Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-28T17:51:33.605Z Has data issue: false hasContentIssue false
  • English
  • Français

Doctors' responses to patients' concerns; an exploration of communication sequences in gynaecology

Published online by Cambridge University Press:  11 October 2011

Sandra Van Dulmen ,
Matthias Nübling  and
Wolf Langewitz
Sandra Van Dulmen*
Affiliation:
NIVEL (Netherlands Institute of Health Services Research), Utrecht, The Netherlands
Matthias Nübling
Affiliation:
Society for Empirical Consulting (GEB), Freiburg i Brsg, Germany
Wolf Langewitz
Affiliation:
Division Psychosomatic Medicine, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
*
Address for correspondence: Dr. A.M. van Dulmen, NIVEL, P.O.Box 1568, 3500 BN Utrecht (The Netherlands). Fax: ++31-302729729 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Aims – Like other medical doctors, gynaecologists have difficulty attending to psychosocial issues and concerns. Communication training has proven to be effective in teaching them to spend more time on discussing these factors. However, whether or not they do this in response to patients' utterances remains unclear. The question is how gynaecologists respond to patients' concerns, whether or not they do this adequately and what the effects of a communication training are on the use of these communication sequences. Methods – Nineteen gynaecologists participated in a study which examined the effects of a three-day residential communication training. Before and after the training the gynaecologists videotaped series of consecutive outpatient visits. The communication during these visits was rated using the Roter Interaction Analysis System. Gynaecologists' responses to patients' concerns were examined at lag one, i.e. immediately following the patient's concern. Results – The most prevalent responses made by the gynaecologists were showing agreement and understanding and giving medical information. Affective responses were observed less. At postmeasurement, the gynaecologists responded neither more adequately nor inadequately to patients' concerns. Conclusions – The gynaecologists did not respond in a very affective way to patients' concerns. However, the patients did not express many concerns. Future studies should focus on more prevalent communication behaviours and incorporate more lags.

Declaration of Interest: none.

Keywords

concernsgynaecologycommunication sequencescommunication training
Type
Sequence Analysis of Patient-Provider Interaction
Information
Epidemiology and Psychiatric Sciences , Volume 12 , Special Issue 2: Sequence Analysis of Patient-Provider Interaction , June 2003 , pp. 98 - 102
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bensing, J.M. 1991. Doctor-patient Communication and tlie Quality of Care. (PhD thesis). NIVEL: Utrecht.CrossRefGoogle Scholar
Brink-Muinen van den, A. & Caris-Verhallen, W. 2003. Doctors' responses to patients' concerns; testing the use of sequential analysis. Epidemiologia e Psichiatria Sociale, 12, 92–97.CrossRefGoogle Scholar
Del Piccolo, L., Saltini, A., Zimmermann, C. & Dunn, G. 2000. Differences in verbal behaviours of patients with and without emotional distress during primary care consultations. Psychological Medicine 30, 629–643.CrossRefGoogle ScholarPubMed
Dulmen van, A.M. 1999. Communication during gynecological outpatient consultations. Journal of Psychosomatic Obstetrics and Gynecology 20, 119–126.CrossRefGoogle Scholar
Dulmen van, A.M. & Weert van, J.C.M. 2001. Effects of gynaecological education on interpersonal communication skills. British Journal of Obstetrics and Gynaecology 108, 485–491.CrossRefGoogle Scholar
Dulmen van, A.M., Verhaak, P.F.M. & Bilo, H.J.G. 1997. Shifts in doctor- patient communication during a series of outpatient consultations in non-insulin-dependent diabetes mellitus. Patient Education and Counseling 30, 227–237.CrossRefGoogle Scholar
Himmel, W., Ittner, E., Kron, M. & Kochen, M.M. 1999. Comparing women's views on family and sexual problems in family and gynecological practices. Journal of Psychosomatic Obstetrics and Gynecology 20, 127–135.CrossRefGoogle ScholarPubMed
Hunter, M. 1990. Gynaecological complaints. In Somatization: Physical Symptoms & Psychological Illness (ed. Bass, C.). Blackwell Scientific Publishers: Oxford.Google Scholar
Levenstein, J.H., McCracken, E.C., McWhinney, I.R., Stewart, M.A. & Brown, J.B. 1986. The patient-centred clinical method. 1. A model for the doctor-patient interaction in family medicine. Family Practice 3, 24–30.CrossRefGoogle Scholar
McCormick, D.P., Rassin, G.M., Stroup-Benham, C.A., Baldwin, C.D., Levine, H.G., Persaud, D.I. & Wolf, W.J. 1993. Use of videotaping to evaluate pediatric residents performance of health supervision examinations of infants. Pediatrics 92, 116–120.CrossRefGoogle ScholarPubMed
Mellink, W.A.M., Dulmen van, A.M., Wiggers, Th., Spreeuwenberg, P.M.M., Eggermont, A.M.M. & Bensing, J.M. (in press). Cancer patients seeking a second opinion: results of a study on motives, needs and expectations. Journal of Clinical Oncology.Google Scholar
Ong, L.M.L., Visser, M.R.M., Kruyver, I.P.M., Bensing, J.M., van den Brink-Muinen, A., Stouthard, J.M., Lammes, F.B. & de Haes, J.C. 1998. The Roter Interaction Analysis System (RIAS) in oncological consultations: psychometric properties. Psycho-Oncology 7, 387–401.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Roter, D. 1989. Tlie Roter Method of Interaction Process Analysis. Johns Hopkins University: Baltimore:Google Scholar
Roter, D.L., Cole, K.A., Kern, D.E., Barker, L.R. & Grayson, M. 1990. An evaluation of residency training in interviewing skills and the psychosocial domain of medical practice. Journal of General Internal Medicine 5, 347–354.CrossRefGoogle ScholarPubMed
Roter, D.L., Hall, J.A., Kern, D.E., Barker, L.R., Cole, K.A. & Roca, R.P. 1995. Improving physicians' interviewing skills and reducing patients' emotional distress. A randomized clinical trial. Archives of Internal Medicine 155, 1877–1884.CrossRefGoogle ScholarPubMed
Weijts, W., Widdershoven, G. & Kok, G. 1991. Anxiety-scenarios in communication during gynaecological consultations. Patient Education and Counseling 18, 149–163.CrossRefGoogle Scholar