Greer RC et al. (2010)77. Greer RC, Cooper LA, Crews DC, Powe NR, Boulware Le. Quality of
patientphysician discussions about CKD in primary Care: a cross-sectional study. Am J
Kidney Dis 2011;57:583-91.
|
Evaluate the quality of communication about chronic kidney disease in
primary care |
USA
(Baltimore, MD) |
236 |
40 |
• The physicians frequently used technical terms (28%, n=
17). |
• 15 primary care practices. |
• Hypertensive patients. Studies with the
enrollment of more participants might be desirable(conclusions are not
generalizable). |
• The comprehension of technical terms by patients rarely was confirmed by
physicians (2%, n= 1). |
• The discussion on chronic renal disease was not frequent in
encounters. |
• Ideally, these types of discussions must be encouraged. |
• The optimization of the communication between patients and physicians on
these issues might promote better health outcomes. |
Beach MC et al. (2006)88. Beach MC, Roter DL, Wang NY, Duggan PS, Cooper LA. Are physician's
attitudes of respect accurately perceived by patients and associated with more
positive communication behaviors? Patient Educ Couns 2006;62:347-54.
|
Evaluate the attitudes of respect between physicians and patients |
USA (Baltimore and Washington, DC) |
215 |
30 |
• The physicians' perception of respect by patients was variable, and was
preferentially associated with patients' familiarity. |
• Physicians rated their level of respect by patients (after
each encounter).Questionnaire (patients). |
Haskard B et al. (2008)99. Haskard B, Williams L, DiMatteo R, Rosenthal R, White K, Goldstein G.
Physician and patient communication training in primary care: effects on
participation and satisfaction. Health Psychol 2008;27:513-22.
|
Investigate the impact of a training intervention on communication |
USA |
2196
(Total treated patients) |
156 |
• This training aimed to improve physicians' communication, and
stimulate the participation of the patients. |
• Randomized experiment. |
• Controlled trial. |
• Groups: 1)
physicians received training; 2) patients received training, and 3) both
received training. |
• Patients' and
physicians' satisfaction might be improved with this type of training. |
Bensing M et al. (2008) 1010. Bensing M, Verheul W, Van Dulmen S. Patient anxiety in the medical
encounter: a study of verbal and nonverbal communication in general practice. Health
Educ 2008;108:373-83.
|
To
characterize the verbal and non-verbal communication, and possibly patients'
anxiety |
Holland |
2095
(1388) |
142 |
• The patients' concerns were not directly expressed in more than a half of
the consultations, nor even by patients with a higher level of anxiety. |
• Patient direct
gaze (percentage). Questionnaire (administered before consultation).
Patients' subjective health, state anxiety, and reason for encounter was
evaluated. |
• General
practitioners might encourage patients to express their concerns: verbally,
or non-verbally (e.g. showing more affect). |
Mjaaland TA et al. (2009) 1111. Mjaaland TA, Finset A. Communication skills training for general
practitioners to promote patient coping: the GRIP approach. Patient Educ Couns
2009;76:84-90.
|
Analyze the effects of a communication skills training for general
practitioners |
Norway |
266 |
25 |
•
The communication patterns between general practitioners and patients
changed in some situations. |
• Communication skill training: 40h |
• Examples of
skills: 1) obtain indicators of the disease, such as subjective symptoms of
the patient; 2) give an explanation to the patient about their health
problems; 3) identify solutions and resources, and 4) promote appropriate
behaviors. |
Weingarten MA et al. (2010) 1212. Weingarten MA, Guttman N, Abramovitch H, Margalit RS, Roter D, Ziv A
et al. An anatomy of conflicts in primary care encounters: a multi-method study. Fam
Pract 2010;27:93-100.
|
Investigate the nature of conflicts between doctors and patients (primary
care encounters) |
Israel |
291 |
28 /
56 |
• 40% of consultations with cases of conflicts (21.2% related to the
packages of health services/ rationing). |
• Videotape of
291 consultations (28 general practitioners). 7 focus groups with 56 general
practitioners (to collect provider opinion about conflicts). |
• Conflictual encounters were characterized by shorter opening and closing
phases. |
• The physician showed a certain duality in the management of problems,
because of the health system demands |
• The
physicians' training might be relevant in view of an adequate managing
conflict situations. |
Street JR et al. (2007) 1313. Street RL Jr, Gordon H, Haidet P. Physicians' communication and
perceptions of patients: Is it how they look, how they talk, or is it just the
doctor? Soc Sci Med 2007;65:586-98.
