Improving communication skills in the Southeast Asian health care context.

Mora Claramita,Astrid Pratidina Susilo

doi:10.1007/s40037-014-0121-4

Mora Claramita, Astrid Pratidina Susilo

Open Access

https://doi.org/10.1007/s40037-014-0121-4

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Abstract

The aim of these two PhD thesis are to develop a guideline on doctor-patient communication skills based on cultural characteristics of Southeast Asian context and to develop communication skills training for nurses to enhance their contribution to the informed consent and shared decision making process, in the same context. These studies started with qualitative methods; including grounded theory methodology, by exploring doctors’, patients’, medical students’ and nurses’ perceptions on the current and desired communication skills in which influenced by culture. Based on the results, we design communication skills training and evaluate the training with quantitative methods, using pre and post test studies. Southeast Asian desired ideal partnership style in communicating with their doctors. More emphasize on basic skills such as listening to subtle non-verbal cues are needed for doctors and nurses. A guideline on doctor-patient communication tailored to local culture was developed as well as training for nurses using 4CID design to enhance their contribution to the shared decision making process. To promote two-way interaction between doctors and patients and between health professionals require mastering basic skills in communicating with people, such as explorations on the unspoken concern. In a culturally hierarchical context of Indonesia, this two-way interaction is quite a challenge. To generalize our studies to other culture, more studies with rigorous methods should follow. To promote the use of basic skills in communicating with patients to approach the desired partnership communication style in Southeast Asian context, we need to use local evidences.

Highlights

Communicating with patients is considered to be central to the clinical abilities of health professionals world-wide and its correct application is essential in different phases of clinical care, including during the decision-making process [1]
The aim of these two PhD thesis are to develop a guideline on doctor-patient communication skills based on cultural characteristics of Southeast Asian context and to develop communication skills training for nurses to enhance their contribution to the informed consent and shared decision making process, in the same context
To apply the desired partnership style of communication with patients, our findings suggest that doctors need to use more the core communication skills, which turned out to be the key to addressing cultural aspects of Southeast Asian people: (1) When doctors greet their patients they should explore what the patients would like to be called

Summary

Introduction

Communicating with patients is considered to be central to the clinical abilities of health professionals world-wide and its correct application is essential in different phases of clinical care, including during the decision-making process [1]. Studies on communication in health care have been mostly conducted in the Western world. They might limit the validity of the evidence for the Southeast Asian context which is characterized by both a strong hierarchical and communal culture [2]. In a strong hierarchical culture, the power distance among people is large, including that between doctors and patients and doctors and nurses [3]. There is a strong involvement of community and family in individual decisionmaking in health care. Lack of time for consultation is the number one barrier in communicating properly with patients because of the high patient load due to a system which is not ‘appointment-based’

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