Medical care · 2009
Kelly B Haskard Zolnierek、M Robin Dimatteo
BACKGROUND: Numerous empirical studies from various populations and settings link patient treatment adherence to physician-patient communication. Meta-analysis allows estimates of the overall effects both in correlational research and in experimental interventions involving the training of physicians' communication skills. OBJECTIVES: Calculation and analysis of "r effect sizes" and moderators of the relationship between physician's communication and patient adherence, and the effects of communication training on adherence to treatment regimens for varying medical conditions. METHODS: Thorough search of published literature (1949-August 2008) producing separate effects from 106 correlational studies and 21 experimental interventions. Determination of random effects model statistics and the detailed examination of study variability using moderator analyses. RESULTS: Physician communication is significantly positively correlated with patient adherence; there is a 19% higher risk of non-adherence among patients whose physician communicates poorly than among patients whose physician communicates well. Training physicians in communication skills results in substantial and significant improvements in patient adherence such that with physician communication training, the odds of patient adherence are 1.62 times higher than when a physician receives no training. CONCLUSION: Communication in medical care is highly correlated with better patient adherence, and training physicians to communicate better enhances their patients' adherence. Findings can contribute to medical education and to interventions to improve adherence, supporting arguments that communication is important and resources devoted to improving it are worth investing in. Communication is thus an important factor over which physicians have some control in helping their patients to adhere.
Journal of psychosomatic research · 2023
Maria Kleinstäuber、Michael A Diefenbach、Winfried Rief
暂无摘要
BMC Medical Education · 2022
Jun-Feng Du、Gwendolyn Mayer、Elisabetta Posenato 等
Background The Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. Communication skills (CS) training of physicians holds the key to improving patient confidence and diffusing stressful situations. This survey reports on the status of CS training in medical education in China, and the experiences and attitudes of physicians towards CS training. Methods A cross-sectional survey was conducted at medical institutions across China. A questionnaire developed for this study included the status of CS training, current aspects of patient-physician relationships, perceived own CS and patient-centeredness with Likert-scaled items from 1 (most negative) to 6 (most positive). Physicians’ attitude towards CS training was measured with the Communication Skills Attitude Scale (CSAS) and its subscales PAS (Positive Attitude Scale) and NAS (Negative Attitude Scale). Data were analyzed descriptively and for group differences between the hospital level and operating vs. non-operating physicians. Binary logistic regression analysis was done to find associations explaining the occurrence of verbal and physical attacks and the role of CS attitudes. Results Out of 1080 questionnaires, 772 physicians met inclusion criteria. A total of 466/772 participants (60.4%) had received at least one CS training during their career. The participants rated the current situation related to patient-physician relationship in China as highly stressful (mean = 4.52, SD = 1.26, 95% CI: 4.43–4.60), experiencing verbal attacks in the past three years once a year in 372/772 cases (48.2%) and physical attacks 111/772 times (14.4%). The mean PAS was 62.96 (SD = 7.63, 95% CI: 62.41–63.47). Being female was associated with increased risk of verbal attacks (OR = 1.51, 95% CI: 1.01–2.25) while working in a tertiary hospital and showing high levels of PAS decreased this risk (OR = 0.62, 95% CI: 0.43–0.89, and OR = 0.95, 95% CI: 0.93–0.98). Having received a previous CS training decreased the odds of physical attacks (OR = 0.54, 95% CI: 0.35–0.83). Conclusions A majority of Chinese physicians showed a high positive attitude towards CS training, were trained in CS and would value further training. Our results highlight that CS training is likely to promote patient-centered communication and reduce attacks against physicians. Both of these effects are to improve the patient-physician-relationship in the long run. More CS training should be offered to Chinese physicians, especially at secondary- and primary-care hospitals, where such practices remain infrequent.
Cancer · 2020
Bryan A Sisk
暂无摘要
Patient Preference and Adherence · 2025
Minjuan Wu、Wen-Qin Wang、Hongmei He 等
Purpose Patient participation is essential for improving patient safety and quality of care. It mainly refers to patients participating in their own healthcare through various ways, such as searching information on treatment options, engaging in decision-making, and communicating with healthcare professionals. This study aimed to investigate the relationships between disease knowledge, health literacy, self-efficacy, social support, and patient participation behavior in chronic ill patients based on the Capability-Opportunity-Motivation and Behavior (COM-B) model. Methods This cross-sectional survey, conducted from October 2023 to January 2024, involved 389 chronic ill patients from five clinical departments (cardiology, endocrinology, respiratory medicine, neurology, and geriatrics) at a tertiary hospital in Hangzhou, Zhejiang Province. Patients completed the health literacy management scale, general self-efficacy scale, core knowledge of chronic diseases questionnaire, social support rating scale, and patient participation scale. We used t-tests / ANOVA, Pearson’s correlation coefficient, Fisher’s z-test, linear regression, and mediation model to analyze data. Results The total effect of disease knowledge on patient participation behavior was significant (β = 0.496, p < 0.001), and the direct effect was also significant (β = 0.144, p < 0.001). Meanwhile, the relationship between disease knowledge and patient participation behavior was mediated by self-efficacy (β = 0.043, p < 0.001), health literacy (β = 0.027, p < 0.001), and social support (β = 0.193, p < 0.001), respectively. Conclusion This study proposed a conceptual model that includes the mediating effects of health literacy, self-efficacy, and social support, which helps clarify the underlying mechanisms between disease knowledge and patient participation behavior. Targeted interventions to increase disease knowledge, health literacy, self-efficacy, and social support can help chronic ill patients engage more actively in their own healthcare.