|
Study of the communication style of physicians, and their perception about
patients |
USA
(Houston, Texas) |
207 |
29 |
• The doctors' communication was more appropriated in relation
to the patients with a communication more positive. |
• 10 clinics (public or private). |
• Possible
limitations: small sample size, non-evaluation of patients' health
condition, the reason for the encounter, or the specialty of
physicians. |
•
Physicians might communicate better with patients of certain ethnic groups
(possibility of bias). |
Bensing JM et al. (2006) 1414. Bensing JM, Tromp F, Van Dulmen S, Van den Brink-Muinen A, Verheul
W, Schellevis FG. Shifts in doctor-patient communication between 1986 and 2002: a
study of videotaped general practice consultations with hypertension patients. BMC
Fam Pract 2006;7:62.
|
Assessing the variations on communication patterns between general
practitioners and patients |
Holland |
102/108 (1986 /2002) |
27/108 (1986 /2002) |
• No differences were found between both patients' groups
regarding sex and age. |
• Longitudinal study. |
• Analysis of
video tapes (general practice consultations with hypertensive
patients). |
• In relation to
the most recent data: the general practitioners gave more medical
information and expressed less concern about patients' health conditions;
patients were less active (e.g. made less questions, and also demonstrated
less concerns). |
Van Den Brink-Muinen A et al. (2006) 1515. Van den Brink-Muinen A, Van Dulmen S, de Haes H, Visser A,
Schellevis F, Bensing J. Has patients' involvement in the decision-making process
changed over time? Health Expect 2006;9:333-42.
|
Identify communication changes between patients and general
practioners over time (about medical treatment issues) |
Holland |
442/2784 (1987/ 2001) |
16/142 (1987/ 2001) |
• In 2001: general practitioners provided more information and
requested the patient involvement in the decision-making process more often,
on the other hand this providers checked less patients' understanding.
Excepting older patients the involvement of patients in medical
decision-making was higher in 2001. |
• Questionnaire (pre and post visit). Descriptive and
multivariate Analysis. |
Zantinge M et al.
(2009) 1616. Zantinge E, Verhaak P, Bakker D, Van der Meer K, Bensing J. Does
burnout among doctors affect their involvement in patients' mental health problems? A
study of videotaped consultations. BMC Fam Pract 2009;10:60.
|
Analyze if
doctors' burnout affect their communication on patients' mental health
problems, and the duration of consultations |
Holland |
1890
(consultations) |
126 |
• In the case of
general practitioners suffering from bunout neither their attention on
patients' psychological problems nor their diagnosis were affected.It was
found that general practitioners with more possibility of exhaustion
sometimes create more opportunities to discuss the mental health problems of
patients. General practitioners suffering from burnout might benefit from
training (or coaching). |
• Nationally representative sample of general
practioners. |
•
Subscales of burnout: 1) emotional exhaustion, 2) depersonalization, or 3)
personal accomplishment. |
Ratanawongsa N et
al. (2008) 1717. Ratanawongsa N, Roter D, Beach MC, Laird SL, Larson SM, Carson KA et
al. Physician burnout and patient-physician communication during primary care
encounters. J Gen Intern Med 2008;23:1581-8.
|
Describe the
patient-physician communication in the case of physicians' burnout |
USA (Baltimore,
MD) |
235 |
40 |
• The signs of physicians' professional exhaustion
did not affect significantly:1) their attention with the patient, 2) verbal
dominance, 3) the consultation length, and 4) the levels of satisfaction or
confidence of the patients. |
• 15 clinics. |
• Hypertensive
patients were enrolled in view of improving their adherence. |
•
The patients of doctors with more serious problems gave twice negative
rapport-building statements. |
Zantinge EM et
al. (2007) 1818. Zantinge EM, Verhaak PF, de Bakker DH, Kerssens JJ, Van der Meer K,
Bensing JM. The workload of general practitioners does not affect their awareness of
patients' psychological problems. Patient Educ Couns 2007;67:93-9.
|
Evaluate how the
workload of general practitioners affect their attention on patients'
psychological problems |
Netherlands |
2095
(consultations) |
142 |
• Physicians'
professional exhaustion was not significantly associated with:1)
patient-centeredness, 2) verbal dominance, 3) the length of consultation,
and 4) patients' satisfaction.The patients of doctors with more serious
problems gave more negative rapport-building statements. |
• 2095 videotaped consultations. |
• The videotapes were from a National survey (2000-2002). |
•
Eye contact was quantified (%). |
Mjaaland TA et al. (2009) 1919. Mjaaland TA, Finset A. Frequency of GP communication addressing the
patient's resources and coping strategies in medical interviews: a videobased
observational study. BMC Fam Pract 2009;10:49.
