impact of virtual care on relationship centered care: Observations of a family physician

The COVID-19 pandemic propelled many physicians and their patients into an unfamiliar world of virtual care. This presentation is based on the perceptions of a family physician/ teacher/ researcher with 43 years of interest in, and promotion of, a strong doctor-patient relationship. It will describe a protocol that governed how tele-medicine and video-conferencing took place over nearly 18 months in his practice. It will then describe observed positive and negative impacts for the patients, their family members, the physician, and members of the family medicine health care team. Interpretation will be made about what such observations mean for the doctor-patient relationship.

Satisfaction with Telepsychiatry during the COVID-19 pandemic: Patients’ and psychiatrists’ report from a University Hospital

Background: The COVID-19 pandemic has led to important changes in the approach to patients worldwide. Different agencies have proposed and implemented telemedicine-based care services in order to ensure access to health care for all people. Aim: The aim of this study was to determine the satisfaction of patients using the Telepsychiatry service offered by the Department of Psychiatry of the Hospital de Clínicas (National University of Asunción, Paraguay). Methods: A cross sectional and descriptive study has been conducted. Participants were recruited through a phone-based survey. Satisfaction with Telepsychiatry has been measured with an adapted version of a satisfaction survey in Teleneurology. As a complement, psychiatrists from the Hospital de Clínicas were also interviewed about their rate of satisfaction with Telepsychiatry. Results: A total of 530 patients were included, 51.3% of whom were women. The consultation satisfaction scale ranged between 2.15 and 4.30 with a mean score of 3.02 ± 0.32. Cronbach’s alpha for the scale was .897, indicating a good internal consistency. Patients’ satisfaction was higher for the perception of Telepsychiatry and lower for the doctor-patient relationship. Of the physicians, 87.5% were satisfied with the Telepsychiatry service. Conclusion: The satisfaction overall score indicates patients’ general satisfaction with the quality of care in Telepsychiatry, mainly regarding the perception of health care. and lower satisfaction with the doctor-patient relationship. Nine out of 10 psychiatrists felt satisfied with the Telepsychiatry service and considered that the degree of patient’s satisfaction was acceptable during the Telepsychiatry consultation.

Bioethics and Nutrition in the Older Adult

At the professional practice of nutrition, as in the rest of the health disciplines, it is necessary to follow high standards in order to establish the best doctor-patient relationship and the greatest benefit in the user's health. In a special way, the factors that are indexed in the nutrition of the elderly must be specified; since, during the stage of old age, individuals present physiological and psychosocial changes that affect their nutritional status, which lead to both overweight and malnutrition, implying malnutrition problems. Thus, recommendations are established for both the ethical aspects and the components that must be considered for the adequate feeding of the elderly, including the ethical considerations involved in the interventions.

Collaborative domestication

This article proposes an extension to domestication theory by introducing the concept of collaborative domestication, which we define as the ongoing mutual influence and interdependence of technology users in specific interactional contexts. This concept arose from our investigation of how patients integrate healthcare-related video consultations into their daily lives. In Denmark, the Covid-19 pandemic has expedited the implementation of video consultations in general practice, yet little is known about their use in this context. To address this, we conducted 13 interviews with patients and analysed the interviews from the perspective of domestication theory. We find that the general practitioner plays a central role throughout patients’ domestication processes, and the doctor–patient relationship significantly influences how patients experience video consultations. We argue that there is a collaborative aspect to domesticating video consultations that needs to be considered in both future studies and the ongoing implementation of video consultations

Evaluation of Patient Satisfaction and Patient-physician Relationship in an Out- Patient Department Re-engineered through a Health Information Management System: A Descriptive Study Done at a Major Women’s Hospital in Sri Lanka

Introduction: Health information management is one of the major pillars in a health system that improves the effectiveness and efficiency of health services. It is essential to assess the patient perception towards re-engineered services provide through Hospital Information Management Systems (HIMSs) and how this implementation affects the doctor-patient relationship. The objective of the study was to describe the extent of patient satisfaction towards Out-Patient Department (OPD) services, pharmacy service and patient physician relationship in the OPD, re-engineered through a HIMS, at the Castle Street Hospital for Women (CSHW), Sri Lanka. Methods: A descriptive cross-sectional study was carried out among 362 out-patients aged over 18 years attending the OPD of the CSHW during 2018-2019. Consecutive sampling method, and an interviewer-administrated questionnaire were used to collect data. The quantitative analysis was done using the SPSS software version 23. The sentiment analysis was performed to analyze comments given by patients using the Rapid Miner software. Results: All participants were females with a mean age of 41years (±13.58). Almost all participants were satisfied with overall services provided by the OPD (99.7%) and the pharmacy (98.4%). The majority (65.3%) agreed that implementation of the HIMS had improved the doctor-patient relationship. All reported comments regarding the re-engineered services of the OPD were ‘positive’. The study also suggests considering providing information in all common languages while announcing the patient’s OPD number at the waiting area in future implementations. Conclusions: The majority of patients were satisfied with the overall OPD services provided through implementation of the HIMS at the CSHW, Sri Lanka. Keywords: Health information systems, Hospital information management system, Outpatientdepartment, Patient-physician relationship.

