Dissertations / Theses: 'Physician-patient communication'

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Bambino, Linda E. "Physician Communication Behaviors That Elicit Patient Trust." Digital Commons @ East Tennessee State University, 2006. https://dc.etsu.edu/etd/2185.

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The general relationship between the physician and the patient is one where communication is used to establish and maintain what will likely become a long-term partnership. Health communication research indicates that physicians who have apt communication skills in the patient-physician relationship develop a platform of trust behaviors. The physician communication behaviors perceived to elicit trust reported by patients are; comfort/caring, agency, competence, compassion and honesty. The objective of the research project was to assess patient perceptions of previously determined physician communication behaviors that predict patient trust through individual surveys (N=162) between foreign-born international medical graduates and American-born non-IMG resident physicians. Patients reported finding a difference in the exhibited communication behaviors between non-IMG and IMG resident physicians, with the exception of comfort/caring. A modified Trust Model guided the research and supported certain prior findings, claiming that effective communication cannot exist in the absence of a solid, trusting physician-patient relationship.

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Labuda, Schrop Susan M. "The Relationship between Patient Socioeconomic Status and Patient Satisfaction: Does Patient-Physician Communication Matter?" Kent State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=kent1320002395.

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Ashley, Mary U. "Physician opinion of the effect of direct-to-consumer advertising on physician-patient relations." The Ohio State University, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=osu1406030745.

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Krainin, Penelope. "The influence of patient weight on patient-physician interaction and patient satisfaction." Full text available online (restricted access), 2001. http://images.lib.monash.edu.au/ts/theses/krainin.pdf.

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Layton, Cheryl Marie. "Relationship Between Hospital Size, Staff Communication, Physician Communication, and Patient Experience Scores." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7816.

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Healthcare leaders who struggle to understand the importance of interactions between patients, staff, and physicians can result in poor patient experience. Healthcare care leaders who understand the importance of patient experience can develop customer service training modules and tutorials to improve organizational outcomes. The purpose of this correlational study was to examine the relationship between staff communication, physician communication, size of the hospital, and patient experience. House's path-goal theory was used to frame the study. Secondary data were collected from hospitals in Northeastern Ohio, that reported patient experience scores through the Centers for Medicare and Medicaid's Hospital Consumer Assessment of Healthcare Providers and Systems survey database for the years 2016 and 2017. The results of the multiple linear regression indicated the results were significant, F(5, 144) = 56.822, p <.001, R2 = .652. The findings may provide health care leaders with tools to communicate with staff on how to improve patient experience through improving employee and patient engagement, thereby improving patient experience scores.

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Fagerlind, Hanna. "Patient-Physician Communication in Oncology Care : The character of, barriers against, and ways to evaluate patient-physician communication, with focus on the psychosocial dimensions." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-183841.

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The overall aim of this thesis was to characterize patient-physician communication in oncology care with focus on the content and quality of the consultations from the perspectives of patients, oncologists and observer. Further, the aim was to explore oncologists’ perceived barriers against psychosocial communication in out-patient consultations. Finally, the aim was to evaluate different methods for evaluating communication in this setting. Routine oncology out-patient consultations from two different hospitals were audio-recorded. After the consultations, patients and oncologists perceptions of the content and quality of the communication were assessed using a self-report questionnaire. A nation-wide survey was performed to assess oncologists’ perceived barriers against psychosocial communication. Finally, the audio-recorded consultations were used for evaluating inter-rater reliability and feasibility of two different communication analysis instruments. Patient-physician consultations in oncology care are focused on the physical aspects of disease and treatment, both in terms of how often these issues were discussed and in terms of the amount of time spent on discussing them. Psychosocial issues, such as the disease’s effects on patients’ emotional or social functioning, are not always discussed during consultations, and the time spent on such discussions is limited. When psychosocial issues are discussed during the medical consultations, they are most often patient-initiated. Reasons for why psychosocial aspects are seldom discussed during the medical consultations can be the barriers concerning this kind of communication perceived by a large majority (93%) of the oncologists. Barriers against psychosocial communication were identified at organizational levels (including guidelines, routines, and resources) and individual levels (including physicians’ knowledge and attitudes). Furthermore, this thesis shows that there are methods with high feasibility and reliability for evaluating the content of patient-physician communication, in large study samples in oncology care. The method (observation/self-report) and perspective (patient, physician, and observer) used when evaluating communication affects the results. This needs to be considered when choosing evaluation methods in intervention studies. There are reasons to continue to evaluate, promote and implement promising ways of achieving better communication in clinical practice. Research should focus on how to overcome barriers against psychosocial communication.

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Acquah, Shirley A. "Physician-Patient Communication in Ghana: Multilingualism, Interpreters, and Self-Disclosure." Ohio University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1305026002.

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Budyn, Cynthia Lee. ""Great Expectations" communication between stadardized patients and medical students in Objective Structured Clinical Examinations." Connect to resource online, 2007. http://hdl.handle.net/1805/1187.