|
Investigate the use of questions and comments during the consultations |
Nor
way (Bœrum) |
145 |
24 |
• In addition to RIAS, 4 new coding categories were created to
classify the interactions of communication. |
• Pilot Study. |
• Additional
categories: 1) resources (e.g. general practitioner comment something
positive), 2) coping (e.g. comments/questions on the managment of dificult
health situations), 3) attribution (e.g. question/ comments discussing
patients' opinion about their own situation), and 4) Solution-focused
techniques (e.g. use of scales to classify a problem). |
• 2% of the utterances were classified as resource or coping oriented (6
general practitioners were responsible for 59% of these utterances). |
•
The general practitioners might be more trained to cognitively manage their
interactions with patients. |
Van Den Brink-Muinen A et al. (2008)2020. Van den Brink-Muinen A, Maaroos HI, Tähepõld H. Communication style
in primary health care in Europe. Health Educ 2008;108:384-96.
|
Investigate patterns of communication in primary health care (diverse
European countries) |
Estonia, Poland and Romania |
1376 |
92 |
• It were found difference between the patterns of communication of general
practitioners. Intercultural differences should be taking into account
during the providers' eduction (e.g. communication skills trainning). |
• Videotaped consultations (doctor-patient). |
|
Pediatrics
|
|
|
|
|
|
Johnson KB et al. (2008) 2121. Johnson KB, Serwint JR, Fagan LA, Thompson RE, Wilson ME, Roter D.
Computer-based documentation: effects on parent-provider communication during
pediatric health maintenance encounters. Pediatrics 2008;122:590-8.
|
Evaluate the parent-provider communication before and after the
introduction of a computer-based documentation tool in consultations |
USA |
243
(consultations) |
149/94 |
• Computer-based vs. control consultations: duration slightly higher (32
vs. 27 min); more open-ended questions (28% vs. 21 %); > use of
partnership strategies; > use of positive and social talk; more
patient-centered interactions; < use of orienting and transition
phrases. |
•
Pediatrics residents. The audio recordings were coded. One control group:
149 consultations were not computer-based (control group), and 94
consultations were computer-based. |
• The quantity of dialogs (conversation) was similar in both groups. |
• The
introduction of the computerized system had a positive impact on the
communication between family and providers. |
Hart
N et al. (2006) 2222. Hart N, Drotar D, Gori A, Lewin L. Enhancing parent-provider
communication in ambulatory pediatric practice. Patient Educ Couns
2006;63:38-46.
|
Evaluating parent-provider communication after a training |
USA |
92
(consultations) |
28 |
• 28 residents. The consultations (92) were audio-taped. |
• 3
consultations: 1 before and 2 after the residents' training. |
• Parents were significantly more satisfied (p < 0.05), and providers
use more interpersonal communication after the training intervention. |
• Residents'
training on communication skills may contribute to increas parents'
satisfaction of parents. |
Wissow L et al. (2011) 2323. Wissow L, GadomskiA, Roter D, Larson S, Lewis B, Brown J. Aspects of
mental health communication skills training that predict parent and child outcomes in
pediatric primary care. Patient Educ Couns 2011;82:226-32.
|
Determining indicators to predict parent and child outcomes after a mental
health training |
USA
(Baltimore, MD, Washington, DC and New York) |
403 |
50 |
•
Providers who received training on mental care were more patient-centerd,
and presented more appropriate characteristics of communication.The
consultations more family-centered were predictive of an improvement on
children and adolescents mental symptoms. |
• Children and adolescents with emotional and behavioral problems (5 to 16
years). 50 providers: trained in pediatrics (68%), or family practice
(30%). |
•
15 primary care offices. |
Liu
CC et al. (2008) 2424. Liu CC, Wissow LS. Residents who stay late at hospital and how they
perform the follow day. Med Educ 2008;42:74-81.
|
How
working until late might in influence residents' communication/ performance
in the consultations of the following day |
USA |
243
(primary care visits) |
52 |
• Residents who stay working until late were more verbally dominant, and
less patient centered. |
•
Teaching hospital. |
•
Implications: it is required a better management of profissional performance
in case of fatigue. |
Greenley RN et al. (2006) 2525. Greenley RN, Drotar D, Zyzanski SJ, Kodish E. Stability of parental
understanding of random assignment in childhood leukemia trials: an empirical
examination of informed consent. J Clin Oncol 2006;24:891-97.
|
Analyze the stability of parents' understanding of the random assignment in
childhood leukemia trials |
USA |
84 |
Not
applicable (only patients' interviews) |
• 49% of parents failed to understand the random assignment.
