus, greater use of socioemotional communication by rural doctors, which may ease patient anxiety and increase patient trust, did not appear to add extra time to the patient visit. Research suggests that socioemotional communication may ultimately lead to better patient outcomes, which implies that health differences between rural and urban settings could be linked to differences in doctor-patient communication styles.

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“…It is based on a sequential exploratory design, in which each phase was conducted independently, on a different sample of patients and physicians (Figure 1; Kelly-Irving et al, 2009):…”

Section: Methodsmentioning

confidence: 99%

Integrating Multidisciplinary Results to Produce New Knowledge About the Physician–Patient Relationship

Schieber

Kelly-Irving

Génolini

et al. 2016

Journal of Mixed Methods Research

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The INTERMEDE Project brought together a number of research teams to study the interaction between a patient and their general practitioner, and how this can produce social inequalities in health. The ultimate objective of the project was to formalize a core of common findings by integrating qualitative and quantitative results. The methodology chosen for the integration was inspired by the Delphi participatory method. It involves several rounds of questions and feedback in writing between all members of project teams, in order to compare contradictory opinions and identify key concepts arising from the project. This interdisciplinary research has provided a more nuanced understanding of the mechanisms underlying physician–patient interaction by revealing the convergences of the various disciplinary approaches.

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Patient-physician interaction in general practice and health inequalities in a multidisciplinary study: design, methods and feasibility in the French INTERMEDE study

Cited by 14 publications

References 13 publications

Quality of doctor–patient communication through the eyes of the patient: variation according to the patient’s educational level

Quality of doctor–patient communication through the eyes of the patient: variation according to the patient’s educational level

Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics

Integrating Multidisciplinary Results to Produce New Knowledge About the Physician–Patient Relationship

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