Problems in Communications with Patients in General Surgery Outpatient Practice

Abstract

Objective: Communication between the patient and physician is central to medical care. However communication skills in Turkey haven't been gained so much concern. This situation effect the national quality of health care. Here, we tried to perform some basic communication skills and to find the problems with the possible solution suggestions. Materials and Methods:The study was conducted for a month in general surgery outpatient department located in the slum part of Ankara with low socio-economic population. Basic communication skills were performed. The age, sex, education levels of the patients were obtained. Total symptom expression and interview time were recorded. Previous medical histories were asked. Interruptions including telephone, door knocking were noted. The questions of the patients at the end of the interview classified as hospital setting, nutrition and treatment.Results: Total 410 interviews were analysed. Mean symptom expression and interview times were 22.9 sec and 7.05 min, respectively. Educated patients, males and young patients expressed symptoms longer than the others (p<0.05). There were 174 interruptions in which total interview time signifantly increased than the non interrupted ones (p<0.05). Final questions about hospital setting were signifantly higher in illiterate patients than the educated ones (p<0.05). Awareness of medical history is higher in educated and young patients. Conclusion:Basic communications skills can be performed whether in rural regions. Much more concern should be given to the education of communication skills. The obstacles in communication in medicine are low education levels, and unorganised health system. Keywords: Communication skills, surgery, education ÖzetAmaç: İletişim, tıbbi bakımda hasta doktor arasında temel teşkil eder. Fakat Türkiye'de iletişim becerilerine fazla ilgi gösterilmemiştir. Bu konu ülkede sağlık kalitesini de etkilemektedir. Bu çalışmada bazı temel iletişim becerilerini uyguladık ve karşılaştığımız problemleri olası çözüm önerileri ile birlikte sunmak istedik. Gereç ve Yöntem:Çalışma Ankara'nın varoş semtinde bulunan Genel Cerrahi polikinliniğinde 1 aylık süre içinde gerçekleşirildi. Hasta muayenesinde temel iletişim becerileri kullanıldı. Hastaların yaşı, cinsiyet ve eğitim düzeyleri belirlendi. Toplam semptomları anlatma ve muayene süreleri belirlendi. Geçmiş tıbbi hikayeleri alındı. Telefon çalması, kapı açılması gibi muayeneyi engelleyen faktörler belirlendi. Muayene sonunda hastaların soruları hastane işleyişi, tedavi ve beslenme ile ilgili olarak gruplandırıldı. Bulgular:Toplam 410 görüşme yapıldı. Ortalama semptom belirtme 22,9 saniye, ortalama muayene 7,05 dakika sürdü. Eğitimli, erkek ve genç olma semptom anlatım süresini uzatmıştır (p<0,05). Toplam 174 kez muayene kesilmiştir ki bunlar muayene süresini anlamlı artır-mıştır (p<0,05). Hastane işleyişi ile ilgili sorular en çok okuma yazma bilmeyen hastalar tarafından sorulmuştur (p<0,05). Tıbbi öykü farkın-dalığı, eğitimli ve genç hastalarda daha fazla bulundu. Sonuç:Te...

Communication in patient–physician relationship in Turkey: opinions of family medicine residents

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