scholarly journals Disparity in physician-patient communication by ethnicity: evidence from Bangladesh

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Muhammad Zakaria ◽  
Rezaul Karim ◽  
Murshida Rahman ◽  
Feng Cheng ◽  
Junfang Xu
Keyword(s):  
Decision Making ◽  
Linear Regression ◽  
Ethnic Minority ◽  
Health Problem ◽  
Patient Communication ◽  
Medical Consultation ◽  
Communication Behavior ◽  
Medical Consultations ◽  
Physician Patient Communication ◽  
Physician Patient

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.

scholarly journals Disparity in physician-patient communication by ethnicity: evidence from Bangladesh

2021 ◽  
Author(s):  
Muhammad Zakaria ◽  
Rezaul Karim ◽  
Murshida Rahman ◽  
Feng Cheng ◽  
Junfang Xu
Keyword(s):  
Decision Making ◽  
Linear Regression ◽  
Ethnic Minority ◽  
Health Problem ◽  
Patient Communication ◽  
Medical Consultation ◽  
Communication Behavior ◽  
Medical Consultations ◽  
Physician Patient Communication ◽  
Physician Patient

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.

scholarly journals Disparity in Physician-Patient Communication by Ethnicity: Evidence from Bangladesh

2020 ◽  
Author(s):  
Muhammad Zakaria ◽  
Rezaul Karim ◽  
Murshida Rahman ◽  
Feng Cheng ◽  
Junfang Xu
Keyword(s):  
Decision Making ◽  
Linear Regression ◽  
Ethnic Minority ◽  
Health Problem ◽  
Patient Communication ◽  
Medical Consultation ◽  
Medical Decision ◽  
Medical Consultations ◽  
Physician Patient Communication ◽  
Physician Patient

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.

scholarly journals Variance components of ratings of physician-patient communication: A generalizability theory analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252968
Author(s):  
Nicole Röttele ◽  
Christian Schlett ◽  
Mirjam Körner ◽  
Erik Farin-Glattacker ◽  
Andrea C. Schöpf-Lazzarino ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Variance Components ◽  
Generalizability Theory ◽  
Patient Communication ◽  
Communication Behavior ◽  
Shared Decision ◽  
Open Communication ◽  
Physician Patient Communication ◽  
Physician Patient

Background The ratings of physician-patient communication are an important indicator of the quality of health care delivery and provide guidance for many important decisions in the health care setting and in health research. But there is no gold standard to assess physician-patient communication. Thus, depending on the specific measurement condition, multiple sources of variance may contribute to the total score variance of ratings of physician-patient communication. This may systematically impair the validity of conclusions drawn from rating data. Objective To examine the extent to which different measurement conditions and rater perspectives, respectively contribute to the variance of physician-patient communication ratings. Methods Variance components of ratings of physician-patient communication gained from 32 general practitioners and 252 patients from 25 family practices in Germany were analyzed using generalizability theory. The communication dimensions “shared decision making”, “effective and open communication” and “satisfaction” were considered. Results Physician-patient communication ratings most substantially reflect unique rater-perspective and communication dimension combinations (32.7% interaction effect). The ratings also represented unique physician and rater-perspective combinations (16.3% interaction effect). However, physicians’ communication behavior and the observed communication dimensions revealed only a low extent of score variance (1% physician effect; 3.7% communication dimension effect). Approximately half of the variance remained unexplained (46.2% three-way interaction, confounded with error). Conclusion The ratings of physician-patient communication minimally reflect physician communication skills in general. Instead, these ratings exhibit primarily differences among physicians and patients in their tendency to perceive shared decision making and effective and open communication and to be satisfied with communication, regardless of the communication behavior of physicians. Rater training and assessing low inferential ratings of physician-patient communication dimensions should be considered when subjective aspects of rater perspectives are not of interest.

scholarly journals Physician-Patient Communication in Decision-Making about Caesarean Sections in Eight District Hospitals in Bangladesh: A Mixed-Method Study

2020 ◽  
Author(s):  
Sathyanarayanan Doraiswamy ◽  
Sk Masum Billah ◽  
Farhana Karim ◽  
Md. Shahjahan Siraj ◽  
Alan Buckingham ◽  
...  
Keyword(s):  
Decision Making ◽  
Mixed Method ◽  
Patient Preferences ◽  
Clinical Encounter ◽  
Patient Communication ◽  
Mixed Method Study ◽  
Eligibility Criteria ◽  
District Hospitals ◽  
Physician Patient Communication ◽  
Physician Patient