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Thesis (M.A.)--Indiana University, 2007.
Title from screen (viewed on January 9, 2008). Department of Communication Studies, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Stuart M. Schrader, Kim D. White-Mills, Elizabeth M. Goering, Jane E. Schultz. Includes vitae. Includes bibliographical references (leaves 85-94).

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Eger-Dreyfuss, Leora. "The impact of intercultural communication on physician-patient relations in Israel." Thesis, University of Liverpool, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425457.

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Johnson, Joan Delores. "Assertiveness as a Measure of Satisfaction in the Physician-Patient Communication Process." TopSCHOLAR®, 1992. http://digitalcommons.wku.edu/theses/1721.

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In recent years medical societies have begun to recognize the effects and benefits of good communication between physician and patient. Like any other relationship, the exchange of information with fluent understanding creates a stronger bond of trust. Most applied research conducted in the area of physician-patient communication concentrates on physician behaviors which the patient views as problematic. This thesis focuses on patient assertiveness and its relationship to physician-patient satisfaction in the consultation process. Specifically, the study focuses on the relationship between patient assertiveness and physician-patient satisfaction. For the study the researcher developed a patient questionnaire and pre- and post-physician questionnaires to assess patient assertiveness. This factor relates to outcomes of satisfaction from the physician-patient consultation. Twenty doctors and two hundred patients participated in the study. The implications of these finding should provide insight into the patient-physician consultation process.

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Carroll, Melissa A. "Communication Theory in Physician Training: Examining Medical School Communication Curriculum at American Medical Universities." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504873270954601.

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Wieczorek, Susan M. "An exploratory study on physician/patient electronic messaging within secured health portals." Thesis, University of Pittsburgh, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10076186.

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When the HITECH Act of 2009 set mandates for the transition from paper to electronic health records (EHRs), few realized the far-reaching impact this technological change would have on the entire healthcare environment. This dissertation examines the many facets of this adoption process by exploring perceptions, responses, and reactions of physicians and patients alike as they navigate through this transformative “medicological environment.” Characterized by influences from legal, political, governmental, medical, social, geographical, economic, and technological factors, this multi-faceted space reveals how a new medium for communication—the electronic message within secured health portals—transforms the way in which healthcare is managed and utilized today.

Multiple methods of observation, including oral histories, surveys, critical incident reports, and content analyses of data mined messages, together reveal the many challenges faced by patients and healthcare professionals alike as they attempt to adapt to this change while still maintaining (or improving upon) primary healthcare needs. As demonstrated by the varied responses from those living in rural and urban areas, it was found that each population approached the transition process from different vantage points. The early-adopting, urban physicians provided patient online communication simply because they felt patients expected it while rural physicians tended to resist the process, arguing that patients were media illiterate, lacked Internet access, and preferred face-to-face interactions. Others cited implementation costs and personnel training issues as a deterring factor. This provides insight into how such a new medium can affect user perceptions about online healthcare, including physician availability, online relationship factors, and overall patient care. Future research suggestions include expanded content analyses of the electronic messages themselves and follow-up, longitudinal research once implementation is more widespread.

As the Institute of Medicine (2008) states, all patients have the right to varied means of communicating with their physicians, including but not limited to online interactions. Evidence of a paradigmatic shift exists in physician training as well as patient expectations. The influence of online communication within secured health portals certainly has contributed towards this shift as more personalized, patient-centered care becomes a vital part of this ever-changing medicological environment.

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Doyle, Todd A. "Cardiac Risk, Patient-Physician Communication, And Exercise Among Patients With Type 2 Diabetes." Ohio University / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1196102689.

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MacArthur, Kelly. ""Doing gender" in doctor-patient interactions gender composition of doctor-patient dyads and communication patterns /." [Kent, Ohio] : Kent State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1216054789.

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Thesis (M.A.)--Kent State University, 2008.
Title from PDF t.p. (viewed Nov. 10, 2009). Advisor: Timothy Gallagher. Keywords: sociology, gender, doctor-patient interactions, doing gender. Includes bibliographical references (p. 78-88).

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Abramson, Lisa Diane. "The relationship of patients' perceptions of physicians' communication style to patient satisfaction." PDXScholar, 1991. https://pdxscholar.library.pdx.edu/open_access_etds/4121.

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This thesis examines the relationship between physician communication style and patient satisfaction in the diagnostic medical interview. Patient satisfaction is a critical issue for health care organizations today. Health care organizations are coping with the recruitment and maintenance of patient consumers in a competitive and costly market. The literature indicates that effective communication between the physician and the patient is important to patient satisfaction. The physician needs to structure the medical visit in order to acquire medical information and, at the same time, invite communication with patients to determine their concerns and needs. Patient satisfaction may ensue if the patient perceives the physician as possessing a positive communication style.

