scholarly journals Proposal for a Global Adherence Scale for Acute Conditions (GASAC): a prospective cohort study in two Emergency Departments

2019 ◽  
Author(s):  
Mélanie Sustersic ◽  
Aurélie Gauchet ◽  
Amélie Duvert ◽  
Laure Gonnet ◽  
Alison Foote ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Patient Communication ◽  
Public Health Issue ◽  
Good Doctor ◽  
Doctor Patient Communication ◽  
Acute Conditions ◽  
Adherence Scale ◽  
Communication Score ◽  
Internal Coherence ◽  
Hospital Emergency Departments

AbstractBackgroundAdherence in the context of patients with acute conditions is a major public health issue. It is neglected by the research community and no clinically validated generic scale exists to measure it.ObjectiveTo construct and validate a Global Adherence Scale usable in the context of Acute Conditions (GASAC) that takes into account adherence both to advice and to all types of prescriptions that the doctor may give. To measure adherence and to study its determinants.Materials and methodWe based the construction of the GASAC questionnaire on a theoretical model and a literature search. Then, between 2013 and 2014, we validated it in a prospective observational study in two hospital emergency departments. Patients were contacted by phone about one week after their consultation to answer several questionnaires, including GASAC and the Girerd self-administered questionnaire about medication adherence as a control.ResultsGASAC consists of four adherence subscales: drug prescriptions; blood test/ radiography prescriptions; lifestyle advice and follow-up instructions. An analysis of the 154 sets of answers from patients showed that the GASAC drug subscale had satisfactory internal coherence (Cronbach’s alpha = 0.78) and was correlated with the Girerd score, as was GASAC as a whole (p<0.01)). The median score was 0.93 IQR [0.78-1] for a maximum value of 1 (n = 154). In multivariate analysis, infection was more conducive of good adherence (cut off at ≥ 0.8; n=115/154; 74.7% [67.0-81.3]) than trauma (OR 3.69; CI [1.60-8.52]). The Doctor-Patient Communication score (OR 1.06 by score point, CI [1.02-1.10]) also influenced adherence.ConclusionsGASAC is a generic score to measure all dimensions of adherence in emergency departments for clinical research and the evaluation of clinical practice. The level of adherence was high for acute conditions and could be further improved by good Doctor-Patient Communication.

scholarly journals Impact of patient information leaflets on doctor–patient communication in the context of acute conditions: a prospective, controlled, before–after study in two French emergency departments

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024184 ◽  
Author(s):  
Mélanie Sustersic ◽  
Marisa Tissot ◽  
Julie Tyrant ◽  
Aurelie Gauchet ◽  
Alison Foote ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Information ◽  
Emergency Departments ◽  
Healthcare Professionals ◽  
Patient Communication ◽  
Doctor Patient Communication ◽  
Patient Information Leaflets ◽  
Information Leaflets ◽  
Acute Conditions ◽  
The Impact

ObjectiveIn the context of acute conditions seen in an emergency department, where communication may be difficult, patient information leaflets (PILs) could improve doctor–patient communication (DPC) and may have an impact on other outcomes of the consultation. Our objective was to assess the impact of PILs on DPC, patient satisfaction and adherence, and on patient and doctor behaviours.DesignProspective, controlled, before–after trial between November 2013 and June 2015.SettingTwo French emergency departments.ParticipantsAdults and adolescents >15 years diagnosed with ankle sprain or an infection (diverticulitis, infectious colitis, pyelonephritis, pneumonia or prostatitis).InterventionPhysicians in the intervention group gave patients a PIL about their condition along with an oral explanation.Main outcome measures7–10 days later, patients were contacted by phone to answer questionnaires. Results were derived from questions scored using a 4-point Likert scale.Main findingsAnalysis of the 324 patients showed that PILs improved the mean DPC score (range: 13–52), with 46 (42–49) for 168 patients with PILs vs 44 (38-48) for 156 patients without PILs (p<0.01). The adjusted OR for good communication (having a score >35/52) was 2.54 (1.27 to 5.06). The overall satisfaction and adherence scores did not show significant differences. In contrast, satisfaction with healthcare professionals and timing of medication intake were improved with PILs. The overall satisfaction score improved significantly on per-protocol analysis. When using PILs, doctors prescribed fewer drugs and more examinations (radiology, biology, appointment with a specialist); the need for a new medical consultation for the same pathology was reduced from 32.1% to 17.9% (OR 0.46 [0.27 to 0.77]), particularly revisiting the emergency department.ConclusionIn emergency departments, PILs given by doctors improve DPC, increase patients’ satisfaction with healthcare professionals, reduce the number of emergency reconsultations for the same pathology and modify the doctor’s behaviour.Trial registration numberNCT02246361.

