Supplemental Material for Medical Consultation Experience Questionnaire: Assessing Perceived Alliance and Experienced Confusion During Medical Consultations

2018 ◽  
Vol 30 (11) ◽  
pp. 1499-1511 ◽  
Author(s):  
Keith Sanford ◽  
Alannah Shelby Rivers ◽  
Tara L. Braun ◽  
Kelly P. Schultz ◽  
Edward P. Buchanan

2020 ◽  
Author(s):  
Muhammad Zakaria ◽  
Rezaul Karim ◽  
Murshida Rahman ◽  
Feng Cheng ◽  
Junfang Xu

Abstract Background: Physician-patient communication is the primary process by which medical decision-making occurs and health outcome depends. Physician-patient communication differences may partly from the ethnic disparities. To examine this problem, this study aims to explore whether physician-patient communication differs by ethnic in primary care medical consultations. Methods: The study was conducted among the Bengali and ethnic minority patients (N = 850) who visited the physician for medical consultations. Data were collected using a structured post-consultation questionnaire. T-test was conducted to compare the communication between the Bengali and ethnic minority patients. Multiple linear regression analyses were performed to identify the factors associated with favorable communication behavior from the physicians. Results: Bengali patients received more supportive communication behaviors from the Bengali doctors than that of ethnic minority patients including physicians’ cheerful greetings, encouraging patients to express health problems and asking questions, listening carefully, responding to the questions and concerns, explaining the patients about a medical test, medication, and probable side effects, discussing the treatment options, involved the patients in decisions and spending adequate time. Results of linear regression explored that respondents’ education year, internet use, knowledge on the health problem, having a pre-plan about the content of medical consultation, information seeking about the health problem, visiting female doctors, and quiet ambience of the doctor’s room are significantly associated with better PPCB score for the Bengali patients. In contrast, age, being the resident of an urban area, perception of affecting a minor health problem, having a pre-plan about the content of medical consultation, patients’ involvement in physicians’ decision-making about the treatment, and talking time resulted in better physician-patient communication for the ethnic minority patients. Conclusion: This study suggests for reducing the disparity in the socio-economic status of the ethnic minority people through development program and teaching healthcare providers how to use patient-centered communication skills to engage their patients is one solution to improve equity in the delivery of healthcare and make sure patients are receiving high-quality treatment, no matter their race or ethnicity.


PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0236933
Author(s):  
Robyn Fernando ◽  
Ashley C. McDowell ◽  
Rajita Bhavaraju ◽  
Henry Fraimow ◽  
John W. Wilson ◽  
...  

2013 ◽  
Vol 9 (2) ◽  
pp. 159-171 ◽  
Author(s):  
Caroline H. Vickers ◽  
Ryan Goble ◽  
Christopher Lindfelt

The purpose of this paper is to examine patient-provider narrative co-construction of symptoms, diagnosis and treatment in the medical consultation. Narrative scholarship has demonstrated that conversational narratives, including those that take place in medical consultations, are typically co-constructed by all participants within the conversation. In the context of the medical consultation, this means that patient narratives are co-constructed with providers, and that at times, provider contributions to the patient narrative can hide patient contributions. The inherent power asymmetry that exists between patient and provider facilitates the possibility for provider contributions to obscure those of the patient. Based on audio-recorded data from medical consultations between two different nurse practitioners and one patient, findings from this study demonstrate that such narrative co-construction leads to differential information regarding the patient’s symptoms, diagnosis and treatment. Implications include the need for providers to relinquish control over to the patient to allow the patient to fully articulate narrative accounts of their medical issues.


2012 ◽  
Vol 116 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Duminda N. Wijeysundera ◽  
Peter C. Austin ◽  
W. Scott Beattie ◽  
Janet E. Hux ◽  
Andreas Laupacis

Background Patients scheduled for major elective noncardiac surgery frequently undergo preoperative medical consultations. However, the factors that determine whether individuals undergo consultation and the extent of interhospital variation remain unclear. Methods The authors used population-based administrative databases to conduct a cohort study of patients, aged 40 yr or older, who underwent major elective noncardiac surgery in Ontario, Canada, between April 2004 and February 2009. Multilevel logistic regression models were used to identify patient- and hospital-level predictors of consultation. Results Within the cohort of 204,819 patients who underwent surgery at 79 hospitals, 38% (n = 77,965) underwent preoperative medical consultation. Although patient- and surgery-level factors did predict consultation use, they explained only 5.9% of variation in consultation rates. Differences in rates across hospitals were large (range, 10-897 per 1,000 procedures), were not explained by surgical procedure volume or hospital teaching status, and persisted after adjustment for patient- and surgery-level factors. The median odds of undergoing consultation were 3.51 times higher if the same patient had surgery at one randomly selected hospital as opposed to another. Conclusions One-third of surgical patients undergo preoperative medical consultation. Although patient- and surgery-level factors are weak predictors of consultation use, the individual hospital is the major determinant of whether patients undergo consultation. Additional research is needed to better understand the basis for this substantial interhospital variation and to determine which patients benefit most from preoperative consultation.