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Lashley, Myrna. "Informed proxy consent : communication between surgeons and surrogates about surgery." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=29068.

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Professionals whose job it is to counsel patients must be cognizant of the role played by communication in the establishment of a trusting working relationship. This is no less true for those within the medical community who must obtain informed consent for surgical interventions than it is for those working within the area of mental health. In order to determine what role communication plays in the obtaining of informed consent within a pediatrics setting, a qualitative study was conducted of 20 surrogates (those individuals giving consent on behalf of legally incompetent children) and of 5 surgeons performing surgical interventions on those children. Two sets of questionnaires were administered in order to elicit information pertaining to how surgeons communicate information to surrogates and to investigate how that information is received and processed by the surrogate. Results showed that while the obtaining of signed informed consent itself may not be a major problem, there are some difficulties in the communication between surgeons and surrogates in this domain. Based on the findings, recommendations for improved communication between surgeons and surrogates are proposed.

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Rivers, Desiree Avia. "An examination of the relationship among patient factors, patient-physician interaction, and utilization of health services in adults with diabetes." [College Station, Tex. : Texas A&M University, 2007. http://hdl.handle.net/1969.1/ETD-TAMU-1324.

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Lin, Abraham. "Perceived Efficacy in Patient-Physician Interactions among Older Adults with Atrial Fibrillation." eScholarship@UMMS, 2020. https://escholarship.umassmed.edu/gsbs_diss/1080.

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Background: Management of atrial fibrillation (AF) is complex and requires active patient engagement in shared decision making to achieve better clinical outcomes, greater medication adherence, and increased treatment satisfaction. Efficacy in patient-physician interactions is a critical component of patient engagement, but factors associated with efficacy in older AF patients have not been well-characterized. Methods: We performed a cross-sectional analysis of baseline data from the ongoing Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) study, a cohort study of older adults (age ≥ 65) with non-valvular AF and CHA2DS2-VASc score ≥ 2. Participants were classified according to their Perceived Efficacy in Patient-Physician Interactions (PEPPI-5) score (lower: 0-44; higher: 45-50). Logistic regression analysis was used to identify sociodemographic, clinical (AF type, AF treatment, medical comorbidities), and geriatric (cognitive impairment, sensory impairment, frailty, independent functioning) factors associated with lower reported efficacy. Results: Participants (n = 1209; 49% female) had a mean age of 75. A majority (66%) reported higher efficacy in their interactions with physicians. Lower efficacy was associated with persistent AF (adjusted odds ratio [aOR] = 1.52; 95% confidence interval [CI] = 1.13-2.04) and with symptoms of depression (aOR = 1.67; CI = 1.20-2.33) or anxiety (aOR = 1.40; CI = 1.01-1.94). Decreased odds of lower efficacy were observed in participants with chronic kidney disease (aOR = 0.68; CI = 0.50-0.92) and those classified as pre-frail compared to those classified as not frail (aOR = 0.71; CI = 0.53-0.95). Conclusion: Older patients with persistent AF or symptoms of depression or anxiety have decreased efficacy in patient-physician interactions. These individuals merit greater attention from physicians when engaged in shared decision making.

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Ku, Wai-yin Ellen. "An exploration of the communication needs of cancer patients." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22078988.

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Parrott, Roxanne Louise. "Physicians' verbal immediacy as a mediator of patients' understanding and satisfaction." Diss., The University of Arizona, 1990. http://hdl.handle.net/10150/185224.

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This study examines specific speech forms that comprise physicians' language use, and motives for use. A coding system combining work on verbal immediacy and conversational involvement was used to assess the language of 19 physicians during 58 videotaped interactions with patients. Physicians were found to use more nonimmediate than immediate speech. Information-giving was positively related to use of nonimmediate speech. Use of implicit nonimmediacy was positively related to physicians' perceptions of the medical community's consensus regarding a patient's condition and recommendations for treatment. Experience was positively related to use of spatial nonimmediacy and automatic phrases. Gender and experience interact to predict use of temporal, implicit, and qualified nonimmediacy. Inexperienced males used the least of these forms of speech, while experienced males used the most. No relationship was found between use of nonimmediate speech and patients' understanding, satisfaction, or met expectations. Implicit nonimmediacy was directly related to patients' behavioral intent to comply. Findings are reviewed for implications to both Communication and Medicine.

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Clifford, Julie Veronica. "Computers in general practice consultations : impact on doctor-patient relationships /." Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmc637.pdf.

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Zheng, Yan. "Strategies for Cross-Cultural Physician-Patient Communication: A Case of International Patients in a Cultural Competency Laboratory." Ohio University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1373634504.

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Rankin, Anna M. "Communication and Uncertainty in Illness: The Struggle for Parents to Assign Meaning to an “Orphan” Illness." University of Cincinnati / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1276527383.

