The interaction between physician and patient communication behaviors in Japanese cancer consultations and the influence of personal and consultation characteristics

Ishikawa, Hirono; Takayama, Tomoko; Yamazaki, Yoshihiko; Seki, Yukiko; Katsumata, Noriyuki; Aoki, Yutaka

doi:10.1016/s0738-3991(01)00164-1

Cited by 45 publications

(30 citation statements)

References 44 publications

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“…In this system, each statement (utterance) by either physician or patient is coded into mutually exclusive physician or patient categories. While RIAS has been extensively used and validated in general practice [17], internal medicine [18], oncology [19,20] and gynaecology [21] (for a complete list of the RIAS bibliography see [22]), it has rarely been used in the peri-operative period [23]. This study presents a detailed description and analysis of the routine pre-operative communication between anaesthetists and patients.…”

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confidence: 99%

A quantitative analysis of anaesthetist–patient communication during the pre‐operative visit

Kindler¹,

Szirt

Sommer

et al. 2004

Anaesthesia

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SummaryPrevious communication research in general medical practice has shown that effective communication enhances patient compliance, satisfaction and medical outcome. It is expected that communication is equally important in anaesthesia, since patients often suffer from anxiety and lack of knowledge about anaesthetic procedures. However, little is known about the nature of communication during routine anaesthetic visits. The present study of 57 authentic anaesthetic visits provides the first results on the structure and content of communication in the pre-operative setting using the Roter Interaction Analysis System (RIAS). Patient-centred communication behaviours of anaesthetists and the extent of patient involvement were particularly investigated. From the 57 pre-operative visits, 18 267 utterances were coded. The mean (SD) [range] duration of the visit was 16.1 (7.8) [3.7-42.7] min. Anaesthetists provided 169 (68) and patients 153 (82) utterances per visit (53.5% vs. 46.5%). Physician and patient gender had no impact on the distribution of utterances and the duration of the visit. Conversation mainly focussed on biomedical issues with little psychosocial discussion (< 0.1% of all anaesthetist utterances). However, anaesthetists quite frequently used emotional comments toward patients (7%) and involved them in the conversation. The use of facilitators, open questions and emotional statements by the anaesthetist correlated with high patient involvement. The amount of patient participation in anaesthetic decisions was assessed with the Observing Patient Involvement Scale (OPTION). Compared with general practitioners, anaesthetists offered more opportunities to discuss treatment options (mean (SD) OPTION score 26.8 (16.8) vs. 16.8 (7.7) postgraduate training for specialists [6]. In the past, communication skills training as a component of formal training was only emphasised for general practitioners and internists, but the importance of such non-technical skills is now also recognised in anaesthesia and critical care medicine [7][8][9][10][11][12]. For this purpose, simulator-based modular human factor and communication training has recently been made available to anaesthetists [13].Since pre-operative anxiety is often directed towards the anaesthetic itself [14], an anaesthetist is best able to decrease a patient's anxiety [15]. Our aim is to improve the anaesthetist's ability to elicit and respond to the patient's concerns and questions during the pre-operative anaesthetic visit. In order to define more precisely those skills that would best help an anaesthetist to become a more professional communicator, the current study investigates the anaesthetist-patient interaction in 57 videotaped real-life pre-operative visits using the standard instrument Roter Interaction Analysis System (RIAS) [16]. In this system, each statement (utterance) by either physician or patient is coded into mutually exclusive physician or patient categories. While RIAS has been extensively used and validated in general practice [17]...

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mentioning

confidence: 99%

A quantitative analysis of anaesthetist–patient communication during the pre‐operative visit

Kindler¹,

Szirt

Sommer

et al. 2004

Anaesthesia

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“…22,23 Additionally, patient satisfaction is influenced by physicians’ ability to exhibit friendly and compassionate behavior, 24 and a warm communication style is important in making patients feel comfortable asking questions. 25 Prior studies have shown that empathic communication is important for reducing anxiety and fear, providing support and reassurance, improving patient satisfaction, as well as adherence to physician recommendations. 26-29 However, we did not find that physician support was associated with increased cancer-directed treatment rates.…”

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confidence: 99%

Association of Patient–Provider Communication Domains with Lung Cancer Treatment

Lin

Lake

Wall³

et al. 2014

Journal of Thoracic Oncology

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Background Patient-physician communication is critical for helping patients understand and complete the complex steps needed to diagnose stage and treat lung cancer. We assessed which domains of patient-physician communication about lung cancer and its treatment are associated with receipt of disease-directed, stage-appropriate treatment. Methods Patients with recently-diagnosed lung cancer were recruited from four medical centers in New York City from 2008 to 2011. Participants were surveyed about discussions with physicians regarding treatment, symptoms and needs. Multiple regression analysis and structural equation modeling were used to assess which communication factors were associated with disease treatment. Results Of the 352 participants, 191 (54%) received disease-directed, stage-appropriate treatment. Unadjusted associations between communication items and treatment found that participants who felt that their physicians explained the risks and disadvantages of lung cancer treatment (P<0.01), discussed their chances of cure (P=0.02), discussed goals of treatment (P<0.01) or who were warm and friendly (P=0.04) were more likely to undergo treatment. Three communication domains were identified: treatment information, physician support, and patient symptoms/needs. After adjusting for known determinants of lung cancer treatment, increased treatment information was associated with higher probability of cancer-directed treatment (P=0.003). Other communication domains (physician support or patient symptoms/needs) were not independent predictors of treatment (P>0.05 for both comparisons). Conclusions These data suggest that treatment information is particularly important for increasing the probability of cancer-directed therapy among lung cancer patients. Clinicians should ensure that they clearly discuss treatment goals and options with patients while maintaining empathy, supporting patient needs, and addressing symptoms.

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“…The RIAS has been developed to analyze interactions in general practice, but the system is flexible and responsive to study context when tailored categories are added or elaborated [34]. The RIAS has been used in several physician-patient communication studies in oncology [31,[35][36][37][38][39] and has been adapted when necessary.…”

Section: Measurement Of Physician-patient Communicationmentioning

confidence: 99%

Patient participation in discussing palliative radiotherapy

Timmermans

Maazen

Verhaak

et al. 2005

Patient Education and Counseling

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The interaction between physician and patient communication behaviors in Japanese cancer consultations and the influence of personal and consultation characteristics

Cited by 45 publications

References 44 publications

A quantitative analysis of anaesthetist–patient communication during the pre‐operative visit

A quantitative analysis of anaesthetist–patient communication during the pre‐operative visit

Association of Patient–Provider Communication Domains with Lung Cancer Treatment

Patient participation in discussing palliative radiotherapy

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