Favorable factors related to parents' understanding: majority ethnicity,
high socioeconomic status, provider-patient communication, and the presence
of nurses during the consultation. |
• Pediatric Hospitals. |
• Limitations:
only urban areas and academic centers, small sample size, informational
materials not evaluated, and the parents' understanding only was checked at
two points (48 h and 6 months later). |
•
Implications: Further studies are advisable (in different geographical
locations and clinical contexts). |
|
Nursing
|
|
|
|
|
|
Sheldon LK et al. (2009) 33. Sheldon LK, Ellington L, Barrett R, Dudley WN, Clayton MF, Rinaldi
K.. Nurse responsiveness to cancer patient expressions of emotion. Patient Educ Couns
2009;76:63-70.
|
Analyze nurse responsiveness to cancer patient expressions of emotion |
USA |
Simulated patients |
74 |
• The simulated patients' expressions of sadness elicited a
superior affective responses (e.g. concern, approval, empathy and
concordance) than anger. The simulated patients' expressions of neutrality
and anger elicited a superior instrumental behaviors in professionals (e.g.
orient, check, opinion about the therapy) than sadness. Age, work stress,
and professional experience were variables significantly correlated. |
• 8 sites (e.g. oncology services). |
• The simulated
expressions were: 1) anger, 2) sadness, and 3) neutrality. |
•
This methodology was considered convenient to training communication skills
by the majority of nurses. |
Gilbert DA et al. (2009) 2626. Gilbert DA, Hayes E. Communication and outcomes of visits between
older patients and nurse practitioners. Nurs Res 2009;58:283-93.
|
Investigate patient-nurse communication, and variations in outcomes |
USA (New England) |
155 |
31 |
• Better outcomes were obtained in the case of: older patients with less
previous medical and social assistance, nurses with previous longer
professional experience, the encounters with higher biomedical and
psychosocial information, or predominance of positive dialogs (e.g.
expressing reassurance or optimism). |
• Studies in view of improving communication on lifestyle are needed. |
Langewitz W et al. (2010) 2727. Langewitz W, Heydrich L, Nübling M, Szirt L, Weber H, Grossman P.
Swiss Cancer League communication skills training programme for oncology nurses: an
evaluation. J Adv Nurs 2010;66:2266-77.
|
Studying the impact of a training on the communication between the nurses
and simulated oncologic patients |
Switzerland |
Simulated patients |
70 |
• There was a statiscally significant increase regarding the statements:
appropriate empathic (1.6% vs. 3.2%), reassuring (2.3% vs. 3.4%), questions
concerning psychosocial information (2.8% vs. 4.0%). |
• The training was advertized by email. The patient centeredness was
assessed based on the type and duration of dialogs (between health
professionals and simulated patients). |
• On the other
hand biomedical utterances: 17.8% vs. 13.3% (nurses) and 8.1% vs. 6.7%
(patients) decreased. |
• Video record ofinterviews (pre- and post-intervention). |
•
Only 61 video recordings were analyzed. |
Kim
YM et al. (2008) 2828. Kim YM, Heerey M, Kols A. Factors that enable nurse-patient
communication in a family planning context: a positive deviance study. Int J Nurs
Stud 2008;45:1411-21.
|
Identifying factors that contribute to increase the effectiveness
communication between nurses and patients |
Indonesia (Java) |
768 |
64 |
•
More effective communication in 32 patients (4.2% of 768) and 7 providers
(10.9 % of 64). Example of additional measures: better management of
patients flow and media campaigns. |
• 64 clinics (randomized). |
• Qualitative interviews with collection of individual and profissional
data (e.g. number of years of professional experience). |
• Potential sources of bias: social correct responses, or mood states (from
patients or providers). |
• Limitations:
only 1 consultation, translation of the audio recording of the consultation
to English (for application of RIAS) with possible compromise of texts
integrity, and a reduced number of evaluations. |
|
Geneticists |
|
|
|
|
|
Roter DL et al. (2009) 2929. Roter DL, Erby L, Larson S, Ellingtion L. Oral literacy demand of
prenatal genetic counseling dialogue: predictors of learning. Patient Educ Couns
2009;75:392-97.
|
Observe how the complexity of genetic counseling sessions are related with
the learning of genetic-related information by low literate
participants |
USA |
Simulated patients |
96 |
• 312 participants observed videos of genetic consultations.The
genetic informations learned by participants were assessed.Highly technical
terms/ dialogs represent an obstacle for individuals of lower literacy.