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Caruso, Myah. "The Patient-Physician Relationship from the Perspective of Economically Disadvantaged Patients." Antioch University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=antioch150362027045926.

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Hicks, Michelle B. "Informed Consent in Obstetric Anesthesia: The Effect of the Amount, Timing and Modality of Information on Patient Satisfaction." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9771/.

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Using mainly quantitative methods of evaluation, as well as patient comment assessment, this study evaluated whether changing the current informed consent process for labor epidural analgesia to a longer, more informational process resulted in a more satisfied patient. Satisfaction with the labor epidural informed consent process was evaluated using a questionnaire that was mailed and also available online. Half of the patient population was given a written labor epidural risk/benefit document at their 36-week obstetric check up. All patients received the standard informed consent. Survey responses were evaluated based on three independent variables dealing with the modality, timing, amount of informed consent information and one dependent variable, whether the patient's expectations of the epidural were met, which is equated with satisfaction. Patients in this study clearly indicated that they want detailed risk/benefit information on epidural analgesia earlier in their pregnancy. A meaningfully larger percentage of patients who received the written risk/benefit document were satisfied with the epidural process as compared to those who did not receive the document.

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Rosenberg, Brett Allen. "Describing the nature of interpreter-mediated doctor-patient communication : a quantitative discourse analysis of community interpreting /." Full text (PDF) from UMI/Dissertation Abstracts International, 2001. http://wwwlib.umi.com/cr/utexas/fullcit?p3008433.

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Williams, Amanda L. "Physician adherence to communication tasks with adult vs. older adult female patients." CardinalScholar 1.0, 2010. http://liblink.bsu.edu/uhtbin/catkey/1560844.

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The study investigated whether physician communication adherence was similar between adult and older adult female patients in a family medicine setting. Additionally, the study investigated whether or not the level of communication adherence was related to patient perceptions of working alliance. Previous research has failed to adequately examine age as a variable in physician-patient communication and has neglected to examine the working alliance within the physician-patient relationship. The sample included 41 adult female, family medicine patients, who agreed to have their appointment with their physician videotaped. The videotaped encounters were coded by trained observers using the Behavioral Science Tape Review Checklist (BSTRC). Participants also completed the Working Alliance Inventory-Short Form (WAI-SF). Results from the study suggested that physician adherence to communication tasks did not vary significantly between adult patients and older adult patients. Further, results demonstrated that the combination of responses to the bond and tasks subscales of the WAI-SF significantly accounted for 16% of the variance in communication adherence.
Department of Counseling Psychology and Guidance Services

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Farrell, Carrie. "Improving the Quality of an After-Visit Summary (AVS) to Enhance Patient-Centered Care." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522332443156384.

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Jorina, Maria. "Determinants of Satisfaction and Willingness to Recommend: Physician and Patient Perspectives." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1376905286.

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van, Walsum Kimberly Lynn. "Transference effects on student physicians' affective interactions and clinical inferences in interviews with standardized patients: an experimental study." Texas A&M University, 2005. http://hdl.handle.net/1969.1/2548.

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This study applied Andersen??s social cognitive paradigm for the experimental study of transference to the problem of understanding transference effects on the affective interactions and clinical inferences of student physicians with standardized patients. The investigator designed a 2X2 experimental study in which the independent variables were: source of information for statements about a standardized patient (participant??s own or matched participant??s) and valence of information in statements about the patient (positive or negative). Dependent variables were: affect expressed by a student physician in videotapes of a medical interview with a standardized patient, as measured by a modified version of the Specific Affect ?? 16 code system (SPAFF-16), and clinical inferences by the student physician as measured by the Physician Clinical Inferences Scale (PCIS) developed by the investigator. Covariates included gender, physician verbosity, and intergenerational family relationship variables as measured by the Personal Authority in the Family System Questionnaire ?? Version C (PAFS-QVC). A 2X2 MANCOVA was conducted, along with hierarchical regressions of gender and PAFSQVC variables as predictors of negative and positive affect and clinical inferences (likelihood of treatment success and patient as partner). One sample of undergraduate medical students (n= 71) provided data for the study. Results indicated no statistically significant differences between experimental groups regarding the effect of the experimental manipulation of patient information on student physicians?? affective interactions and clinical inferences with patients when gender, physician verbosity, and related PAFS-QVC variables were controlled. Hierarchical regression analyses of gender and related PAFS-QVC variables onto positive affect, negative affect, clinical inferences (patient as partner) and clinical inferences (likelihood of treatment success) revealed statistically significant effects of intergenerational family relationship and peer relationship variables on student physicians?? affective interactions and clinical inferences with patients.

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Bigney, Mark W. "Neither mechanic nor high priest : moral suasion and the physician-patient relationship." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=99576.

