Patient-Provider Communication

Question 1

3 ways of conceptualizing provider-patient communication

Answer 1

1. Focus on the individual
2. Focus on interactions
3. Focus on relationships

Question 2

Individually-centered theories

Answer 2

• Theories that examine how individuals’ beliefs shape interactions with others
• Often focus on how individuals evaluate and cope with new information and uncertainty experienced in healthcare settings
• Focus on the patient-provider interaction itself (transactional nature)
• Looks at how patients and healthcare providers use verbal and nonverbal behavior to communicate

Question 3

What causes feeling of uncertainty?

Answer 3

1) Volume of information
- too much info is overwhelming and too little is worrying
2) Complex information
- medical jargon and terminology
3) Ambiguous information
- unclear
4) Conflicting information
- contradicting from different doctors

Question 4

Uncertainty Management Theory

Answer 4

• How patients evaluate uncertainty and predict whether they seek or avoid information from their physician.
• Negative perception of uncertainty: patients likely to avoid information that would reduce their uncertainty
• Neutral or positive perception of uncertainty: patients likely motivated to seek information that would reduce their uncertainty.

Healthcare providers should:
- Facilitate information-seeking
- Reduce negative emotions in patients
- Build patients’ feelings of self-efficacy
- Ensure feelings of response efficacy

Question 5

Communication Accommodation Theory

Answer 5

When people interact, they adjust their speech, their vocal patterns, and their gestures.

Convergence: an individual shifts speech patterns in interaction so that they closely resemble the speech patterns of speech partners
Divergence: speakers wish to maintain social distance from others consciously or unconsciously which emphasizes power differentials

Healthcare providers should:
- Recognize power differential between themselves and their patients
- Acknowledge that healthcare visits can be anxiety-producing for patients
- Balance communicating competence with convergence
- Beware of over-accommodation: a communicator adjusts to a style that they have little or no experience in, which can often be the result of stereotyping. It can actually alienate them further.

Question 6

Politeness Theory

Answer 6

Positive face: the desire a patient or provider has to be accepted, respected, liked and included
- Threats: appearing incompetent, unknowledgeable, and/or unlikeable

Negative face: the desire a patient or provider has to maintain autonomy
- Threats: feeling pressured to spend personal time in a particular way or to do something they don’t want to do

Healthcare providers should:
- Be mindful of patients’ face threats. A patient may not ask questions because they don’t want to seem unintelligent.
- Be mindful of personal face threats. A patient may bring up internet research to preserve their positive face, but a doctor’s expertise may be questioned because of it.

Question 7

Relational-centered theories

Answer 7

• Focuses on information disclosure within personal relationships
• Social Penetration Theory

Question 8

Social Penetration Theory

Answer 8

Developed to explain relational closeness as it relates to disclosure levels. Over time, relationships become closer and more intimate.

Breadth: range of topics discussed
Depth: degree of superficiality

Healthcare providers should:
- Build relationships with their patients over time
- Disclosure is a gradual process. It feels uncomfortable for patients to disclose sensitive info to someone they don’t know well

Question 9

The RESPECT Model

Answer 9

• Rapport: connect on a social level, see patient’s pov
• Empathy
• Support: ask about and try to understand barriers to care and compliance
• Partnership: both patients and provider are involved in healthcare decisions
• Explanations: provider checks for understanding and clarifies
• Cultural competence: be aware of your own biases and respect the patient’s culture
• Trust: disclosure makes people feel vulnerable

Question 10

Patient-centered communication

Answer 10

Creates:
- Patient satisfaction
- Informational recall and understanding
- More positive health outcomes and fewer negative outcomes

Barriers that it helps to address:
- Health literacy
- Language barriers
- Dysphoria
- Time constraints on patient or doctor
- Mental state/illness state
- Medication effects
- Gender differences
- Racial differences