However these obstacules were smaller, in the case of the sessions with more
dialogs/ interactivity. |
• 79 video sessions of prenatal counseling were observed by a total of 312
participants. |
• 9 simulated patients. The genetic counselors were recruited through the
National Society of Genetic Counselors. |
• The number of
words related to genetic terms were quantified. |
• It is
advisable that the genetic counselor communicate in a suitable manner,
especially with low literate patients. |
Roter DL et al. (2007) 3030. Roter DL, Erby LH, Larson S, Ellington L. Assessing oral literacy
demand in genetic counseling dialogue: preliminary test of a conceptual framework.
Soc Sci Med 2007;65:1442-57.
|
Assessing the impact associated with the complexity of the genetic
counseling sessions |
USA |
Simulated clients |
152 |
• Sessions with a high porportion of technical terms were
associated with short sessions, less interactive dialogs, and less satisfied
simulated clients. |
• Audio and video recording (152 sessions on pre-natal, and cancer
counseling). |
• It was
evalutated: 1) the use of technical terms, 2) the complexity of language
(use of the Microsoft Word grammar), and 3) the structural characteristics
of dialogs (RIAS). |
•
The opinion of the simulated client on the information provided by the
genetic counselor is inversely related with the use of technical terms. |
Roter D et al.
(2006) 3131. Roter D, Ellington L, Erby LH, Larson S, Dudley W. The Genetic
Counseling Video Project (GCVP): models of practice. Am J Med Genet C Semin Med Genet
2006;142C:209-20.
|
Identify patterns
of communication in genetic counseling sessions: teaching vs.
counseling |
USA |
Simulated
clients |
152 |
• Identification of 4 communication patterns: 2 teaching
patterns and 2 counseling patterns. |
• Questionnaires:
1) simulated clients (to collect data on their opinion about the genetic
counselor, and on their satisfaction with the verbal and non-verbal
communication of the genetic counselor), and 2) genetic counselors (to
collect demographic data, and their perception about interpersonal
relationship with the client simulated and opinion about the realism of the
session). |
•
The genetic counselor were more verbally dominant (i.e. using greater
conversation times) in the teaching patterns. |
|
Aids care
|
|
|
|
|
|
Kumar R et al. (2010) 3232. Kumar R, Korthuis PT, Saha S, et al. Decision-making role
preferences among patients with HIV: associations with patient and provider
characteristics and communication behaviors. J Gen Intern Med
2010;25:517-23.
|
Explore how the communication between patients with HIV and health
providers might influence patients' decisions |
USA
(Baltimore, Detroit, New York and Portland) |
434 |
45 |
• In relation to patients: 72% preferred to share decisions, 23% preferred
that the provider take de decision alone, and 5% preferred to take their own
decisions. |
• Health professionals: doctors and nurses. Patients were questioned about
their role in relation to the medical decions. |
• Patients who
prefer that the professional decide alone are less likely: to manifest
symptoms of depression, to understand providers' explanations. Might be
considered a more appropriate approach when the health professional involves
patients in the decision making process. |
|
Beach CM et al. (2010) 3333. Beach CM, Wilson I, Saha S et al. Impact of a patient and provider
intervention to improve the quality of communication about medication adherence among
HIV Patients. Conference abstracts: 5th International Conference on HIV treatment
adherence 2010 (Abst. 61339).
|
Impact of a training administered to health professionals of HIV patients
(on medication adherence). |
USA |
140 |
24 |
• The training produced a positive impact on communication
about medication adherence. |
• Providers from 3 care sites. |
• HIV patients. |
• Conference
abstract. |
• Differences
(before and after training): more dialogs on therapeutic regims (p= 0.003),
more positive dialogs (p= 0.039), more emotional dialogs (p< 0.001), more
questions on patients' opinion (p= 0.009), and discussions about adherence
(p = 0.026). |
|
Oncology
|
|
|
|
|
|
Daugherty C et al. (2009) 3434. Daugherty C, Kass NE, Roter DET et al. A study of physician
investigator (PI) disclosure of alternatives of care and prognostic information to
adVanced cancer patients (ACP) enrolling in phase I trials.ASCO Meeting Abstracts
2009 (Abst. 6508).
