Nationwide survey of patients\u2019 and doctors\u2019 perceptions of what is needed in doctor - patient communication in a Southeast Asian context

Trung Quang Tran,Jan Van Dalen,Elaine Pamela Wright,Dung Do Van,A J J A Scherpbier

doi:10.1186/s12913-020-05803-4

Abstract

BackgroundAsian countries are making efforts to apply the partnership model in doctor-patient communication that has been used effectively in Western countries. However, notable differences between Western and Asian cultures, especially the acceptance of a hierarchical order and little attention to individuality in Asian cultures, could mean that the application of the partnership model in Vietnam requires adaptation.The study aimed to investigate whether communication models used in the Western world are appropriate in Southeast Asia, and to identify key items in doctor-patient communication that should be included in a doctor-patient communication model for training in Vietnam.MethodsIn six provinces, collaborating medical schools collected data from 480 patients using face-to-face surveys with a structured guideline following a consultation session, and from 473 doctors using a cross-sectional survey on how they usually conduct consultation sessions with patients. Data collection tools covered a list of communication skills based on Western models, adapted to fit with local legislation.Using logistic regression, we examined whether doctor patient communication items and other factors were predictors of patient satisfaction.ResultsBoth patients and doctors considered most elements in the list necessary for good doctor-patient communication. Both also felt that while actual communication was generally good, there was also room for improvement. Furthermore, the doctors had higher expectations than did the patients. Four items in the Western model for doctor-patient communication, all promoting the partnership relation between them, appeared to have lower priority for both patients and doctors in Vietnam.ConclusionThe communication model used in the Western world could be applied in Vietnam with minor adaptations. Increasing patients’ understanding of their partner role needs to be considered. The implications for medical training in universities are to focus first on the key skills perceived as needing to be strengthened by both doctors and patients. In the longer term, all of these items should be included in the training to prepare for the future.

Highlights

Asian countries are making efforts to apply the partnership model in doctor-patient communication that has been used effectively in Western countries
A standard communication structure for a medical interview is described in the Calgary-Cambridge Observation Guide [2], which has been an effective model for communication skills in medical interviews and has strongly influenced the development of medical communication skills training programs [6, 7]
This study aimed to identify the essential items in communication that doctors should perform during a consultation applying the partnership model; the results will guide the application of the partnership model in training doctor patient communication

Summary

Introduction

Asian countries are making efforts to apply the partnership model in doctor-patient communication that has been used effectively in Western countries. A standard communication structure for a medical interview is described in the Calgary-Cambridge Observation Guide [2], which has been an effective model for communication skills in medical interviews and has strongly influenced the development of medical communication skills training programs [6, 7] In this “partnership” model, which has been effectively applied in Western countries, the patient is actively involved in the consultation, and doctor and patient are equal [8]. A pioneering researcher on cross-cultural communication and organization, who developed the Cultural Dimensions Theory and Country Comparison Tool [17], reported notable differences between Western and Asian cultures Using this tool, Vietnam scores highest on the dimension “Power distance” and lowest on the dimension “Individualism,” showing that Vietnamese people accept a hierarchical order in which everybody has a place without further justification, and pay less attention to the individual than to the group. In Western countries the “Individualism” score is higher than “Power distance,” meaning that equal respect and individual rights are expected and deserved [18]

Objectives

Methods

Results

Discussion

Conclusion