Quality of Communication and Trust in Patients With Serious Illness: An Exploratory Study of the Relationships of Race/Ethnicity, Socioeconomic Status, and Religiosity

Coats, Heather; Downey, Lois; Sharma, Rashmi; Curtis, J. Randall; Engelberg, Ruth A.

doi:10.1016/j.jpainsymman.2018.07.005

Cited by 40 publications

(22 citation statements)

References 40 publications

(45 reference statements)

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“…A limited number of studies have found that race and ethnicity influence PPR, for example, patient-centered encounters, communication ratings, and trust in the provider, but confounding factors can lead to conflicting study results. 57,58 More research on race and ethnicity is needed.…”

Section: During Office Hoursmentioning

confidence: 99%

A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

et al. 2021

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BACKGROUND & AIMS: Over several decades, changes in health care have negatively impacted meaningful communication between the patient and provider and adversely affected their relationship. Under increasing time pressure, physicians rely more on technology than face-to-face time gathering data to make clinical decisions. As a result, they find it more challenging to understand the illness context and fully address patient needs. Patients experience dissatisfaction and a diminution of their role in the care process. For patients with disorders of gut-brain interaction, stigma leads to greater care dissatisfaction, as there is no apparent structural basis to legitimize the symptoms. Recent evidence suggests that practical communication skills can improve the patient-provider relationship (PPR) and clinical outcomes, but these data are limited. METHODS: The Rome Foundation convened a multidisciplinary working team to review the scientific evidence with the following aims: to study the effect of communication skills on patient satisfaction and outcomes by performing an evidence-based review; to characterize the influence of sociocultural factors, health care system constraints, patient perspective, and telehealth on the PPR; to review the measurement and impact of communication skills training on these outcomes; and to make recommendations to improve communication skills training and the PPR. RESULTS: Evidence supports the fact that interventions targeting patientprovider interactions improve population health, patient and provider experience, and costs. Communication skills training leads to improved patient satisfaction and outcomes. The following are relevant factors to consider in establishing an effective PPR: addressing health care system constraints; incorporating sociocultural factors and the role of gender, age, and chronic illness; and considering the changing role of telehealth on the PPR. CONCLUSIONS: We concluded that effective communication skills can improve the PPR and health outcomes. This is an achievable goal through training and system change. More research is needed to confirm these findings.

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Section: During Office Hoursmentioning

confidence: 99%

A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

et al. 2021

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“…However, most of the elements of support and communication measured by this instrument were associated with a significant change in PTSD symptoms even after adjusting for patient death in a multivariable model, suggesting that this content is applicable to both bereaved and non-bereaved surrogates. Additionally, the results of the ADBFMI are generally interpreted using composite problem scores rather than responses to each individual question, and our utilization of both represents a different approach that has recent precedent in the medical literature [35]. As such, results for analyses of specific items should be considered exploratory in nature.…”

Section: Discussionmentioning

confidence: 99%

Modifiable elements of ICU supportive care and communication are associated with surrogates’ PTSD symptoms

et al. 2019

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Purpose: To identify specific components of ICU clinician supportive care and communication that are associated with increased post-traumatic stress disorder (PTSD) symptoms for surrogate decision makers of patients with chronic critical illness (CCI). Methods: We conducted a secondary analysis of data from a randomized controlled trial of palliative care-led meetings to provide information and support for CCI surrogates. The primary outcome for this secondary analysis was PTSD symptoms at 90 days, measured by the Impact of Event Scale-Revised (IES-R). Caregiver perceptions of clinician support and communication were assessed using a version of the After-Death Bereaved Family Member Interview (ADBFMI)

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“…15 However, other studies failed to show a clear disparity in patient-reported QOC. 16,17 In fact, Coats et al 17 showed increased satisfaction with communication among racial and ethnic minorities and those of lower socioeconomic status in a study of enhanced communication in serious illness in the outpatient setting. Measures of satisfaction with communication for seriously ill patients in the acute care setting, particularly in the intensive care unit (ICU), have not been compared by race or ethnicity.…”

Section: Introductionmentioning

confidence: 99%

Race and Ethnicity and Satisfaction With Communication in the Intensive Care Unit

Chuang

Fiter

Sanon

et al. 2020

Am J Hosp Palliat Care

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Purpose: Racial and ethnic minority patients receive poorer quality end-of-life (EoL) care compared with white patients. Differences in quality of communication (QOC) with clinicians may contribute to these disparities. We measured differences in satisfaction with communication in the intensive care unit (ICU) by race and ethnicity. Materials and Methods: This is a cross-sectional survey of family members of patients in ICUs of an academic medical center serving a diverse urban population using The Family Satisfaction with the ICU (FS-ICU) and QOC scales. Results: One hundred surveys were completed (18.8% white, non-Hispanic; 34.4% black, non-Hispanic; 31.3% Hispanic; 15.6% other race/ethnicity). Mean FS-ICU score was 84.2 (standard deviation [SD] 20.5) for white patients, 83.3 (SD 16.2) for black patients, 82.7 (SD 17.8) for Hispanic or Latino patients, and 80.9 (SD 18.8) for patients with other race/ethnicity (Kruskal-Wallis, P = .92). Differences remained insignificant when controlling for patient and respondent characteristics. The QOC scale was not scored due to nonresponse levels on questions about EoL communication. Conclusions: Uniformly high ratings may have been influenced by avoidance of EoL discussion. This study is inconclusive regarding whether QOC influences disparities in EoL care since quality of EoL communication was not captured.

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Quality of Communication and Trust in Patients With Serious Illness: An Exploratory Study of the Relationships of Race/Ethnicity, Socioeconomic Status, and Religiosity

Cited by 40 publications

References 40 publications

A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

Modifiable elements of ICU supportive care and communication are associated with surrogates’ PTSD symptoms

Race and Ethnicity and Satisfaction With Communication in the Intensive Care Unit

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