Impact of the Doctor-Patient Relationship

Chipidza, Fallon E.; Wallwork, Rachel; Stern, Theodore A.

doi:10.4088/pcc.15m01840

Cited by 60 publications

(75 citation statements)

References 0 publications

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“…Poor interpersonal communication between practitioners in the same setting as well as across settings, and between practitioners and family carers, not surprisingly appeared to increase the difficulty of decision making. Good communication has been consistently highlighted as an important aspect of shared decision making in various health conditions as well as in end of life care . Our study suggests that good communication needs to be considered at system level (eg information sharing) as well as interpersonal levels.…”

Section: Discussionmentioning

confidence: 78%

A qualitative study exploring the difficulties influencing decision making at the end of life for people with dementia

Lamahewa

Mathew

Iliffe

et al. 2017

Health Expectations

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BackgroundDementia is a progressive neurodegenerative condition characterized by declining functional and cognitive abilities. The quality of end of life care for people with dementia in the UK can be poor. Several difficult decisions may arise at the end of life, relating to the care of the person with dementia, for example management of comorbidities.ObjectiveTo explore difficulties in decision making for practitioners and family carers at the end of life for people with dementia.DesignQualitative methodology using focus groups and semi‐structured interviews and thematic analysis methods.Settings and participantsFormer (n=4) and current (n=6) family carers of people with experience of end of life care for a person with dementia were recruited from an English dementia voluntary group in 2015. A further 24 health and care professionals were purposively sampled to include a broad range of expertise and experience in dementia end of life care.ResultsFour key themes were identified as follows: challenges of delivering coherent care in dynamic systems; uncertainty amongst decision makers; internal and external conflict amongst decision makers; and a lack of preparedness for the end of life. Overarching difficulties such as poor communication, uncertainty and conflict about the needs of the person with dementia as well as the decision maker's own role can characterize decision making at the end of life.ConclusionsThis study suggests that decision making at the end of life for people with dementia has the potential to be improved. More planning earlier in the course of dementia with an on‐going approach to conversation may increase preparedness and family carers’ expectations of end of life.

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Section: Discussionmentioning

confidence: 78%

A qualitative study exploring the difficulties influencing decision making at the end of life for people with dementia

Lamahewa

Mathew

Iliffe

et al. 2017

Health Expectations

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“…Giving printed information may be helpful, so the patients can have time to analyze and review it if necessary. Additionally, an empathic relationship is essential, as in fact the doctor-patient relationship can have an important impact on patient outcome, and even survival (101).…”

Section: Hints To Improve Patient's Quality Of Lifementioning

confidence: 99%

Quality of Life in Patients With Cushing's Disease

et al. 2019

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Cushing's disease (and by extension, Cushing's syndrome) is a rare disease due to a chronic cortisol excess, which usually has an important impact on quality of life (QoL). It can lead to numerous comorbidities that can interfere with daily life, as fatigability, myopathy, bone loss and fragility, increased cardiovascular risk, depression, and cognitive alterations. Of note, psychological alterations (including depression and anxiety) occur often, and are an important determinant of impaired quality QoL. QoL scores using different questionnaires are poorer in comparison to healthy controls, other pituitary adenomas and some chronic diseases. Even if some improvements can be observed after successful treatment, recovery does not seem to be complete, and comorbidities persist. This persistent QoL impairment has been found using both generic and disease-specific QoL questionnaires, and is also reported by the patients themselves, when asked directly. Multidisciplinary teams are essential to improve patients' well-being. Clinicians should take into account the whole scope of clinical problems and address the different comorbidites associated with the disease. Screening in the psychological sphere, with further intervention if necessary, can be helpful in the management of these patients. Interventions and programs have shown promising results, although there is a need for further development of new strategies for the benefit of these patients.

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“…It influences patient management outcomes, especially in the treatment of long term illness, as well as influences outcomes of health promotion and prevention initiatives. A trusting relationship between healthcare provider and patient can have a direct therapeutic effect 8. Trust relations can be distinguished at the micro and macro levels.…”

Section: Introductionmentioning

confidence: 99%

A study of the nature and level of trust between patients and healthcare providers, its dimensions and determinants: a scoping review protocol

et al. 2020

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IntroductionThe aim of this scoping review is to systematically search the literature to identify the nature and or level of trust between the patient, the users of health services (eg, clients seeking health promotion and preventive healthcare services) and the individual healthcare providers (doctors, nurses and physiotherapists/ occupational therapists), across public and private healthcare sectors, at all levels of care from primary through secondary to tertiary care. It also aims to identify the factors that influence trust between patients, users of health services (clients) and providers of healthcare at all levels of care from primary care to tertiary care, and across all health sectors (public and private). The study will also identify the tools used to measure trust in the healthcare provider.Methods and analysisThe scoping review will be conducted based on the methodology developed by Arksey and O’Malley’s scoping review methodology, and Levacet al’s methodological enhancement. An experienced information specialist (HM) searched the following databases MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature. The search terms were both keywords in the title and/or abstract and subject headings (eg, MeSH, EMTREE) as appropriate. Search results were downloaded, imported and stored into a ‘Refworks’ folder specifically created for reference management. The preliminary search was conducted between 7 December 2017 and 14 December 2017. Quantitative methods using content analysis will be used to categorise study findings on factors associated with trust between patients, clients and healthcare providers. The collection of studies will be also examined for heterogeneity. Qualitative analysis on peer reviewed articles of qualitative interviews and focus group discussion will be conducted; it allows clear identification of themes arising from the data, facilitating prioritisation, higher order abstraction and theory development. A consultation exercise with stakeholders may be incorporated as a knowledge translation component of the scoping study methodology.Ethics and disseminationEthical approval will be obtained for the research project from the Institutional Review Board. The International Medical University will use the findings of this scoping review research to improve the understanding of trust in healthcare, in its endeavour to improve health services delivery in its healthcare clinics and hospitals, and in its teaching and learning curriculum. The findings will also help faculty make evidence based decisions to focus resources and research as well as help to advance the science in this area. Dissemination of the results of the scoping review will be made through peer-reviewed publications, research reports and presentations at conferences and seminars.

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Impact of the Doctor-Patient Relationship

Cited by 60 publications

References 0 publications

A qualitative study exploring the difficulties influencing decision making at the end of life for people with dementia

A qualitative study exploring the difficulties influencing decision making at the end of life for people with dementia

Quality of Life in Patients With Cushing's Disease

A study of the nature and level of trust between patients and healthcare providers, its dimensions and determinants: a scoping review protocol

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