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The most ordinary man or woman has means of knowledge concerning his own feelings and circumstances that immeasurably surpass those that anyone else can have.-John Stuart Mill, On Liberty
One feature that varies within competing conceptions of medical shared decision-making is how a patient's values are to be engaged by a physician. One detail that can be overlooked under "shared" decision-making is whether or not a physician ought (or be allowed) to attempt to persuade the patient to adopt particular health-related values. Some argue that it is incumbent on a physician to share her privileged understanding of medicine so as to help her patient embrace "better" values. This thesis argues that it is dangerous to patient autonomy for a physician to exert moral suasion on her patient to attempt to influence or change those values; the danger lies in the power imbalance between patients and physicians that seems inherent in medical encounters, and is exacerbated by the sick role. Thus, while a physician ought to help her patient articulate his health-related values, she ought not try to change them.

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Lauret, Fanny, and Stephanie Härdig. "Patients’ Communication with Primary Care: A Pre-study for a new communication system." Thesis, Linköpings universitet, Företagsekonomi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-131108.

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The purpose of this study is to explore patients’ experiences and preferences concerning communication with primary care, as well as their attitude towards a future digital system to manage communication. The Swedish county councils and municipalities (SKL) is developing a new digital tool as a complement in the communication between patients and physicians, thus this research is a preliminary investigation of a larger approach. The research has been based on 20 semi-structured interviews with patients in ages between 21 and 86 from 13 different health care centers in Sweden. The interviews indicate that the communication between patients and physicians needs development in numerous ways and that the system used by the primary care contributes to negative outcomes in the communication. Patients’ attitudes towards a new digital system to manage communication were investigated and a majority was positive. The study’s results pointed out the importance of the physicians’ attitudes in the physician-patient communication, and brought some possible improvements to be done in the actual primary care system; as for example implementing new communication channels to allow an easier contact of patients with their health care center. The new communication tool was overall well received and even appeared to be a suitable solution for some of the problems discovered along the patients’ journey. The overall results obtained are positive and promising towards its implementation in Sweden.

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Novosel, Lorraine Marie. "Depressive symptomatology, patient-provider communication, and patient satisfaction : a multilevel analysis." [Tampa, Fla] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0001866.

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Le, Poire Beth Ann 1964. "Communication strategies to restore or preserve informational and psychological privacy; the effects of privacy invasive questions in the health care context." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276798.

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This investigation explored the role of informational and psychological privacy in the health context by examining the relationship between type of relationship (physician versus acquaintance), type of observation (self-report versus observation), and communication strategies used to restore or preserve privacy (interaction control, dyadic strategies, expressions of negative arousal, blocking and avoidance, distancing, and confrontation). It was hypothesized and confirmed that individuals report exhibiting more behaviors to restore or preserve informational privacy in response to an informationally privacy-invasive question posed by an acquaintance than by a physician. The hypothesis that presentation of an informationally privacy invasive question by the physician causes patients to exhibit more communication strategies after the privacy invasive question than before, was unsupported. Finally, the hypothesis that individuals actually exhibit more privacy restoration behaviors than they report using in a similar situation with their physician was also unsupported. Patients reported using more communication strategies than they actually exhibited. One confound to the self reports was that videotaped participants reported the use of fewer direct privacy restoring communication strategies than non-videotaped.

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Ahmed, Rukhsana. "Assessing the role of cultural differences on health care receivers' perceptions of health care providers' cultural competence in health care interactions." Ohio : Ohio University, 2007. http://www.ohiolink.edu/etd/view.cgi?ohiou1178244318.

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Hundley, Gulnora. "THE EFFECTIVENESS OF "DELIVERING UNFAVORABLE NEWS TO PATIENTS DIAGNOSED WITH CANCER" TRAINING PROGRAM FOR ONCOLOGISTS IN UZBEKIS." Doctoral diss., University of Central Florida, 2008. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/3675.

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Effective physician-patient communication is primary to successful medical consultation and encourages a collaborative interactional process between patient and doctor. Collaborative communication, rather than one-way authoritarian, physician-led medical interview, is significant in navigating difficult circumstances such as delivering "bad news" to patients diagnosed with cancer. Additionally, the potential psychological effects of breaking bad news in an abrupt and insensitive manner can be devastating and long-lasting for both the patient and his or her family. The topic of delivering unfavorable news to patients is an issue that many medical professionals find to be challenging and is now getting the attention of medical professionals in many countries, including the former Soviet Union (FSU) republics. The limited literature on communication skills in oncology in the FSU republics supports that the physician-patient communication style is perceived as significantly physician-oriented rather than patient-oriented. More specifically, the Soviet medical education system, as well as post-graduate medical education, has placed little to no emphasis on physician-patient communication training. Physician-oriented communication leads to patients being less forthcoming and open regarding their own feelings about being diagnosed with cancer, which may exacerbate the overall communication problem. The purpose of this study was to investigate the effectiveness of the training program "Delivering Unfavorable News to Patients Diagnosed with Cancer" (Baile et al., 2000) conducted in Uzbekistan, one of the FSU republics. A total of 50 oncologists from the National Oncology Center of Uzbekistan (N = 50, n = 25 , n = 25 ) completed Self-Efficacy, Interpersonal skills (FIRO-B), Empathy (JSPE), and Physician Belief (PBS), and demographic instruments before, immediately after, and then two weeks after the training intervention. Results of MANOVA and bivariate statistical analyses revealed significant differences in self-efficacy, empathy, and PBS scores within the experimental group, but not within the control group, from pre-test to post-test. The follow-up data analysis suggested that participants maintained the level of change that occurred immediately after the training intervention.
Ph.D.
Department of Child, Family and Community Sciences
Education
Education PhD

