Physician-Patient Communication Project

描述(由申请人提供)：提供者与患者之间的沟通是患者护理的核心。讨论诊断和治疗决定的方式可能会影响患者对提供者建议的遵守，进而影响患者的健康结果。研究表明，在办公室就诊期间收到更多信息的患者对自己的护理更满意，回忆更多信息，更遵守治疗计划。那些在与提供者互动时参与更多的人会有更好的健康结果。然而，提供信息量的一个重大障碍是提供者只能在有限的时间内访问办公室，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条件和治疗的教育。需要高效而有效的沟通来引导这些就诊，但在门诊期间处理多个相互竞争的需求的最佳沟通策略尚未得到很好的探索。 这项研究的总体目标是确定在初级保健门诊就诊期间有效和高效的提供者-患者沟通策略。将使用对现有录音的定性分析来开发一种编码系统，以描述有效和有效的提供者和患者的交流。这一分析将为制定一种衡量沟通效率和效果的方法提供信息。随后，初级保健医生和他们的病人将被招募到这项研究中，并对他们的办公室访问进行录音。患者和提供者将完成调查，以评估他们的态度和价值观的关系，以及医患关系对沟通效率和有效性的影响。这项研究还将探讨患者遵守治疗建议意愿的沟通效率与患者和提供者对访问的满意度之间的关系。将采访一部分患者和提供者，询问他们对访问沟通的印象，以及他们对访问期间发生的事情的理解。研究结果将被用于开发以医生和患者为目标的干预措施，以促进在办公室访问期间进行高效、有效的沟通，从而最大限度地提高患者的理解和满意度。

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.