Physician-Patient Communication Project

描述（由申请人提供）：提供者-患者沟通是患者护理的核心。 讨论诊断和治疗决策的方式可能会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，在门诊期间获得更多信息的患者对他们的护理更满意，回忆更多信息，并且更遵守治疗计划。 那些在与提供者互动时参与更多的人有更好的健康结果。 然而，所提供的信息量的一个重大障碍是提供者的办公室访问时间有限，在此期间，他们必须执行健康维护和疾病管理任务，解决患者的问题，并提供有关患者医疗条件和治疗的患者教育。 高效而有效的沟通，需要导航这些访问，但最佳的沟通策略，处理多个竞争的需求，在门诊访问还没有得到很好的探讨。 本研究的总体目标是确定有效和高效的提供者与患者的沟通策略，在初级保健门诊访问。 现有的音频记录的定性分析将被用来开发一个编码系统，描述高效和有效的供应商和患者的沟通。 这一分析将有助于制定衡量通信效率和效力的标准。 随后，初级保健医生和他们的患者将被招募参加研究，并将他们的办公室访问录音。 患者和医疗服务提供者将完成调查，以评估他们的态度和价值观的关系，以及医患关系的沟通效率和有效性。 该研究还将探讨沟通效率与患者遵守治疗建议的意愿以及患者和提供者对访问的满意度之间的关系。 将对一部分患者和提供者进行访谈，了解他们对访视沟通的印象以及他们对访视期间发生的事情的理解。 研究结果将用于制定针对医生和患者的干预措施，以促进门诊访视期间的高效，有效的沟通，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.