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Hundley, Gulnora. "The effectiveness of "delivering unfavorable news to patients diagnosed with cancer" training program for oncologists in Uzbekistan." Orlando, Fla. : University of Central Florida, 2008. http://purl.fcla.edu/fcla/etd/CFE0002043.

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Lan, Wei. "Crossing the Chasm : embodied empathy in medical interpreter assessment." HKBU Institutional Repository, 2019. https://repository.hkbu.edu.hk/etd_oa/674.

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Research on medical interpreters (MIs) in recent years has informed us of the visible and active participating roles that MIs play in the doctor-interpreter-patient triadic encounter. The use of multi-faceted, authentic data has also allowed both verbal and nonverbal nuances to be studied. However, while empirical studies have shown that physician empathy in medical communication is beneficial to the patient's healthcare outcomes, empathy in medical interpreting, especially the one that is expressed nonverbally, is rarely examined in medical interpreting research, even though MI is the key communication facilitator and in principle shares a communicative goal with the doctor. This study aims to acquire a deeper understanding of how an MI's empathy is constructed nonverbally and perceived by service users, and how it affects interlocutors and the communication process. This research argues that MI empathy in communication is desired and should be incorporated in the training, assessment, and most importantly, in the interpreting practice. Three sets of research questions are thus formed: 1) How do Mis communicate empathy, if any, for and to the patient? 2) How do the other medical interview participants (doctor and patient) and observers (video observers) perceive the empathic performance of the interpreters? Is there any discrepancy? Why? and 3) How do internal and external factors such as an MI's nonverbal sensitivity and personality traits influence empathic performance? The findings are expected to inform medical interpreting training and assessment and to enhance doctors' awareness of the roles of MIs so that a more patient-centred and empathic communication environment can be nurtured.

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Pérez, María Teresa. "Interprofessional Conflict: A Preventive Health Approach to Ineffective Communication in Nurse-Physician Relationships." Thesis, Boston College, 2010. http://hdl.handle.net/2345/3249.

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Thesis advisor: Judith A. Vessey
This undergraduate thesis explores the underlying problem of interprofessional conflict and the resulting poor communication between physicians and nurses. It establishes the importance of understanding and addressing this subject within the health care community on a basis of reported negative outcomes, including compromised patient safety and quality of care. It also proposes a preventive health model as the most effective approach to describing the problem. An exploration of the antecedents to this interprofessional conflict identifies gender identity as having a significant role in setting the stage for the kind of relationships between nurses and physicians that harbor tension. Gender roles are discussed in the context of the developing professional identities of both physicians and nurses. The discussion further identifies how these social and professional distinctions result in the imposition of hierarchical arrangements that give way to oppressive relationships. The analysis proposes a need for dialogue –a form of primary prevention- regarding the oppressive internalized sexism that appears to have resulted from this hierarchical evolution
Thesis (BS) — Boston College, 2010
Submitted to: Boston College. Connell School of Nursing
Discipline: College Honors Program

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Hoffmann, Mikael. "Risk Talk : On Communicating Benefits and Harms in Health Care." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7338.

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Keon, Claire M. "Risk amid Protection and Motivation: A Communicative Cardiovascular Physician-Patient Model of Message Preparation-Perception (CPMP)2." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/22676.

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Effective risk communication is essential in the field of health to ensure patients understand the information being presented to them by medical professionals and appreciate the level of risk involved in treatments. Cardiovascular disease, being the leading cause of death worldwide, is relevant to consider when examining risk communication in a health setting. Those afflicted with cardiovascular ailments are both high in number and exposed to information communicating risk. This research aims to identify presentation formats that are more effective communicating risk information to recovering cardiovascular patients at the University of Ottawa Heart Institute. The formats’ effectiveness is measured by gauging the population’s understanding of the material and perception of the information as it relates to risk and motivation. The research draws on Max Weber’s concept of rationality and subsequent scholars who developed social judgment theory, the heuristic-systematic model, expected utility theory, protection motivation theory, and the extended parallel process model. Utilizing an experimental research design, risk information handouts and questionnaires are distributed to, and completed by, a stratified sample of cardiovascular disease patients. Effective presentation formats are examined, and the results identify comparatively effective presentation formats for minimizing and maximizing risk perception. The results also identify presentation formats’ impact on a patient’s level of motivation to avoid / indulge in behaviours that may maximize or minimize risk. The results, synthesized herein, suggest a model (communicative cardiovascular physician-patient model of message preparation-perception), which may contribute to the effectiveness of risk communication between physicians and cardiovascular disease patients.

