Patients' Perceptions of Medical Encounters in Great Britain: Variations With Health Loci of Control and Sociodemographic Factors

Arntson, Paul; Makoul, Gregory; Pendleton, David; Schofield, Theo

doi:10.1207/s15327027hc0102_1

Cited by 27 publications

(6 citation statements)

References 13 publications

(17 reference statements)

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“…The PCPs' patient-centered communication (PCC) was assessed with a 12-item measure initially developed by Arntson et al [14] and later adapted by others for use either as a patient self-report [15,16] or as a rating scale for observers of medical encounters [17]. On five-point Likert scales, the respondent rates the extent to which the PCP was informative (e.g., the provider did not fully discuss with the patient what was causing the patient's problem; the provider thoroughly explained everything to the patient), used supportive communication (e.g., the provider showed a genuine interest in the patient's health; the provider seemed to care about the patient's feelings), and engaged in partnership-building (e.g., the provider encouraged the patient to express concerns and worries; the provider asked for the patient's thoughts about his/her health).…”

Section: Methodsmentioning

confidence: 99%

Provider interaction with the electronic health record: The effects on patient-centered communication in medical encounters

Street

Liu

Farber

et al. 2014

Patient Education and Counseling

132

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Objective The computer with the electronic health record (EHR) is an additional ‘interactant’ in the medical consultation, as clinicians must simultaneously or in alternation engage patient and computer to provide medical care. Few studies have examined how clinicians' EHR workflow (e.g., gaze, keyboard activity, and silence) influences the quality of their communication, the patient's involvement in the encounter, and conversational control of the visit. Methods Twenty-three primary care providers (PCPs) from USA Veterans Administration (VA) primary care clinics participated in the study. Up to 6 patients per PCP were recruited. The proportion of time PCPs spent gazing at the computer was captured in real time via video-recording. Mouse click/scrolling activity was captured through Morae, a usability software that logs mouse clicks and scrolling activity. Conversational silence was coded as the proportion of time in the visit when PCP and patient were not talking. After the visit, patients completed patient satisfaction measures. Trained coders independently viewed videos of the interactions and rated the degree to which PCPs were patient-centered (informative, supportive, partnering) and patients were involved in the consultation. Conversational control was measured as the proportion of time the PCP held the floor compared to the patient. Results The final sample included 125 consultations. PCPs who spent more time in the consultation gazing at the computer and whose visits had more conversational silence were rated lower inpatient-centeredness. PCPs controlled more of the talk time in the visits that also had longer periods of mutual silence. Conclusions PCPs were rated as having less effective communication when they spent more time looking at the computer and when there was more periods of silence in the consultation. Because PCPs increasingly are using the EHR in their consultations, more research is needed to determine effective ways that they can verbally engage patients while simultaneously managing data in the EHR. Practice implications EHR activity consumes an increasing proportion of clinicians' time during consultations. To ensure effective communication with their patients, clinicians may benefit from using communication strategies that maintain the flow of conversation when working with the computer, as well as from learning EHR management skills that prevent extended periods of gaze at computer and long periods of silence. Next-generation EHR design must address better usability and clinical workflow integration, including facilitating patient-clinician communication.

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Section: Methodsmentioning

confidence: 99%

Provider interaction with the electronic health record: The effects on patient-centered communication in medical encounters

Street

Liu

Farber

et al. 2014

Patient Education and Counseling

132

View full text Add to dashboard Cite

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“…Coders assessed the physicians’ overall informativeveness on 5 point Likert scales using 4 items from a previously validated measure [47,54,55]: the doctor did not fully discuss with the patient what was causing the patient’s problem (R), the doctor explained everything to the patient, the doctor was very informative about the patient health, the doctor’s explanations and recommendations were clear and easy to understand. Coders also rated physicians’ pain-specific informativeness with 3 items: the doctor thoroughly explained everything about pain to the patient, the doctor was very informative about the patient’s pain and ways to control pain, the doctor’s explanations about pain and ways to manage pain were clear and easy to understand.…”