scholarly journals Nationwide survey of patients’ and doctors’ perceptions of what is needed in doctor - patient communication in a Southeast Asian context

2020 ◽  
Author(s):  
Trung Quang Tran ◽  
Jan van Dalen ◽  
Albert Scherpbier ◽  
Dung van Do ◽  
E. Pamela Wright
Keyword(s):  
Medical Training ◽  
Southeast Asian ◽  
Patient Communication ◽  
Western World ◽  
Communication Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Good Doctor ◽  
Doctor Patient Communication ◽  
Key Skills

Abstract Background Asian countries are trying to apply the partnership model in doctor-patient communication that has been effectively applied in Western countries. The study aimed to investigate whether communication model used in the Western world are appropriate in Southeast Asia and to identify key items in doctor-patient communication that should be included in a doctor-patient communication model for training in Vietnam (a Southeast Asian country).Methods In six provinces, collaborating medical schools collected data from 480 patients interviewed using a structured guideline after a consultation session and from 473 doctors using a cross-sectional survey on how they conduct consultation sessions with patients. Data collection tools covered a list of communication skills based on Western models, adapted to fit with local legislation.Results Both patients and doctors considered most elements in the list necessary for good doctor-patient communication. Both also felt that while actual communication was generally good, there was also room for improvements. Furthermore, the doctors had higher expectations than the patients. Four items in the Western model for doctor-patient communication, all promoting the partnership relation between them, appeared to have lower priority for both patients and doctors in Vietnam.Conclusion The communication model used in the Western world could be applied in Vietnam with minor adaptations. Increasing patients’ understanding of their partner role needs to be considered. The implications for medical training in universities are to focus first on the key skills perceived as needed to be strengthened by both doctors and patients. In the longer term, all of these items should be included in the training to prepare for the future.

scholarly journals Nationwide survey of patients’ and doctors’ perceptions of what is needed in doctor - patient communication in a Southeast Asian context

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Trung Quang Tran ◽  
A. J. J. A. Scherpbier ◽  
Jan van Dalen ◽  
Dung Do Van ◽  
Elaine Pamela Wright
Keyword(s):  
Medical Training ◽  
Patient Communication ◽  
Western World ◽  
Communication Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Good Doctor ◽  
Doctor Patient Communication ◽  
Partnership Model ◽  
Key Skills

Abstract Background Asian countries are making efforts to apply the partnership model in doctor-patient communication that has been used effectively in Western countries. However, notable differences between Western and Asian cultures, especially the acceptance of a hierarchical order and little attention to individuality in Asian cultures, could mean that the application of the partnership model in Vietnam requires adaptation. The study aimed to investigate whether communication models used in the Western world are appropriate in Southeast Asia, and to identify key items in doctor-patient communication that should be included in a doctor-patient communication model for training in Vietnam. Methods In six provinces, collaborating medical schools collected data from 480 patients using face-to-face surveys with a structured guideline following a consultation session, and from 473 doctors using a cross-sectional survey on how they usually conduct consultation sessions with patients. Data collection tools covered a list of communication skills based on Western models, adapted to fit with local legislation. Using logistic regression, we examined whether doctor patient communication items and other factors were predictors of patient satisfaction. Results Both patients and doctors considered most elements in the list necessary for good doctor-patient communication. Both also felt that while actual communication was generally good, there was also room for improvement. Furthermore, the doctors had higher expectations than did the patients. Four items in the Western model for doctor-patient communication, all promoting the partnership relation between them, appeared to have lower priority for both patients and doctors in Vietnam. Conclusion The communication model used in the Western world could be applied in Vietnam with minor adaptations. Increasing patients’ understanding of their partner role needs to be considered. The implications for medical training in universities are to focus first on the key skills perceived as needing to be strengthened by both doctors and patients. In the longer term, all of these items should be included in the training to prepare for the future.

scholarly journals Proposal for a Global Adherence Scale for Acute Conditions (GASAC): A prospective cohort study in two emergency departments

PLoS ONE ◽  
2019 ◽  
Vol 14 (12) ◽  
pp. e0215415
Author(s):  
Mélanie Sustersic ◽  
Aurélie Gauchet ◽  
Amélie Duvert ◽  
Laure Gonnet ◽  
Alison Foote ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Emergency Departments ◽  
Prospective Cohort ◽  
Acute Conditions ◽  
Adherence Scale

scholarly journals A Study of Patient-Physician Communication and Barriers in Communication