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Jordan, Joanne Emma. "Conceptualising and measuring health literacy from the patient perspective." Connect to thesis, 2009. http://repository.unimelb.edu.au/10187/6776.

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The current patient-centred healthcare approach encourages individuals to assume greater roles in decisions about their health. The premise is that patients who are well informed about healthcare options are more likely to adhere to prescribed treatments and achieve better health outcomes. This approach assumes that patients have an adequate level of health literacy. While a range of definitions exist, health literacy is commonly defined as an individual’s ability to seek, understand and utilise health information to make appropriate health decisions.
Health literacy is increasingly recognised as a complex multi-dimensional concept which involves interactions between individual abilities and broader environmental factors. However across definitions, there has been little consultation with patients to understand what is important to effectively seek, understand and utilise health information. The lack of a consensual understanding has led to debate as to what health literacy represents and how it should be measured. A range of measures exist with the predominant approach being the testing of individual literacy abilities. However measures do not assess the range of attributes described in definitions. Thus a considerable gap exists between how health literacy is defined and how it is measured. This thesis focused on addressing this gap. The objectives were to: (i) critically appraise existing health literacy measures (ii) develop a conceptual framework from the patient perspective and (iii) use this framework to develop a comprehensive measure of health literacy.
A multi-method qualitative and quantitative approach was used:
(1) Systematic review and appraisal of the content, development and psychometric properties of health literacy measures.
(2) In-depth consultations with patients across healthcare and disease continuums to develop a conceptual framework.
(3) Development of a new health literacy measure based on the conceptual framework using a classical test theory approach.
A critical appraisal of the literature revealed that the majority of health literacy measures are not based on a conceptual framework and none appeared to adequately measure a person’s ability to seek, understand and utilise health information. Content focussed primarily on reading, comprehension and numeracy skills and scoring was poorly defined. Only five of the 19 measures had evidence of acceptable reliability.
The conceptual framework of health literacy from the patient perspective identified 17 key elements: six individual abilities and 11 broader contextual factors that are important to seek, understand and utilise health information and expanded previous conceptualisations of health literacy. This informed the development of the Health Literacy Management Scale (HeLMS) which measures six generic and potentially modifiable abilities and three specific broader social factors. Overall the HeLMS measures an individual’s ability to seek, understand and utilise health information within the healthcare setting. The HeLMS consists of 29 items across eight domains. Rigorous psychometric testing demonstrates that it possesses strong construct validity and high reliability (coefficient α >0.80 for all eight domains).
This research provides unique contributions to the conceptualisation and measurement of health literacy. Limitations in the content and psychometric properties of previously developed measures have been identified through a systematic process. A conceptual framework derived from the patient perspective identifies a range of components that provide new insight into: (i) constructs that should be incorporated to measure health literacy and (ii) areas that need to be addressed to improve health literacy. The development of the HeLMS now allows for a more comprehensive assessment of health literacy. Information from the conceptual framework and the HeLMS are likely to be useful tools to inform the development of public health initiatives to enhance patient participation in the management of their health.

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Klein, Susan. "The effects of cancer patient participation in teaching communication skills to medical undergraduates a follow-up evaluation /." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 1996. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=59664.

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44

Fossum, Bjöörn. "Communication in the health service : two examples /." Stockholm : Karolinska inst, 2003. http://diss.kib.ki.se/2003/91-7349-667-7/.

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45

Keiser, Cynthia L. "A QUALITY IMPROVEMENT PROJECT TO IMPROVE PATIENT EXPERIENCE IN THE URGENT CARE." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1594855942964226.

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46

Passalacqua, Stacey Ann. ""Running On Empty": Examining the Effect of Physician Stress, Burnout, and Empathy On Patient-Centered Communication During the Long-Call Shift." Diss., The University of Arizona, 2010. http://hdl.handle.net/10150/145716.

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Medical residency is characterized by sleep deprivation, stress, and heavy workload. The impact of these pressures on physician-patient communication has not been fully explored. The aim of the current study was to investigate how contextual demands, stress, and burnout impact empathy and provision of patient-centered communication among internal medicine residents in two hospitals. The long-call shift was studied, as it is known to be particularly taxing and is a primary feature of medical residency. Assessments were obtained both prior to and at the conclusion of residents' shifts. Cognitive complexity was examined as a potential mediator of the relationship between stress and burnout, and burnout and empathy. Results revealed that there was a significant decline in physician empathy from the beginning to the end of the long-call shift and that this decline in empathy predicted less patient-centered communication from physicians. Stress, burnout, and decline in empathy were all positively associated, indicating that resident physicians who were more stressed and burned out were at increased risk for declines in empathy over the course of their shift. Cognitive complexity was not found to be a significant mediator of any associations between study variables, though it was associated with several key variables in unexpected ways. These findings highlight the importance of identifying and addressing barriers to patient-centered communication, as a number of these barriers may be routinely present in the demanding environment of medical residency.

