practitioner and patient interpersonal skills Flashcards
Aim (McKinstry&Wang)
To determine
- how acceptable patients found different styles of doctors’ dress
- whether the dress style influenced patient’s opinion
Participants (McKinstry&Wang)
opportunity sample
475 patients
all from Scotland
Controls and Methods (McKinstry&Wang)
- same posture
- same male and female
method: self report
Results for most acceptable style of dress (McKinstry&Wang)
male doctor: suit
female doctor: lab coat
What dress do patients object the most? (McKinstry&Wang)
- jeans, object more strongly for female
Which doctor do patients feel more confident being with? (McKinstry&Wang)
41% of patients who said that they are more confident in one specific doctor
- and the doctors who were commonly selected by these are FORMALLY DRESSED
- OLDER patients choose FORMALLY DRESSED
conclusion (McKinstry&Wang)
patient attitude affected by the way doctor dresses
although other variables
age/gender also have an affect
Aim (McKinlay, 1975; Ley, 1988)
To investigate common medical terminologies that doctors use.
- To see whether doctors think patients understand them
- whether patients actually understand them
- and to investigate underlying causes which differentiate patients’ knowledge of medical terminologies.
Participants (McKinlay, 1975; Ley, 1988)
Lower working class patients using a maternity service in Scotland.
Procedure - terminologies (McKinlay, 1975; Ley, 1988)
13 medical terminologies were chosen using a pilot study
- These 13 words fell in the middle category of patient understanding
- (neither very familiar nor completely incomprehensible)
- as rated by Scottish patients in the pilot study.
Procedure (McKinlay, 1975; Ley, 1988)
The interview began with a reassuring statement, “This is not a test”. They were first read the word, then heard the word in a sentence a doctor would use, then asked to explain what the doctor meant.
Patients’ answers were transcribed and their understanding was scored by 2 doctors (1 male, 1 female) as either adequate / vague / wrong / none.
The doctors were blind to the identity of each patient interviewed and to the other doctor’s score.
In order to study the effect of patient characteristics, patients were categorised as utilizers (patients who used the maternity service regularly) and underutilizers (patients who did NOT use the maternity service regularly).
Essay: practitioner and patient interpersonal skills
P1 - non-verbal communications (McKinstry & Wang)
P2 - verbal communications (McKinlay, Ley)
Essay: patient and practitioner diagnosis and style
P1 - practitioner style: doctor and patient-centred (Bryne and Long, Savage and Armstrong)
P2 - practitioner diagnosis: type I and type II errors
P3 - disclosure of information (Robinson & West)
Essay: misusing health services
P1 - delay in seeking treatment (Safer)
P2 - misuse: hypochondriasis (Barlow and Durand)
P3 - Munchausen syndrome (Aleem and Ajarim)
What is the key principles of Ley’s model?
- effective verbal communication
- adherence—understand+remember+satisfied
- improve understanding/recall/satisfaction
- no difficult medical terminology
- primacy/recency effect
- categorise structured
- respond sympathetically
Supporting research for Ley?
- booklet
- 55%—70%
- can improve, using simple technique
Describe Bryne&Long
- doctor centred/patient centred
- tape recorded, transcribed, analysed—medical consultations —indication for particular consultation style
- 6 phases, establishing relationship —investigation—further treatment?
- most doctors were doctor centred
—> more self-reflective, degrees of …
Describe Savage & Armstrong
- patient preference for a sharing/directing
- 2 questionnaire
- quality of doctor’s knowledge + feel helped? immediately+1 week after
- high level of satisfaction in both,higher for directed —> more satisfaction with ‘explanation of doctor’ feel ‘greatly helped’
- authoritarianism + certainty = satisfy
- importance of style
Describe Robinson & West
- patient disclosure
- computerised medical interivew VS paper-based questionnaire VS face to face physician interview
- not honest + exaggerate = type I and II errors
- GU clinic, 33male 36 female
- either condition + physician
- computer>paper>physician
Describe safer
- factors influencing delay for 1st time
- opp sample, 93patients age 44
- if going to tell a new symptom
1. appraisal delay
2. illness delay
3. utilisation delay - individual+situational factors lengthen/shorten delay
Describe Barlow & Durand
- Gail married at 21
- anxiety stress, job stressful
- minor symptom=series illness
- spent time+money visiting doctor even though she is perfectly healthy
Describe Aleem & Ajarim
- Munchausen: fake symptoms of a disease/injury inorder to have hospital treatment
- exaggerating symptoms, inconsistent medical history
- problems w self esteem+longing for attention
- female uni student injected a syringe of fecal into her left breast to develop an abscess
- irrational behaviour, misuse health services, waste time of health professionals