The Medical journal of Australia · 2020
Communicate Study group*
暂无摘要
Health Communication · 2025
Xi Han、Ke Liao、Li Zhang 等
ABSTRACT Online medical consultation services (OMCS) in China always receive high ratings, while offline medical services receive many complaints. The COVID-19 pandemic has strengthened the connection between online and offline medical services in China, but the important question whether the online–offline connection can bring benefits for offline medical services is rarely studied. From a patient perspective, this study explores the impact mechanism of OMCS on the offline physician–patient relationship, attempting to enhance the spillover effect of OMCS on offline medical services and promote communication between physicians and patients. The study adopts trust transfer theory and uses a cross-sectional survey regarding questions about online-to-offline medical service to validate a moderated serial mediation model. The results showed that OMCS usage makes individuals perceive significantly higher levels of offline physician trust and physician–patient relationships. Individuals’ satisfaction with OMCS enhances offline physician–patient relationships through the sequential mediating effect of online and offline trust toward physicians. In the online-to-offline physician trust transfer process, online–offline medical service connection and patients’ prior satisfaction with offline physician service play significant moderating roles. The trust transfer effect is more effective when the online–offline medical service connection is high and the prior offline service satisfaction is low. This study sheds new light on online-to-offline service and OMCS research, and contributes to trust transfer theory. The study also discusses the practical implications for stakeholders.
British medical bulletin · 2025
Alastair Howcroft、Amber Bennett-Weston、Ahmad Khan 等
BACKGROUND: Empathy is widely recognized for improving patient outcomes, including reduced pain and anxiety and improved satisfaction, and its absence can cause harm. Meanwhile, use of artificial intelligence (AI)-based chatbots in healthcare is rapidly expanding, with one in five general practitioners using generative AI to assist with tasks such as writing letters. Some studies suggest AI chatbots can outperform human healthcare professionals (HCPs) in empathy, though findings are mixed and lack synthesis. SOURCES OF DATA: We searched multiple databases for studies comparing AI chatbots using large language models with human HCPs on empathy measures. We assessed risk of bias with ROBINS-I and synthesized findings using random-effects meta-analysis where feasible, whilst avoiding double counting. AREAS OF AGREEMENT: We identified 15 studies (2023-2024). Thirteen studies reported statistically significantly higher empathy ratings for AI, with only two studies situated in dermatology favouring human responses. Of the 15 studies, 13 provided extractable data and were suitable for pooling. Meta-analysis of those 13 studies, all utilising ChatGPT-3.5/4, showed a standardized mean difference of 0.87 (95% CI, 0.54-1.20) favouring AI (P < .00001), roughly equivalent to a two-point increase on a 10-point scale. AREAS OF CONTROVERSY: Studies relied on text-based assessments that overlook non-verbal cues and evaluated empathy through proxy raters. GROWING POINTS: Our findings indicate that, in text-only scenarios, AI chatbots are frequently perceived as more empathic than human HCPs. AREAS TIMELY FOR DEVELOPING RESEARCH: Future research should validate these findings with direct patient evaluations and assess whether emerging voice-enabled AI systems can deliver similar empathic advantages.
BMC Medical Education · 2022
Lucie Bosméan、P. Chaffanjon、A. Bellier
In medicine, the patient-centered approach is based on interpersonal skills, including communication, structuring the medical interview, and empathy, which have an impact on health professionals’ interpersonal relationships and the quality of care. Training courses on this issue are therefore being developed in universities. We hypothesized that specific training courses in the physician–patient relationship could improve interpersonal skills among medical students during simulated consultations and the immediate satisfaction of standardized patients. This cross-sectional study enrolled fourth-year medical students who participated in a simulated medical consultation session with standardized patients. The evaluation of interpersonal skills was carried out using the Four Habits Coding Scheme, producing a synthetic score out of 115 points used as the primary endpoint. Some students benefited from the training courses offered by the university or by other organizations, mainly based on communication, active listening, or patient-centered approach. A comparison was made with students from the same graduating class who had not received any training. The analysis of the primary endpoint showed a difference of 5 points between the group of students who had attended at least one training course and those who did not (p = 0.001). This difference was even more marked when the students had completed several training courses, up to 14 points higher with three training courses (p = 0.001), each with positive results in different areas of the care relationship. Physician–patient relationship training currently provided in initial education appears to be effective in improving interpersonal skills. A repetition of this training is necessary to increase its impact.
Hematology. American Society of Hematology. Education Program · 2002
Stephanie J Lee、Anthony L Back、Susan D Block 等
Physician-patient communication encompasses the verbal and nonverbal interactions that form the basis for the doctor-patient relationship. A growing body of research and guidelines development acknowledges that physicians do not have to be born with excellent communication skills, but rather can learn them as they practice the other aspects of medicine. Improvement in physician-patient communication can result in better patient care and help patients adapt to illness and treatment. In addition, knowledge of communication strategies may decrease stress on physicians because delivering bad news, dealing with patients' emotions, and sharing decision making, particularly around issues of informed consent or when medical information is extremely complex, have been recognized by physicians as communication challenges. This paper will provide an overview of research aimed at improving patient outcome through better physician-patient communication and discuss guidelines and practical suggestions immediately applicable to clinical practice.
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