Gaps in Doctor-Patient Communication

Francis, Vida; Korsch, Barbara M.; Morris, Marie J.

doi:10.1056/nejm196903062801004

Cited by 752 publications

(82 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our respondents, consistent with the findings of others,31–33 report specifically receiving inadequate information about their illness journey and their dialysis treatment options. In our and other chronic diseases settings, patients report needing more information about the causes and progression of their disease, disease symptoms and their impact, and social and financial support 34 35. Patients, often due to the competing demands of daily life, rely on healthcare professionals to initiate discussions about care planning and not having future-oriented conversations reduces patients’ capacity for hope 36.…”

Section: Discussionmentioning

confidence: 99%

Patient satisfaction with in-centre haemodialysis care: an international survey

et al. 2014

View full text Add to dashboard Cite

ObjectivesTo evaluate patient experiences of specific aspects of haemodialysis care across several countries.DesignCross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire.SettingHaemodialysis clinics within a single provider in Europe and South America.Participants2748 adults treated in haemodialysis.Primary and secondary outcomesThe primary outcome was patient satisfaction with overall care. Secondary outcomes included patient experiences of individual aspects of dialysis care.Results2145 (78.1%) adults responded to the questionnaire. Fewer than half (46.5% (95% CI 44.5% to 48.6%)) rated their overall care as excellent. Global perceptions of care were uninfluenced by most respondent characteristics except age and depressive symptoms; older respondents were less critical of their care (adjusted OR for excellent rating 1.44 (1.01 to 2.04)) and those with depressive symptoms were less satisfied (0.56 (0.44 to 0.71)). Aspects of care that respondents most frequently ranked as excellent were staff attention to dialysis vascular access (54% (52% to 56%)); caring of nurses (53% (51% to 55%)); staff responsiveness to pain or discomfort (51% (49% to 53%)); caring, helpfulness and sensitivity of dialysis staff (50% (48% to 52%)); and ease of reaching dialysis staff by telephone (48% (46% to 50%)). The aspects of care least frequently ranked as excellent were information provided when choosing a dialysis modality (23% (21% to 25%)), ease of seeing a social worker (28% (24% to 32%)), information provided about dialysis (34% (32% to 36%)), accuracy of information from nephrologist (eg, about prognosis or likelihood of a kidney transplant; 37% (35% to 39%)) and accuracy of nephrologists’ instructions (39% (36% to 41%)).ConclusionsHaemodialysis patients are least satisfied with the complex aspects of care. Patients’ expectations for accurate information, prognosis, the likelihood of kidney transplantation and their options when choosing dialysis treatment need to be considered when planning healthcare research and practices.

show abstract

Section: Discussionmentioning

confidence: 99%

Patient satisfaction with in-centre haemodialysis care: an international survey

et al. 2014

View full text Add to dashboard Cite

show abstract

“…6 7 Solutions are then couched in terms of improving the delivery of information from clinician to patient by, for example, providing written information8 or more patient-centred consultations 9. There have been calls for the provision of patient information to increase reassurance 10…”

Section: Introductionmentioning

confidence: 99%

Qualitative study of interpretation of reassurance among patients attending rheumatology clinics: "just a touch of arthritis, doctor?"

Donovan¹,

Blake²

2000

BMJ

107

View full text Add to dashboard Cite

Objectives To examine commonly used methods of reassurance by clinicians and explore their effect on patients. Design Qualitative study of tape recordings of in-depth, semistructured interviews with patients before and after consultation and of their consultations with doctors. Setting NHS specialist rheumatology clinics in two large British cities. Participants 35 patients selected by consultant rheumatologists from general practitioner referral letters (28 women, 7 men; 24 with inflammatory arthropathies, 11 other rheumatological complaints). Main outcome measures Patients' perceptions of reassurance.Results Reassurance was an important part of consultations, whether the diagnosis was clear or uncertain. Clinicians tried to reduce anxiety by emphasising the mildness, early stage, or non-seriousness of the disorder and the likelihood that patients would recover. Patients interpreted reassurance in the context of their own views and perceptions. Doctors' emphasis on the mildness or earliness of the condition raised the spectre of future pain and disability rather than providing reassurance. Patients who felt that their problems were properly acknowledged felt more reassured. Conclusions Typical patterns of reassurance were not successful because of the differences in perspective of patients and doctors. A key to successful reassurance seemed to be the doctor's ability to acknowledge patients' perspectives of their difficulties.

show abstract

“…:,b€Goming'frustrated,~~ anxiety: warmth and friendliness; empathy; a desire to understand parental concerns; and utilization of the &dquo;mutual participation model&dquo; in helping parent's gain skills and self-confidence. 4,7,[13][14][15] Regarding the verbal content of management, the literature supports the following as a desirable ~inirr~~am;-understandable and acceptable information regarding diagnosis, cause, seriousness, expected course and treatment of the illness; an opportunity for parents to ask questions and give feedback regarding their understanding and their level of comfort with the diagnosis and plan; and a sense that someone will be available to help if further need arises. ',&dquo;-, In addition, the quality of the parent-clinician relationship will influence parental anxiety.…”

Section: Treatmentmentioning

confidence: 99%

The "Over-Anxious" Parent

Poole¹

1980

Clin Pediatr (Phila)

View full text Add to dashboard Cite

This study describes the sources of anxiety in parents who report being highly anxious at pediatric visits for minor problems, despite usual management and reassurance. During a one-year period, 44 parents (0.8% of all visits; 3% of all families) were identified as "over-anxious" in a private pediatric practice. The most common sign of anxiety in these parents was the lack of satisfaction, or lack of closure, at the end of the visit. Each parent had from one to three underlying sources of anxiety in addition to the presenting complaint. The underlying sources of concern were uncovered in a brief interview and they fell into six categories: hidden agenda (28%); vulnerable child (23%); inexperienced parents (23%); psychosocially stressed parents (14%); iatrogenic anxiety (7%); and the chronically anxious parent (4%). Reassurance alone did not relieve anxiety for these parents. However, their anxiety decreased when the physician recognized and treated their specific underlying concerns. Techniques are suggested for understanding and treating "over-anxious" parents in the practice setting.

show abstract

Gaps in Doctor-Patient Communication

Cited by 752 publications

References 13 publications

Patient satisfaction with in-centre haemodialysis care: an international survey

Patient satisfaction with in-centre haemodialysis care: an international survey

Qualitative study of interpretation of reassurance among patients attending rheumatology clinics: "just a touch of arthritis, doctor?"

The "Over-Anxious" Parent

Contact Info

Product

Resources

About