2015 ◽  
Vol 3 (2) ◽  
pp. 71-78
Author(s):  
Ashok Mittal ◽  
Ginny Kaushal ◽  
Nikita Sabherwal ◽  
NK Pandey ◽  
Paul Kaustav
Keyword(s):  
Patient Safety ◽  
Partial Information ◽  
Patient Communication ◽  
Physician Communication ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Good Doctor ◽  
Doctor Patient Communication ◽  
Healthcare Settings ◽  
Self Administered Questionnaire

ABSTRACT Context Effective doctor-patient communication is the basic requirement in building a good doctor-patient relationship. Safe practices and effective, patient-centered communication is key to quality care. Good doctor-patient communication has the potential to help regulate patients’ emotions, facilitate comprehension of medical information and allow for better identification of patients’ needs, perceptions and expectations. Doctors with better communication and interpersonal skills are able to detect problems earlier, can prevent medical crisis and expensive intervention, and provide better support to their patients. Current research indicates that ineffective communication among healthcare professionals is one of the leading causes of medical errors and patient harm. There are many barriers to good communication in the doctor-patient relationship, including patients’ anxiety and fear, doctors’ burden of work, fear of litigation, fear of physical or verbal abuse, and unrealistic patient expectations. National accreditation board for hospitals and healthcare providers (NABH) standards and international patient safety goals focus on the importance of effective communication in healthcare settings and how it leads to patient safety. This study is an attempt to identify gaps in patient physician communication in the current healthcare settings, find the barriers in communication and give recommendation to enhance good practices in the future. Aims The aim of the study is to analyze the current levels of effective patient communication in a tertiary care hospital in Delhi-NCR with help of a self-administered questionnaire. The study will assess the level of information shared with the patient. Settings and design The design of our proposed study is a descriptive study where we will use a self-administered questionnaire to assess the level of patient-physician communication in the selected study setting. Materials and methods The NABH standard were used as a guideline for preparing the self-administered questionnaire. All admitted vulnerable patients of the selected study area will consist of the population for the study. Simple random sampling technique will be used to derive the sample out of the population. Statistical analysis used Correlation and analysis of variance (ANOVA) were used to establish associations between the independent and dependent variables. Results The study shows that 48% of the respondents were of opinion that they were given partial information, while 20% of the respondents alleged that they were not given any information about the explanation of their disease, its prognosis and the treatment option that were available, i.e. a total of 62% of the patients said that they had partial information to complete lack of information that would have made them aware of their diseases, its prognosis and the treatments options available to cure it, while only 32% of the patients agreed that they were supplied with thorough information during their interaction with the physicians. Conclusion The majority of the patients were not wellinformed about their disease, its prognosis, treatment plan and continuity of care. There was a significant positive correlation between the communication made at initial stages of hospital stay and during the end stages of stay of patient. The main barrier to patient physician communication was time. Key message To ensure patient safety, it is imperative to inform patients about all the important aspects starting from admission till discharge. How to cite this article Sabherwal N, Mittal A, Pandey NK, Kaushal G, Kaustav P. A Study of Patient-Physician Communication and Barriers in Communication. Int J Res Foundation Hosp Healthc Adm 2015;3(2):71-78.

scholarly journals A multidimensional view of racial differences in access to prostate cancer care.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18048-e18048
Author(s):  
Craig Evan Pollack ◽  
Katrina Armstrong ◽  
Nandita Mitra ◽  
Xinwei Chen ◽  
Katelyn R Ward ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Black Men ◽  
Racial Differences ◽  
Cancer Care ◽  
Patient Communication ◽  
Definitive Treatment ◽  
Satisfaction With Care ◽  
Good Doctor ◽  
Doctor Patient Communication

e18048 Background: Racial differences in prostate cancer treatment and outcomes are widespread and poorly understood. We sought to determine whether access to care, measured across multiple dimensions, contribute to racial differences in prostate cancer. Methods: The Philadelphia Area Prostate Cancer Access Study (P2 Access) included 2374 men diagnosed with localized prostate cancer from 2012 to 2014. Patient survey data was used to determine experiences of accessing prostate cancer care (response rate 51.1%). An audit survey using simulated patient calls was used to determine appointment availability and wait times at 151 urology practices. Patient and practice addresses were geocoded to construct distance measures. We used multivariable logistic regression models to determine the association between five different domains of access—availability, accessibility, accommodation, affordability, and acceptability—and receipt of definitive treatment with radical prostatectomy or radiation, satisfaction with care, and doctor-patient communication. Results: There were 1907 non-Hispanic white and 394 black men in our cohort, the majority (71%) with stage 1 disease. Overall, 85% of men received definitive treatment with no differences by race. None of the access domains were significantly associated with definitive treatment overall or with radical prostatectomy in adjusted models. Black men were less likely to report good doctor-patient communication (60% vs 71%, p < 0.001) and high satisfaction with their care (69% vs 81%, p < 0.001). Communication ratings remained significantly lower among black men compared to white men in adjusted models (odds ratio = 1.49, 95% Confidence Interval 1.03, 2.16). Each domain of access was significantly associated with lower satisfaction with care and worse communication; however, differences in access did not mediate racial disparities for these measures. Conclusions: This study presents the first comprehensive assessment of access to prostate cancer care, showing that while access was related to overall satisfaction and better doctor-patient communication, it did not appear to explain racial differences in these measures of cancer care.