Section: Methodsmentioning

confidence: 99%

Improving physician–patient communication about cancer pain with a tailored education-coaching intervention

Street

Slee

Kalauokalani

et al. 2010

Patient Education and Counseling

103

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Objective This study examined the effect of a theoretically grounded, tailored education-coaching intervention to help patients more effectively discuss their pain-related questions, concerns, and preferences with physicians. Methods Grounded in social-cognitive and communication theory, a tailored education coaching (TEC) intervention was developed to help patients learn pain management and communication skills. In a RCT, 148 cancer patients agreed to have their consultations audio-recorded and were assigned to the intervention or a control group. The recordings were used to code for patients’ questions, acts of assertiveness, and expressed concerns and to rate the quality of physicians’ communication. Results Patients in the TEC group discussed their pain concerns more than did patients in the control group. More active patients also had more baseline pain and interacted with physicians using participatory decision-making. Ratings of physicians’ information about pain were higher when patients talked more about their pain concerns. Conclusions The study demonstrates the efficacy of a theoretically grounded, coaching intervention to help cancer patients talk about pain control. Practice implications Coaching interventions can be effective resources for helping cancer patients communicate about their pain concerns if they are theoretically grounded, can be integrated within clinical routines, and lead to improve health outcomes.

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“…33 The coders also rated the physicians' communication during the consultation. Using a measure from earlier studies, [34][35][36] coders rated on 5-point scales the degree to which the physician (1) was informative, (2) used supportive communication, and (3) engaged in partnership-building. An earlier study 33 reported that these scales were highly correlated with one another (r >.70).…”

Section: Outcome and Communication Measuresmentioning

confidence: 99%

Understanding Concordance in Patient-Physician Relationships: Personal and Ethnic Dimensions of Shared Identity

Street¹,

O’Malley²,

Cooper³

et al. 2008

The Annals of Family Medicine

527

367

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PURPOSE Although concordance by race and sex in physician-patient relationships has been associated with patient ratings of better care, mechanisms through which concordance leads to better outcomes remains unknown. This investigation examined (1) whether patients' perceptions of similarity to their physicians predicted their ratings of quality of care and (2) whether perceived similarity was infl uenced by racial and sexual concordance and the physician's communication. METHODSThe research design was a cross-sectional study with 214 patients and 29 primary care physicians from 10 private and public outpatient clinics. Measures included postvisit patient ratings of similarity to the physician; satisfaction, trust, and intent to adhere; and audiotape analysis of patient involvement and physicians' patient-centered communication.RESULTS Factor analysis revealed 2 dimensions of similarity, personal (in beliefs, values) and ethnic (in race, community). Black and white patients in racially concordant interactions reported more personal and ethnic similarity (mean score, 87.6 and 78.8, respectively, on a 100-point scale) to their physicians than did minority patients (mean score, 81.4 and 41.2, respectively) and white patients (mean score, 84.4 and 41.9, respectively) in racially discordant encounters. In multivariable models, perceived personal similarity was predicted by the patient's age, education, and physicians' patient-centered communication, but not by racial or sexual concordance. Perceived personal similarity and physicians' patient-centered communication predicted patients' trust, satisfaction, and intent to adhere. CONCLUSIONSThe physician-patient relationship is strengthened when patients see themselves as similar to their physicians in personal beliefs, values, and communication. Perceived personal similarity is associated with higher ratings of trust, satisfaction, and intention to adhere. Race concordance is the primary predictor of perceived ethnic similarity, but several factors affect perceived personal similarity, including physicians' use of patient-centered communication.

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Patients' Perceptions of Medical Encounters in Great Britain: Variations With Health Loci of Control and Sociodemographic Factors

Cited by 27 publications

References 13 publications

Provider interaction with the electronic health record: The effects on patient-centered communication in medical encounters

Provider interaction with the electronic health record: The effects on patient-centered communication in medical encounters

Improving physician–patient communication about cancer pain with a tailored education-coaching intervention

Understanding Concordance in Patient-Physician Relationships: Personal and Ethnic Dimensions of Shared Identity

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