Abstract Background: Caesarean sections (CS) in Bangladesh have risen eight-fold in the last 15 years. Few studies have explored why. Anecdotally, physicians suggest maternal request for CS is a reason. Women and families suggest physicians influence their decision-making. The aim of this research was to understand more about the decision-making process surrounding CS by exploring physician-patient communication leading to informed-consent for the operation. Methods: We conducted a mixed-method study using structured observations with the Option Grid Collaborative’s OPTION5 tool and interviews with physicians and women between July and December 2018. Study participants were recruited from eight district public-sector hospitals. Eligibility criteria for facilities was ≥80 births every month; and for physicians, was that they had performed CSs. Women aged ≥18 years, providing consent, and delivering at a facility were included in the observation component; primigravid women delivering by CS were selected for the in-depth interviews. Quantitative data from observations were analysed using descriptive statistics. Following transcription and translation, a preliminary coding framework was devised for the qualitative data analysis. We combined both inductive and deductive approaches in our thematic analysis. Results: In total, 306 labour situations were observed, and interviews were conducted with 16 physicians and 32 women who delivered by CS (16 emergency CS; 16 elective CS). In 92.5% of observations of physician-patient communication in the context of labour situations, the OPTION5 mean scores were low (5-25 out of 100) for presenting options, patient partnership, describing pros/cons, eliciting patient preferences and integrating patient preferences. Interviews found that non-clinical factors prime both physicians and patients in favour of CS prior to the clinical encounter in which the decision to perform a CS is documented. These interactions were both minimal in content and limited in purpose, with consent being an artefact of a process involving little communication.Conclusions: Insufficient communication between physicians and patients is one of many factors driving increasing rates of caesarean section in Bangladesh. While this single clinical encounter provides an opportunity for practice improvement, interventions are unlikley to impact rates of CS without simultaneoulsy addressing physician, patient and health system contextual factors too.

scholarly journals Physician-patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: A mixed-method study

2020 ◽  
Author(s):  
Sathyanarayanan Doraiswamy ◽  
Sk Masum Billah ◽  
Farhana Karim ◽  
Md. Shahjahan Siraj ◽  
Alan Buckingham ◽  
...  
Keyword(s):  
Decision Making ◽  
Mixed Method ◽  
Patient Preferences ◽  
Clinical Encounter ◽  
Patient Communication ◽  
Mixed Method Study ◽  
Eligibility Criteria ◽  
District Hospitals ◽  
Physician Patient Communication ◽  
Physician Patient

Abstract Background: Caesarean sections (CS) in Bangladesh have risen eight-fold in the last 15 years. Few studies have explored why. Anecdotally, physicians suggest maternal request for CS is a reason. Women and families suggest physicians influence their decision-making. The aim of this research was to understand more about the decision-making process surrounding CS by exploring physician-patient communication leading to informed-consent for the operation. Methods: We conducted a mixed-method study using structured observations with the Option Grid Collaborative’s OPTION5 tool and interviews with physicians and women between July and December 2018. Study participants were recruited from eight district public-sector hospitals. Eligibility criteria for facilities was ≥80 births every month; and for physicians, was that they had performed CSs. Women aged ≥18 years, providing consent, and delivering at a facility were included in the observation component; primigravid women delivering by CS were selected for the in-depth interviews. Quantitative data from observations were analysed using descriptive statistics. Following transcription and translation, a preliminary coding framework was devised for the qualitative data analysis. We combined both inductive and deductive approaches in our thematic analysis. Results: In total, 306 labour situations were observed, and interviews were conducted with 16 physicians and 32 women who delivered by CS (16 emergency CS; 16 elective CS). In 92.5% of observations of physician-patient communication in the context of labour situations, the OPTION5 mean scores were low (5-25 out of 100) for presenting options, patient partnership, describing pros/cons, eliciting patient preferences and integrating patient preferences. Interviews found that non-clinical factors prime both physicians and patients in favour of CS prior to the clinical encounter in which the decision to perform a CS is documented. These interactions were both minimal in content and limited in purpose, with consent being an artefact of a process involving little communication.Conclusions: Insufficient communication between physicians and patients is one of many factors driving increasing rates of caesarean section in Bangladesh. While this single clinical encounter provides an opportunity for practice improvement, interventions are unlikley to impact rates of CS without simultaneoulsy addressing physician, patient and health system contextual factors too.

Sign in / Sign up

Export Citation Format

Share Document