|
Characterize the communication between oncologists and patients with
advanced cancer in relation to the understanding of the informed consent
(phase I clinical trials) |
USA |
131 |
25 |
• Other treatment options were discussed by physicians in 47% of the
encounters. |
•
Confervâceo abstract. |
• The option of not performing any treatment was reported by the physician
in 29% of encounters. |
• The terms "death" and "terminal" were used by the
physician in 5.8% of the encounters. |
• The
communication on alternative treatments, or prognosis was not considered
adequate. |
Siminoff LA et al. (2006) 3535. Siminoff LA, Graham GC, Gordon NH. Cancer communication patterns and
the influence of patient characteristics: Disparities in informationgiving and
affective behaviors. Patient Educ Couns 2006;62:355-60.
|
Patterns of communication in consultations (patients with breast
cancer) |
USA |
405 |
58 |
• In this study physicians spend more time communicating with the patients
more educated and young, as well as with the patients of higher income
level.These discrepancies in communication might influence patients' health
outcomes. |
• 14
practices (two states). |
• The discussions on psychosocial issues such as how patients deal with
their diagnosis, and patients' feelings were limited. |
• The way how providers communicated was different depending of the
patients' sociocultural characteristics. |
• Specific
training on how to deal with these differences might be useful to patients,
and providers. |
|
Surgery
|
|
|
|
|
|
Levinson W et al. (1997) 3636. Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM.
Physician-patient communication. The relationship with malpractice claims among
primary care physicians and surgeons. JAMA 1997;19:553-9.
|
Relate the communication with malpractice claims |
USA
(Oregon and Colorado) |
10
clinics per doctor |
124 |
• Two groups: primary care physicians, and surgeons. |
• In
view of avoiding claims the implementation of good communication practices
is advisable. |
• Primary care physicians with no-claims registered: more statements of
orientation, laughed more, requested more patients' opinion, confirmed more
patients' understanding, and encouraged more the dialoge comparatively to
the primary care physicians with complaints, as well as their consultations
were more longer (18.3 vs. 15 minutes). |
• It were not
found different communication characteristics between surgeons with claims,
or no-claims. |
Levinson W et al. (1999) 3737. Levinson W, Chaumeton N. Communication between surgeons and patients
in routine office visits. Surgery 1999;125:127-34.
|
Characterize the communication between surgeons and patients in routine
consultations |
USA |
676
(routine visits) |
66
(29/37) |
• 29 general surgeons and 37 orthopaedic surgeons. Social conversations, or
the discussion of patients' problems was limited. |
•
Possible limitations: limited number of topics discussed in this type of
consultations |
• Further
investigations are recommended to understand the influence of surgeons'
communication on patient behavior. |
|
Anesthesia
|
|
|
|
|
|
Kindler CH et al. (2005) 3838. Kindler CH, Szirt L, Sommer D, Hausler R, Langewitz W. A
quantitative analysis of anaesthetist-patient communication during the pre-operative
visit. Anaesthesia 2005;60:53-9.
|
Quantitative Analysis of the communication between the anesthetist and the
patient in preoperative consultation |
Switzerland (Basel) |
57 |
57 |
• Duration of visit: 16.1 min (average). |
•
The discussions on biomedical, and psychosocial issues were quantified
(number of utterances). |
• The number of utterances per patient/anaesthesist, and the duration of
the consultations were not influenced by gender. % of
utterances/consultation: anaesthesists (53.5%) and patients (46.5%). |
• Anaesthetists: < 0.1% utterances related with psychosocial issues
(dialogs mainly related with biomedical issues). |
• The use of
open questions and emotional statements by these providers were positively
related with the patients' involvment. |
|
Family planning
|
|
|
|
|
|
Abdel-Tawab N et al. (2002) 3939. Abdel-Tawab N, Roter D. The releVance of client-centered
communication to family planning settings in developing countries: lessons from the
Egyptian experience. Soc Sci Med 2002;54:1357-68.
|
Investigate the importance of client-centered communication in
consultations of family planning |
Egypt |
112 (clients) |
34 |
• The communication was physician-centered in 2/3 of consultations. |
• Home visits to confirm clients' contraceptive adherence (at 3
and 7 months). |
• Client-centered consultations were one minute longer than
physician-centered consultations. |
• Client-centered consultations were associated with great satisfaction,
and adherence. |
• The interruption of the contraceptive method was associated with more
physicians' disagreement statements. |
• Similarly to what happen in developed countries, client-centered models
are more advantageous than physician-centered models. |