Doctor-Patient Communication in Palliative Care

2014 ◽  
pp. 143-148
Author(s):  
William S. Breitbart
Keyword(s):  
Communication Skills ◽  
Training Programs ◽  
Communication Training ◽  
Patient Communication ◽  
Adjustment Disorders ◽  
Good Doctor ◽  
Doctor Patient Communication ◽  
Clinical Encounters ◽  
Communication Problems ◽  
Dying Patient

Doctor-patient communication is an essential component in caring for a dying patient. Communication problems have been identified in 84% to 94% of clinical encounters. Good doctor-patient communication reduces the risk of iatrogenic suffering, mood, anxiety, and adjustment disorders among cancer patients and their families. This chapter provides an overview of the guidelines for communication and empathy in caring for terminally ill patients, including essential strategies for effective doctor-patient communication, core communication skills, and teaching methods utilized in communication training programs.

scholarly journals Perception of patients with chronic respiratory disorders regarding doctor-patient communication at a tertiary care hospital

2021 ◽  
Vol 6 (2) ◽  
pp. 71-75
Author(s):  
Dimple Shah ◽  
Shreya Patel ◽  
Varsha J Patel
Keyword(s):  
Patient Satisfaction ◽  
Tertiary Care Hospital ◽  
Treatment Plan ◽  
Tertiary Care ◽  
Patient Communication ◽  
Care Hospital ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Good Doctor ◽  
Doctor Patient Communication

It is believed that doctor-patient relationship is an important determinant in patient’s adherence to the treatment. The doctor-patient relationship can be seen as the perception of the patient concerning shown by the doctor, and the attitude and behaviour of the doctor towards the patient. For management of chronic illness where patient adherence to treatment is challenging, good doctor patient communication is very essential. This study was planned to assess the doctor patient communication status, effectiveness and patient satisfaction resulting after consultation with the doctor in a tertiary care setting.This study aims to assess the doctor-patient communication status, patient satisfaction level and identify the factors affecting the communication with the patients. This was a cross-sectional questionnaire based analytical study. The questionnaire mainly included various questions to assess the patient satisfaction in terms of time spent by doctor during visit, examination performed, discussion on treatment plan, medication dosage and side effects explained, response to patient questions and concern and overall satisfaction of the site visit. The study population included patients of Chronic Obstructive Pulmonary Diseases (COPD) and bronchial asthma attending the outpatient departments of Medicine and Respiratory Medicine of a tertiary care hospital. Total 70 patients had filled the questionnaire and all of them were satisfied with their visit with attending physician in OPD. Age, education level and income class affect the satisfaction score of participants.Overall the study showed a good level of satisfaction of patients with services obtained from this tertiary care centre. Physician can improve the doctor-patient communication by empathising with the patients and rendering them sufficient time to explain the treatment regimens.

scholarly journals A scale assessing doctor-patient communication in a context of acute conditions based on a systematic review

PLoS ONE ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. e0192306 ◽  
Author(s):  
Mélanie Sustersic ◽  
Aurélie Gauchet ◽  
Anaïs Kernou ◽  
Charlotte Gibert ◽  
Alison Foote ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Communication ◽  
Doctor Patient Communication ◽  
Acute Conditions

scholarly journals Dermatology patients’ and their doctors’ representations about adherence

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Csanád Szabó ◽  
Lajos Kemény ◽  
Márta Csabai
Keyword(s):  
Multidimensional Scaling ◽  
Patient Adherence ◽  
Patient Communication ◽  
Background Information ◽  
Evidence Based ◽  
Quantitative Methodology ◽  
Patient Relationship ◽  
Good Doctor ◽  
Doctor Patient Communication ◽  
Basic Determinant

AbstractThe aim of our study was to identify representations about patient adherence among dermatologists (N=40) and their patients (N=153). A combined qualitative-quantitative methodology was applied. Dermatologists identified good doctor-patient relationship, information from the doctor, and background information as the most important determinants of adherence. In patients’ rankings, information from the doctor and understandable communication received the highest scores. Multidimensional scaling arranged patients’ results into four content groups which helped to reveal the structure of the representations. Our results may contribute to the evidence-based confirmation that transparency of views and expectations in doctor-patient communication is a basic determinant of successful adherence.

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