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Dahl, Aaron. "ASSESSING PHYSICIAN‐PARENT COMMUNICATION DURING EMERGENCY MEDICAL PROCEDURES IN CHILDREN: AN OBSERVATIONAL STUDY OF THE EFFICACY OF THE INFORMED CONSENT PROCESS IN A LOW‐LITERACY LATINO PATIENT POPULATION." Thesis, The University of Arizona, 2015. http://hdl.handle.net/10150/528182.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
Objective: Effective physician‐patient communication is critical to the clinical decision making process. The informed consent process for any intervention can be one of the most important moments for effective physician‐patient communication in regards to outcome and liability. We studied parental recall of information provided during an informed consent discussion process prior to performance of emergency medical procedures in a pediatric emergency department of an inner city hospital with a large bi‐lingual population. Methods: Parent/child dyads undergoing emergency medical procedures were surveyed prospectively in English/Spanish, post‐procedure for recall of informed consent information. Logistic regression analysis was used; outcome variables were the ability to name a risk, a benefit, and an alternative to the procedure and predictors were language, education, and acculturation. Results: Fifty‐five parent/child dyads completed the survey. Logistic regression analysis showed that respondents with less than high school education were approximately 80% less likely to be able to name a risk or a benefit, while respondents with a high school education were approximately 24 times more likely to be able to name an alternative procedure. Conclusion: A gap in communication exists between physicians and patients during the consent taking; it is significantly impacted by socio‐demographic factors like education level, language and acculturation.

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Bokström, Malin, and Malin Törnquist. "För patientens bästa : kommunikation mellan sjuksköterska och läkare." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-15267.

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För att säkra patientsäkerheten krävs att kommunikationen mellan vårdpersonal främjas, de har visat sig att kommunikationen har ett samband med de misstag som sker i patientvården. Ett speciellt behov av vidare forskning på kommunikationen mellan sjuksköterska och läkare finns, detta för att professionernas kommunikation sinsemellan är en stor del av patientens vård och säkerhet. Syftet med denna litteraturstudie var att belysa faktorer som påverkar kommunikation mellan läkare och sjuksköterska relaterat till patientsäkerheten. Studien utfördes som en litteraturstudie. Resultatet visade att C-HIP och SBAR ansågs vara användbara för att främja en god kommunikation mellan professionerna och för att främja patientsäkerheten. För att främja kommunikationen professionerna emellan krävs god kvalitet av information och att informationen är relevant. Humor, empati, förståelse och öppenhet är faktorer i beteendet som främjar en god kommunikation. Hierarkin som fortfarande råder i sjukvården påverkar kommunikationen mellan sjuksköterskan och läkaren negativt. Att höja rösten, nedvärdera varandra och att uppvisa ett respektlöst beteende är också faktorer som hindrar kommunikationen. Fler kurser behöver införas i sjuksköterskan och läkarens utbildning för att främja kommunikationen dem emellan. Ett förslag kan vara att införa en gemensam kurs där professionerna kan öva och även få en inblick i varandras arbetsuppgifter.
It requires better communication between medical staff to ensure patient safety. It’s proved that communication is linked to the mistakes that occur in patient care. A special need for further research on communication between nurses and doctors are needed, this for the communication between them is a big part of patient care and safety. The purpose of this study was to illuminate factors that affect communication between doctors and nurses related to patient safety. The study was conducted as a literaturestudy. The results showed that C-HIP and SBAR were useful methods for promoting good communication between the professions and to promote patient safety. It requires good quality of the information and relevant information to foster good communication. Humor, empathy, understanding and openness are factors in behavior that promotes good communication. The hierarchy that still exists is affecting communication between the nurse and doctor negative. Raising his voice, depreciate each other and show a disrespectful behavior are barriers that effects the communication. More courses need to be introduced in the nurse and physician education to promote communication. One suggestion might be to introduce a common course in which professions can practice and also get an insight into each other's work.

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Ogle, Kimberly K. "Waiting to Die: An Exploratory Qualitative Study of Older Adults." Miami University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=miami1542731170804458.

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50

Melander, Marttala Ulla. "Innehåll och perspektiv i samtal mellan läkare och patient en språklig och samtalsanalytisk undersökning /." Uppsala : Institutionen för nordiska språk vid Uppsala universitet, 1995. http://catalog.hathitrust.org/api/volumes/oclc/34143907.html.

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Dissertations / Theses on the topic 'Physician-patient communication'

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