Background Communicating with patients has long been identified as an important physician competency. More recently, there is a growing consensus regarding the components that define physician-patient communication. There continues to be emphasis on both the need to teach and to assess the communication skills of physicians. Objective This narrative review aims to summarize the work that has been conducted in physician-patient communication that supports the efficacy of good communications skills. This work may also help to define the physician-patient communication skills that need to be taught and assessed. Results A review of the literature shows it contains impressive evidence supporting positive associations between physician communication behaviors and positive patient outcomes, such as patient recall, patient understanding, and patient adherence to therapy. There is a consensus about what constitutes “best practice” for physician communication in medical encounters: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease- and treatment-related behavior. Conclusions Evidence supports the importance of communication skills as a dimension of physician competence. Effort to enhance teaching of communication skills to medical trainees likely will require significant changes in instruction at undergraduate and graduate levels, as well as changes in assessing the developing communication skills of physicians. An added critical dimension is faculty understanding of the importance of communication skills, and their commitment to helping trainees develop those skills.

Objective: To examine practice nurses' beliefs about obesity and their current practices and the role of the weight management context and their own BMI on these factors. Design: Cross sectional questionnaire. Subjects: Questionnaires concerning beliefs about obesity and current practices were completed by 586 practice nurses. Results: The subjects rated lifestyle as the main cause and cardiovascular problems as the main consequences of obesity, regarded weight loss as bene®cial and reported high con®dence in their ability to give advice to obese patients. However, their expectations of patient compliance and actual weight loss were low indicating that practice nurses rate their advice giving skills as independent to the outcome of this advice. Further, failed weight loss was explained in terms of patient and not professional factors. In addition, the results indicated variability in their beliefs and behaviour according to the location of this advice and the practice nurse's own BMI. In particular, practice nurses who run weight loss clinics reported giving weight loss advice more frequently, spending longer counselling obese patients, reported greater con®dence in giving weight loss advice and more optimism about outcomes. Further, those with low BMIs rated obesity as more preventable, reported being less likely to advise patients to use a calorie controlled diet and more likely to suggest eating less in general. Conclusion: Education programmes for practice nurses should not only include skills training but emphasise both the factors involved in advice giving and self appraisal. Such appraisal should include a role for both the practice nurse's and the patient's behaviour to minimise the`operation was a success but the patient died' approach to obesity management.

Walking and the TPB 2 The Theory of Planned Behaviour predicts self-reports of walking, but does not predict step count ABSTRACT:Objectives: This paper compares multiple measures of walking in two studies, and in the second study, compares how well Theory of Planned Behaviour (TPB) constructs perform in predicting these different measures. Methods:In study one, forty-one participants wore a New Lifestyles NL-2000 pedometer for one week. Subsequently, participants completed a questionnaire containing measures of the TPB constructs and two self-report measures of walking, followed by two interview measures of walking. For study two, 200 RAF trainee aircraftsmen wore pedometers for two weeks. At the end of each week participants completed the questionnaire and interview measures of walking.Results: Both studies found no significant association between questionnaire measures of walking and pedometer measures. In study one, the interview measures produced significant, large correlations with the pedometer measure, but these relationships were markedly weaker in the second study. TPB variables were found to explain 22% of variance in intention to walk in study one and 45% of the variance in study two. In study two, prediction of subsequent measures of behaviour was found to be weak, except when using a single-item measure of walking. Conclusions:Recall of walking is poor and accurate measurement by self-report is problematic. Although the TPB predicts intentions to walk well, it does not predict actual amount of walking, as assessed by pedometer. Possible reasons for these findings include the unique nature of walking as an activity primarily used to facilitate higher order goals. The use of single-item measures may exaggerate the effectiveness of the TPB model for walking, and possibly other forms of physical activity.

(2007). Using the affective priming paradigm to explore the attitudes underlying walking behaviour. British journal of health psychology, 12 (4), p. 571. Objectives: Walking is poorly represented in memory making it difficult to measure using self-report and even harder to predict. To circumvent this, we used the affective priming paradigm (Fazio, Sanbonmatsu, Powell & Kardes, 1986) to assess implicit attitudes towards walking. Copyright and re-use policyMethods: RAF trainee aircraftsmen (n=188) wore pedometers for one week prior to completing the affective priming paradigm, questionnaire and interview. The affective priming paradigm involved a computer-based response latency task containing physical activity words as primes followed by adjectives as targets to be evaluated. Targets were drawn from two bi-polar dichotomies, good-bad (the original Fazio et al items) and happy-sad (mood).Results Priming for mood items was related to levels of physical activity with high frequency participants priming for the positive (happy) pole and low frequency participants priming for the negative (sad). Both groups primed for the negative element of the Fazio (good-bad) dichotomy. Regarding walking and running, there was no differentiation on the basis of participation level. Instead, facilitated responses to happy targets contrasted with inhibited responses to sad targets for both types of locomotion. There was weak evidence that intentions to run were associated with priming of positive target items, irrespective of category. Conclusions:The relationship between implicit attitudes and behaviour is complex.Whereas implicit attitudes were related to overall exercise participation, they were not related to the specific activity of walking, despite the behaviour being mainly under automatic control.Walking and affective priming 3 INTRODUCTION:

Intensive, comprehensive psychosocial training was well accepted by residents. It improved their knowledge, self-awareness, self-assessment, and attitudes, the latter improvement persisting well beyond training.