The Weight of Words: Indian Physicians’ Perspectives on Patient Communication to Promote Diabetes Adherence

Abstract

Background: Effective communication by physicians can lead to improved patient adherence, resulting in better patient outcomes and increased patient satisfaction. This study: (i) examined communication with patients when they were non-adherent, (ii) examined attitudes toward common communication cues, and (iii) explored communication approaches to encourage diabetes adherence used by Indian physicians. Methods: Using a concurrent mixed methods approach, Indian physicians, specialized in diabetes and/or endocrinology were recruited, to complete a survey containing quantitative ( n = 834) and qualitative ( n = 648) questions. The questions included (i) whether physicians expressed disappointment and used scare tactics for non-adherent patients, (ii) to rate the importance of common communication cues when promoting adherence, and (iii) nested, qualitative questions to understand their communication approach to promote adherence. The data were analyzed using descriptive statistics and qualitative content analysis, respectively. Results: The quantitative study reported that the majority of the physicians sometimes showed their disappointment in their patient's progress (44.4%), sometimes used scare tactics to convey disease severity due to non-adherence (34.3%), and rated all communication cues as most important. The qualitative findings revealed that physicians used paternalistic (authoritative, educational, authoritarian) or collaborative (multistakeholder, patient-centered) approaches and the language cues of fear, blame, and threats to promote patient adherence. Conclusion: These findings highlight the need for communication skill training programs for Indian physicians focused on empathic, non-verbal, supportive, and inclusive techniques so as to promote patient adherence. Further, these trainings need to use role-playing, video recording, and peer feedback methods to show physicians how to implement these skills during patient interactions.

Knowledge, Attitudes, and Behaviors towards Proper Nutrition and Lifestyles in Italian Diabetic Patients during the COVID-19 Pandemic

“…Paradoxically, undergoing self-management educational programs seems to worsen, albeit not significantly, patients’ knowledge levels [ 44 , 45 , 46 ]. This is thought-provoking and, only in part, can be attributed to the fact that several patients stated that they received information exclusively from relatives, friends, or via the Internet [ 47 , 48 , 49 , 50 , 51 ]. Certainly, increased age, as shown in the regression analysis, may have played a major role in limiting the understanding of the information received.…”

Response from Authors to Letter to Editor ‘In Search of Unity in Diversity’

“…[ 1 ] However, through the process of writing this document, we came to realise that it would be incomplete to introduce the need for communication skills without narrating physicians’ accounts of the medical consultation. Our current publication,[ 2 ] in the Indian Journal of Endocrinology and Metabolism is the outcome of this endeavour.…”

In Search of Unity in Diversity

“…I read with interest the article by Selvan C, Tejal L, Shweta C et al . [ 1 ] on Indian Physicians’ perspective on patient communication to promote diabetes adherence.…”