Physician-Patient Communication Project

描述（由申请人提供）：医患沟通是患者护理的核心。讨论诊断和治疗决定的方式可能影响患者对提供者建议的依从性，进而影响患者的健康结果。研究表明，在就诊期间获得更多信息的患者对他们的护理更满意，回忆起更多的信息，并且更坚持治疗计划。那些在与医疗服务提供者互动时更多参与的人有更好的健康结果。然而，提供大量信息的一个重大障碍是，提供者进行办公室访问的时间有限，在此期间，他们必须执行健康维护和疾病管理任务，解决患者关注的问题，并向患者提供有关患者医疗状况和治疗的教育。高效而有效的沟通需要导航这些访问，但在门诊访问期间处理多种竞争需求的最佳沟通策略尚未得到很好的探索。

DESCRIPTION (provided by applicant): Provider-patient communication is central to patient care. The manner in which diagnostic and treatment decisions are discussed may influence patient adherence to provider recommendations, and in turn, patient health outcomes. Studies have shown that patients who receive more information during an office visit are more satisfied with their care, recall more information, and are more adherent to treatment plans. Those who participate more when they interact with their providers have better health outcomes. However, a significant obstacle to the amount of information provided is the limited amount of time providers have for office visits, during which they must perform health maintenance and disease management tasks, address patient concerns, and provide patient education about patient medical conditions and treatments. Efficient yet effective communication is needed to navigate these visits, but optimal communication strategies for dealing with multiple competing demands during outpatient visits have not been well explored. The overall objective of this study is to identify effective and efficient provider-patient communication strategies during primary care outpatient visits. Qualitative analysis of existing audio recordings will be used to develop a coding system describing efficient and effective provider and patient communication. This analysis will inform the development of a measure of communication efficiency and effectiveness. Subsequently, primary care physicians and their patients will be recruited for the study, and have their office visits audio taped. Patients and providers will complete surveys to assess the relationship of their attitudes and values, and the physician-patient relationship on communication efficiency and effectiveness. The study also will explore the relationship between communication efficiency on patient intention to adhere to treatment recommendations, and patient and provider satisfaction with the visit. A subset of patients and providers will be interviewed concerning their impressions of the visit communication, and their understanding of what transpired during the visit. Findings will be used to develop physician- and patient-targeted interventions to promote efficient, effective communication during office visits that maximize patient understanding and satisfaction.