Abstract
BackgroundUnderstanding patients’ beliefs about their role communicating in medical visits is an important pre-requisite to encourage patients’ use of active participatory communication, and these beliefs may be particularly relevant for patients with diabetes.MethodsFocus groups were conducted to examine patients with diabetes view of their role communicating in medical encounters. Patients had type 2 diabetes, A1C ≥ 8% (64 mmol/mol), and were from an inner-city VA hospital. Guiding questions for the focus groups were based on theoretical models of patient-physician communication. Focus group transcripts were analyzed with the constant comparative method.ResultsFour focus groups were conducted with a total of 20 male Veterans. Participants mean age was 61 years, 65% self-identified as black or African-American, 80% completed high school or higher education, and mean A1C was 10.3% (89 mmol/mol). Eight themes were identified as to why patients might have difficulty communicating with physicians. These themes were grouped into three overarching categories explaining reasons why patients might avoid participatory communication and included patients’ view about their condition; about physician’s communication behaviors; and about external influences on patient-physician communication. For example, patients described how use of the EHR may deter patients’ use of active participatory communication.ConclusionsThese results are important for understanding how patients’ use of active participatory communication is influenced by their beliefs and expectations, physicians’ behaviors, and structural factors. The results may be useful for educational efforts to increase patient, physician, and healthcare systems awareness of problems that patients perceive when communicating with physicians.
Highlights
Understanding patients’ beliefs about their role communicating in medical visits is an important prerequisite to encourage patients’ use of active participatory communication, and these beliefs may be relevant for patients with diabetes
Our analysis identified eight themes that patients described as challenges to their use of active participatory communication in the medical interaction
Perceptions about external contextual factors that influence patient-physician communication. Understanding these barriers is important because patients who are less engaged and use less active participatory communication may gain less understanding of their Type 2 Diabetes Mellitus (T2DM), may be less likely to adhere to treatment recommendations and may have worse outcomes [18, 19]
Summary
Understanding patients’ beliefs about their role communicating in medical visits is an important prerequisite to encourage patients’ use of active participatory communication, and these beliefs may be relevant for patients with diabetes. Patients’ beliefs about their role in medical interactions with physicians are fundamental to their subsequent communication behaviors [1] Beliefs about whether it is the patients’ role to adopt specific communication behaviors (e.g., ask the physician questions) and beliefs or expectations that their communication will be taken into account, help determine whether patients assume an active communication style during medical encounters [1, 2]. Active patient communication is powerful because it can influence physicians’ communication Patients beliefs about their role communicating with their physicians within medical visits is especially salient for patients with chronic conditions like type 2 diabetes [4]. Research among patients with chronic disease has shown that patients who take an active role in communication are more satisfied, receive more information, and exhibit better health outcomes [5,6,7]
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