Author(s):  
Amal Ponathil ◽  
Aasish Bhanu ◽  
Hunter Rogers ◽  
Mackenzie Wilson ◽  
Kapil Chalil Madathil

Telemedicine allows providers to facilitate online medical consultation to patients when there is a geo-graphical distance between them. Similar to other medical consultations, consent is required to receive medical care. Teleconsent, developed to accommodate this requirement, allows providers to collect patient consent via screen-sharing and videoconferencing. However, its usability needs to be evaluated to improve user acceptance. This study uses a heuristic evaluation to identify the usability issues associated with a tele-consent interface. Based on Nielsen’s 10 heuristics, four experts independently evaluated the consent form on two devices (desktop and smartphone), identified violations and assigned severity. Of the 70 violations identified 33.43% violated consistency and standards and 20% violated user control and freedom. Issues requiring immediate attention included the patient’s inability to scroll and zoom (specific to smartphone) while navigating the consent form and the unintuitive signing process. Remediations were suggested to improve the teleconsent system usability.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Muhammad Zakaria ◽  
Rezaul Karim ◽  
Murshida Rahman ◽  
Feng Cheng ◽  
Junfang Xu

Abstract Background Physician-patient communication behavior (PPCB) is the primary process by which medical decision-making occurs and health outcome depends. Physician-patient communication differences may partly from the ethnic disparities. To examine this problem, this study aims to explore whether physician-patient communication differs by ethnicity during primary care medical consultations. Methods The study was conducted among the Bengali and ethnic minority patients (N = 850) who visited a physician for medical consultations. Data were collected using a structured post-consultation questionnaire. T-test was conducted to compare the communication between the Bengali and ethnic minority patients. Multiple linear regression analyses were performed to identify the factors associated with favorable communication behavior from the physicians. Results Bengali patients received more supportive communication behaviors from the Bengali doctors than that of ethnic minority patients including physicians’ cheerful greetings, encouraging patients to express health problems and asking questions, listening carefully, responding to questions and concerns, explaining to patients about medical examination procedures, medication, probable side effects, discussing treatment options, involved the patients in decisions, and spending adequate time. Results of linear regression showed that respondents’ level of education, internet use, knowledge about the health issue, having a pre-organized plan about the content of medical consultation, information seeking about the health problem, visiting female doctors, and a quiet ambience of the doctor’s room are significantly associated with a better PPCB score for the Bengali patients. In contrast, age, being the resident of an urban area, perception of affecting a minor health problem, having a pre-organized plan about the content of medical consultation, patients’ involvement in physicians’ decision-making about the treatment, and talking time resulted in better physician-patient communication for the ethnic minority patients. Conclusion This study suggests that reducing disparity in the socio-economic status of the ethnic minority groups through development programs and educating healthcare providers on how to use patient-centered communication skills to engage with their patients is one solution to improve equity in the delivery of healthcare and ensure than patients are receiving high-quality treatment, no matter their race or ethnicity.


2021 ◽  
Vol 11 (13) ◽  
pp. 5886
Author(s):  
Matías Galnares ◽  
Sergio Nesmachnow ◽  
Franco Simini

This article presents an automatic system for modeling clinical knowledge to follow a physician’s reasoning in medical consultation. Instance-based learning is applied to provide suggestions when recording electronic medical records. The system was validated on a real case study involving advanced medical students. The proposed system is accurate and efficient: 2.5× more efficient than a baseline empirical tool for suggestions and two orders of magnitude faster than a Bayesian learning method, when processing a testbed of 250 clinical case types. The research provides a framework to implement a real-time system to assist physicians during medical consultations.


2021 ◽  
Vol 12 (3) ◽  
pp. 390-409
Author(s):  
Zhou-min Yuan ◽  
Xingchen Shen

Abstract While previous studies highlight the dynamic nature of identity co-construction, how and especially why speakers construct and shift their own multiple identities still remains understudied. The present study argues that identity is part of speaker communicative resources as evidenced by radio program hosts’ strategic employment and shift among their different identities to facilitate their interactional purposes. Based on data drawn from radio medical consultations, this article attempts to reveal the dynamic adaptability of hosts’ identity construction. It is found that (1) in general, hosts of medical consultation programs construct three identities for themselves, namely an authoritative expert identity, a caring friend identity and a sales representative identity; (2) the three identities constructed are respectively adaptable to power relationships, solidarity and role relationships between hosts and callers in conversation; (3) the three identities shift in conversations to facilitate callers’ purchasing acts.


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