Understanding the multi-dimensional nature of informational language in health care interactions

2020 ◽  
Vol 2 (2) ◽  
pp. 241-274
Author(s):  
Shelley Staples ◽  
Maria K. Venetis ◽  
Jeffrey D. Robinson ◽  
Rachel Dultz
Keyword(s):  
Health Care ◽  
Language Use ◽  
Treatment Options ◽  
Information Provision ◽  
Discourse Markers ◽  
Medical Discourse ◽  
Multidimensional Analysis ◽  
Patient Centered ◽  
Procedural Information ◽  
Centered Care

Abstract Much of the corpus-based research on medical discourse has focused on “involved” language (e.g., 1st person pronouns, discourse markers) and its importance in creating patient rapport (Adolphs, Brown, Carter, Crawford, & Sahota, 2004; Skelton & Hobbes, 1999; Staples, 2016). However, in the broader literature on health care interactions, providers’ information provision is equally important in patient-centered care (Ong, de Haes, Joos, & Lammes, 1995). This paper investigates the ways in which providers and patients use informational language in medical discourse using multidimensional analysis (MDA; Biber, 1988). We first examine three corpora of medical interactions and then focus a new MDA on one type of interaction that requires more informational language use: discussions of disease and treatment options. The analysis revealed multifaceted aspects of information provision that differ depending on the nature of the information, including providers’ procedural information for medical treatment and impersonal information provision for explaining the disease.

scholarly journals Kidney cancer survivorship care: Patient experiences in a Canadian setting

2019 ◽  
Vol 14 (11) ◽  
Author(s):  
Yeshith Rai ◽  
Shiyu Zheng ◽  
Heather Chappell ◽  
Menaka Pulandiran ◽  
Jennifer Jones
Keyword(s):  
Kidney Cancer ◽  
Large Scale ◽  
Barriers To Care ◽  
Financial Burden ◽  
Treatment Options ◽  
Information Provision ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

Introduction: The incidence of kidney cancer (KCa) in Canada is rising. Despite this, there is a shortage of research assessing KCa care experiences. This study aims to explore the current experiences of KCa survivors related to treatment and management, information provision, and barriers to care. Methods: A cross-sectional, descriptive study of KCa patients was conducted online and through various cancer centers across Canada. English- and French-speaking adults who received a KCa diagnosis and were currently undergoing treatment or had completed treatment in Canada were eligible to participate. Results: In total, 368 surveys were completed. Ten percent of respondents had not yet received treatment, 29% were receiving treatment, and 56% had completed treatment. Most respondents (72%) had localized KCa (stage 0–3) at diagnosis. Sixty-one percent of respondents reported that their doctors discussed various treatment options with them and 24% reported discussing applicable clinical trials. Most (85%) respondents received information about their KCa and 36% discussed where to get information about their disease and support. The most commonly reported barriers to care were side effects (26%), system delays (26%), not having access to certain treatments (25%), and financial burden (24%). More participants in Central Region and Quebec (p=0.004) and rural/suburban (p=0.014) areas reported lacking access to certain treatments and KCa experts. Conclusions: This was the first large-scale study to explore access to care experiences of Canadian KCa survivors. Results show examples of good patient-centered care and provide new practical information that can inform efforts to improve patient-centered care for KCa patients.

scholarly journals Concordance and Patient-Centered Care in Medicaid Enrollees’ Care Experience With Providers

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Iwimbong Kum Ghabowen ◽  
Neeraj Bhandari
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Patient Centered Care ◽  
Care Utilization ◽  
Federal State ◽  
Patient Centered ◽  
Care Experience ◽  
Centered Care ◽  
State And Local ◽  
Privately Insured

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, controlling for sociodemographic factors, health care access, and health care utilization of respondents. Compared to Medicare and privately insured enrollees, Medicaid enrollees reported much lower odds of seeing providers who treated them with respect (OR = 1.91, P < .001; OR = 1.62, P < .01) and who offered PCC (OR = 1.35, P < .05; OR = 1.35, P < .01), but similar odds of seeing concordant providers (OR = 0.78, P = .96; OR = 0.96, P = .72). Importantly, Medicaid enrollees reported higher odds of seeing providers who solicited their opinion/beliefs/preferences than their Medicare or privately insured counterparts (OR = 0.82, P < .05; OR = 0.87 P < .10). Medicaid enrollees report less patient-centered experiences in some important facets of their provider interaction than their Medicare or privately insured counterparts. Federal, state, and local policies and practices directed at improving these facets of patient–provider interaction are needed and should be aimed squarely at Medicaid providers, especially those working in geographic areas and settings with a disproportionate number of racial, gender, cultural, and linguistic minorities.

Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Victor Okunrintemi ◽  
Erica Spatz ◽  
Joseph Salami ◽  
Haider Warraich ◽  
Salim Virani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Atherosclerotic Cardiovascular Disease ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care ◽  
Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

scholarly journals Unique Challenges for Otolaryngology Patients During the COVID-19 Pandemic

2020 ◽  
pp. 019459982095483
Author(s):  
Melissa Ghulam-Smith ◽  
Yeyoon Choi ◽  
Heather Edwards ◽  
Jessica R. Levi
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Intimate Contact ◽  
Respiratory Mucosa ◽  
Increased Risk ◽  
Centered Care ◽  
Upper Respiratory

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.

scholarly journals Management strategy of healthcare organizations. PDRQ–9 method

2021 ◽  
pp. 243-248
Author(s):  
Ch. E. Karibdzhanov
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Research ◽  
New Paradigm ◽  
Healthcare Organizations ◽  
Patient Centered ◽  
Brief Assessment ◽  
Centered Care ◽  
Physician Relationship ◽  
Care System

The main source of success for a customer-centric organization is the ability to identify its customers, identify their needs, and use that information to develop a customer-centric strategy. In this regard, there is a widespread change in attitudes toward the construction of management in organizations. Whereas previously the competitiveness of an organization could be measured by its financial performance, now the intellectual potential of an organization is at the forefront. As the role of the patient in the health care system has intensified, the importance of patient participation has received increasing attention and has become central to health care research. In this regard, in today’s environment, the foundation of success in the treatment and delivery of professional care in medicine is primarily the degree of patient satisfaction. Patient-centered care acts as a new paradigm for the development of the health care system, which is characterized by a shift in the center of gravity to the patient. In this regard, in the field of health care, the relationship between the patient and the doctor, as perceived by the patient, is one of the main elements of the methodology of scientific research. The purpose of this article is to review and analyze the results of the PDRQ–9, which assesses the patient-physician relationship. The PDRQ–9 provides researchers with a brief assessment of the therapeutic aspects of the patient-physician relationship in the primary care setting. It is a valuable tool for research and practice purposes that includes monitoring the patient-doctor relationship.

scholarly journals Instilling the core concept of inter professional education

1970 ◽  
Vol 9 (3) ◽  
pp. 201-206
Author(s):  
S Bhattacharya ◽  
SK Bhattacharya ◽  
AP Gautam
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Care Providers ◽  
Professional Education ◽  
Care Delivery ◽  
Care Providers ◽  
Patient Centered ◽  
Innovative Teaching ◽  
Centered Care ◽  
Teaching Learning

The Inter Professional Education (IPE) is an innovative teaching learning intervention in Health Professions’ Education during which members of more than one health profession learn interactively together to improve collaborative practice and/health of the patients. Thus this approach provides positive outcomes for students enhancing their awareness towards other professional groups, improving knowledge and understanding of how to work in an inter professional team and strengthening their communication and collaboration skills. Within the hierarchical nature of many clinical settings, the aims of IPE courses intersect with socialization of health professional (HP) students into roles of responsibility and authority. The IPE in HP courses emphasizes the practice of frequent high quality communication, strong relationships and partnerships among health care providers to maximize the quality of care thus improving the efficiency of care thereby improving clinical outcomes. Health Professional Schools are this motivated to opt for inter professional education to improve the learning of the students, health care delivery and patient outcomes. Keywords: Inter professional relations; patient centered care; education DOI: http://dx.doi.org/10.3126/hren.v9i3.5591   HR 2011; 9(3): 201-206

An Integrative Approach to Abdominal Pain

2019 ◽  
pp. 339-362
Author(s):  
Marika Alois ◽  
Terry Kit Selfe ◽  
Irene M. Estores
Keyword(s):  
Health Care ◽  
Abdominal Pain ◽  
Health Care Professionals ◽  
Gastrointestinal Disease ◽  
Integrative Approach ◽  
Patient Centered ◽  
Integrative Health ◽  
Bowel Diseases ◽  
Centered Care ◽  
Functional Gastrointestinal Disease

This chapter discusses abdominal pain in the context of functional gastrointestinal disease (FGID) and some chronic inflammatory bowel diseases, recognizing the huge burden it places on the health care system and emotional costs to patients and health care professionals. It presents a review of several modalities that include mind–body medicine practices, natural products, botanicals, manual and movement-based therapies, and pharmaceuticals that can be used as part of an integrative health plan for patients presenting with FGID and abdominal pain. It describes an integrative approach that weaves in concepts of patient-centered care, effective communication, empathic listening, mindfulness, and evidence-informed practice.

scholarly journals Varieties of Uncertainty in Health Care

2011 ◽  
Vol 31 (6) ◽  
pp. 828-838 ◽  
Author(s):  
Paul K. J. Han ◽  
William M. P. Klein ◽  
Neeraj K. Arora
Keyword(s):  
Health Care ◽  
Empirical Literature ◽  
Evidence Based ◽  
Shared Decision ◽  
Services Research ◽  
Patient Centered ◽  
3 Dimensional ◽  
Centered Care ◽  
Multiple Meanings ◽  
Based Medicine

Uncertainty is a pervasive and important problem that has attracted increasing attention in health care, given the growing emphasis on evidence-based medicine, shared decision making, and patient-centered care. However, our understanding of this problem is limited, in part because of the absence of a unified, coherent concept of uncertainty. There are multiple meanings and varieties of uncertainty in health care that are not often distinguished or acknowledged although each may have unique effects or warrant different courses of action. The literature on uncertainty in health care is thus fragmented, and existing insights have been incompletely translated to clinical practice. This article addresses this problem by synthesizing diverse theoretical and empirical literature from the fields of communication, decision science, engineering, health services research, and psychology and developing a new integrative conceptual taxonomy of uncertainty. A 3-dimensional taxonomy is proposed that characterizes uncertainty in health care according to its fundamental sources, issues, and locus. It is shown how this new taxonomy facilitates an organized approach to the problem of uncertainty in health care by clarifying its nature and prognosis and suggesting appropriate strategies for its analysis and management.

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