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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]
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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

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