Does training general practitioners to elicit patientsÂ’ illness representations and action plans influence their communication as a whole?
article
Objective: To examine whether the discussion of illness representations and action plans during medical encounters affects the way patients and general practitioners (GPs) communicate.
Methods: In a quasi-experimental design, 10 GPs first performed care-as-usual conversations with patients. After a 6 h training they performed consultations either emphasizing patientsÂ’ illness representations or action plans. Data were collected from 70 videotaped consultations with hypertensive patients, which were analyzed using the Roter Interaction Analysis System. Results: Compared with care-as-usual consultations, communication in the action plan condition resulted in an increased discussion of lifestyle issues whereas communication in the illness representation condition resulted in more discussion of patient concerns. In both experimental conditions the proportion of affective GP utterances was higher while patients contributed more to the conversation. When GPs changed their communication style, patients did accordingly.
Conclusion: The explicit address of illness representations or action plans during consultations results in more attention to patient concerns and lifestyle issues and an overall improvement in patient-GP communication in terms of affective atmosphere and patient involvement. Practice implications: These findings show that after a brief training GPs are able to change their communication style in a way that allows for a more thorough consideration of patient self-management. Keywords: Adherence; Hypertension; Patient-physician interaction; Illness representations; Action plans
Methods: In a quasi-experimental design, 10 GPs first performed care-as-usual conversations with patients. After a 6 h training they performed consultations either emphasizing patientsÂ’ illness representations or action plans. Data were collected from 70 videotaped consultations with hypertensive patients, which were analyzed using the Roter Interaction Analysis System. Results: Compared with care-as-usual consultations, communication in the action plan condition resulted in an increased discussion of lifestyle issues whereas communication in the illness representation condition resulted in more discussion of patient concerns. In both experimental conditions the proportion of affective GP utterances was higher while patients contributed more to the conversation. When GPs changed their communication style, patients did accordingly.
Conclusion: The explicit address of illness representations or action plans during consultations results in more attention to patient concerns and lifestyle issues and an overall improvement in patient-GP communication in terms of affective atmosphere and patient involvement. Practice implications: These findings show that after a brief training GPs are able to change their communication style in a way that allows for a more thorough consideration of patient self-management. Keywords: Adherence; Hypertension; Patient-physician interaction; Illness representations; Action plans
Topics
Action plansAdherenceHypertensionIllness representationsPatient-physician interactionAffectAgedAttitude to HealthClinical CompetenceCommunicationDiscriminant AnalysisEducation, Medical, ContinuingFactor Analysis, StatisticalFemaleHumansLife StyleLinear ModelsMaleMiddle AgedModels, PsychologicalMultivariate AnalysisPatient Care PlanningPatient ParticipationPhysician's RolePhysician-Patient RelationsPhysicians, FamilyProgram EvaluationSelf CareSingle-Blind MethodVideotape Recording
TNO Identifier
18944
Source
Patient Education and Counseling, 66(3), pp. 327-336.
Pages
327-336
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