THE PATIENT-PRACTITIONER RELATIONSHIP Three areas to examine: • Patient & practitioner interpersonal skills • Patient & practitioner diagnosis and style • Using and misusing health services
Q. How well do you get on with your doctor? Do you feel satisfied when you come out of a consultation? Q. Why does the doctor-patient relationship matter? Are communication and listening skills important? – The traditional View (biomedical model)
PATIENT-PRACTITIONER INTERPERSONAL SKILLS Patients’ feelings about doctors & treatment – profound effect on satisfaction & judgement of quality of care. Effect on compliance to advice. Some research; • Moorhead (1991) – Consultative interviewing style, active patient-practitioner participation assoc. with satisfaction, +ve health outcomes. • Kaplan (1989) – Conversational communication by patient, -ve expression of feelings (tension, strain, anxiety) assoc. with +ve health outcomes.
• PROBLEMS OF COMMUNICATION – NVC (non-verbal communication): Very important in social interaction; can have considerable effect on verbal communication. – Argyle (1975) – NVC four times more powerful & effective than verbal communication. Can signal attitudes & emotions, assist or replace speech. – Examples of NVC ……?
• Some research: McKinstry & Wang (1991) – looked at judgements we make about professionals based on appearance and dress. (p.21) Jouard (1966) – acceptability of touching various body parts by other people. (see Banyard 1) Burns (1964) – position of desk in consultation room. (see sheet)
• Use of Jargon/misunderstanding – Use of inappropriate language or puzzling scientific language – Bourhis, Roth & MacQueen (1989) – studied relationship between hospital staff and patients. Looked at factors such as use of language and status & power differences. (see sheet) – Ley (1989) – high no. of patients dissatisfied with info. given by health workers (41%) GPs (28%).
Due to not understanding or forgetting what they are told....
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