Truth-telling and patients' diagnoses in optometric practice in Nigeria

Background: The doctor-patient relationship is crucial to health care services including eye care. Telling the truth is an important aspect of this relationship in ensuring safe and effective treatment and management of patients.Method: A qualitative study using one - on- one in- depth interviews (IDIs) and focus group discussions (FGDs). Forty four respondents comprising 10 eye care practitioners (ECPs) and 34 patients were recruited. The ECPs were between 32 to 51 years while the patients were between 18 and 50 years old.Results: Common lies told were mainly about age, onset or duration of condition, medications used prior to their visit to the doctor's and level of compliance to doctor's prescription. Others were about health status, history of self-medication and social habits like smoking and/or drinking. Reasons for telling some of these lies included fear of early retirement, fear of being judged or stigmatized, lack of privacy during clerking and embarrassment from being caught in a previous lie.Conclusion: Untruths and manipulation of information can damage the relationship between doctor and patient because it leads to distrust and this can compromise eye care. Keywords: Truth, doctor- patient, relationship, diagnoses

A Cognitive Research on Doctor Metaphor and Doctor-Patient Relationship Metaphor

From the perspective of "conceptual metaphor" in cognitive linguistics, 11 kinds of doctor metaphors and 6 kinds of doctor-patient relationship metaphors are reached by a tentative study. Based on nearly 300 questionnaires and interviews with 20 doctors and patients, this paper discusses and analyzes: 1) the current situation of doctor-patient relationship; 2) the understanding of "doctor metaphor" and "doctor-patient relationship metaphor" from both perspectives of doctors and patients, and finds out the similarities and differences; 3) the collection of doctor's description of doctor occupation and patient's description of medical experience, and with the combination of 1) and 2), this paper suggests the measures to alleviate the medical disputes. Medical conflict is a perpetual and intricate social issue, which involves doctor, patient, hospital, government and etc. It is not supposed to be solved in a short time, whereas requires the endeavor of generation after generation.

Doctor-patient relationship improved during COVID-19 pandemic, but weakness remains

Objective To assess the quality of the doctor-patient relationship (DPR) in China and possible influencing factors during the COVID-19 period from the patient’s perspective. Methods An online survey was carried out nationwide from March 12, 2020 to March 30, 2020 in China via a convenience sampling strategy. Patients who met the inclusion criteria were invited to complete a questionnaire regarding the quality of DPR, including sociodemographic information, the Patient-Doctor Relationship Questionnaire (PDRQ-9), and influencing factors for DPR during the pandemic. Results A total of 1903 patients were included. Our result showed that participants had a higher PDRQ-9 score during the COVID-19 pandemic (4.18 ± 0.51) than that before the COVID-19 pandemic (3.86 ± 0.67). Importance-performance analysis (IPA) revealed that doctor-patient communication, patient satisfaction, consultation time, doctor’s attitude, and medical knowledge were specific aspects that needed to be prioritized to improve the DPR. Multiple linear regression analysis suggested that positive media reports, telemedicine, and national policies had a significantly positive effect on the DPR during the pandemic (P < 0.05). Conclusion In general, the DPR had been improved during the COVID-19 pandemic. Our research found the key points that needed to be prioritized to improve the DPR during the pandemic, which may provide effective suggestions for building a harmonious DPR in the future.

The Relationship between the Infertility Specialist and the Patient during the COVID-19 Pandemic

The doctor–patient relationship is fundamental in the treatment of infertility, due to the emotional implications of fertilization procedures. However, insufficient data are available specifically for this relationship. The general objective of the study is to establish the associations between the fundamental concepts that define the doctor–patient relationship: communication, empathy, trust, collaboration, compliance and satisfaction. A cross-sectional study was conducted between May and June 2020 and followed the methods of a quantitative analysis, collecting the data using questionnaires. The research plan was specific to path analysis with the mediation effect, in which the hypotheses were tested. The research group consisted of 151 women diagnosed with infertility, voluntarily recruited through online support communities. Findings demonstrate that affective empathy mediates the relationship between communication and trust in the doctor. In conclusion, this study draws attention to the importance of basic concepts in the relationship of infertility specialists with infertile patients. Thus, it is necessary for health care providers in assisted human reproduction to participate in programs for the continuous training of empathic communication skills, given the sensitivity of this diagnosis.