Physician Communication Research Articles

Utilizing Simulated Telemedicine Encounters to Conduct Nationwide Studies of Physician Communication Practices.

Introduction: High-quality communication and shared decision making (SDM) are crucial elements of effective patient care. SDM conversations are intimate and logistically challenging to capture. Evaluating alternative methods to effectively observe how physicians conduct these conversations may improve research efforts in this core discipline of medicine. Methods: In two distinct qualitative studies (A and B), subspecialist physicians participated in a telemedicine encounter with a simulated patient facing a high-stakes treatment decision. Results: Thirty-seven transplant hematologists (A) and 21 medical oncologists (B) from across the United States successfully completed a telemedicine encounter with a trained actor, allowing for qualitative analysis of their SDM conversations. Discussion: Simulated telemedicine encounters are a feasible method for studying how a broad sample of subspecialty physicians conduct difficult conversations, such as emotionally fraught SDM conversations. This model could improve understanding of the current practice of SDM, identify opportunities for improvement, and serve as a framework for ongoing research of physician communication practices.

The Relationship of Patient Ethnicity/Race to Physician-Patient Communication: A Mixed-Methods Systematic Review.

Some scholars have suggested that social and cultural barriers between physicians and patients might contribute to health disparities. The purpose of this review was to determine the state of evidence regarding how physician communication patterns differ by patient ethnicity. Seventy-nine studies employing a range of methodologies were identified. Results were mixed, with about three-quarters of analyses finding no differences in physician communication by ethnicity, and a small number of analyses finding that Black and Hispanic patients experienced better physician communication than White patients. About one-fifth of analyses reported that Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native patients had poorer experiences of physician communication than White patients. This was the case both for studies that operationalized patient-provider communication as behavior (what physicians did, measured via content analysis), and those that operationalized it as judgment (how patients interpreted that behavior, measured via survey or focus group interview). Methodological limitations in the corpus of the literature make it difficult to determine which contexts and characteristics lead patients from minoritized groups to have better, equivalent, or worse experiences than White patients.

Assessment of Pregnant Women's Satisfaction With the Model of Care Initiative: Antenatal Care Services at Primary Health Care Centers in the Qassim Health Cluster, Saudi Arabia.

Patient satisfaction is a critical indicator of healthcare quality, including high-quality antenatal care (ANC), and it directly impacts care continuity and health outcomes. This study assessed the satisfaction levels of pregnant women with ANC services provided at primary healthcare centers (PHCs) within the Qassim Health Cluster, Saudi Arabia. A cross-sectional survey was conducted among 646 pregnant women attending ANC services in the Qassim region. Participants completed a validated questionnaire assessing demographic characteristics, healthcare interactions, and satisfaction levels across various ANC service aspects, including waiting times, healthcare provider communication, and healthcare service quality. Statistical analyses, including Pearson's chi-squared tests, Fisher's exact tests, and regression analyses, were performed to identify predictors of satisfaction. The majority of participants (N=366, 90.6%) reported successfully booking their appointments, and 368 (91.1%) faced no challenges during the process. While 393 (97.3%)and 398 (98.5%) reported receiving weight and blood pressure measurements, respectively, only 312 (77.2%) were advised on diet, and 298 (73.8%) received explanations about alarming symptoms. Communication gaps were noted, with 71% (N=287) of participants indicating that physicians did not introduce themselves, and 307 (76%) reported that physicians did not disclose their specialties. Satisfaction levels were highest for maintaining privacy (273 (67.6%) highly satisfied) and healthcare staff attitudes (247 (61.1%) highly satisfied), with an overall satisfaction mean score of 4.31±0.869. Regression analyses identified healthcare service levels and years of marriage as significant predictors of satisfaction (p<0.05). While overall satisfaction with ANC services was high, areas such as physician communication and health education require improvement. Interventions focusing on enhancing patient-provider interactions, providing comprehensive health education, and optimizing service delivery could further improve satisfaction.

Female physicians in senior management positions during a crisis: a constructive multimodal communication framework of feminine leadership

Purpose The purpose of the present study is to explore multimodal, i.e. verbal and nonverbal, gendered communication patterns of female physicians in senior management positions (governmental and health authorities) during a crisis. Design/methodology/approach Using a mixed multi-variable design, repeated ANOVA tests, and planned contrasts, the authors analyzed television appearances of 20 female physicians in senior management positions during the COVID-19 crisis (March/2020-April/2021). Findings The findings revealed patterns of mixed-gendered communication structures. Verbally, female physicians primarily displayed a masculine/agentic communication style of assertiveness, control, confidence and rationality. Nonverbally, however, they expressed a feminine/communal communication style of emotional attention, interpersonal sensitivity, responsiveness, kindness and empathy. Moreover, the analysis delineated integrated multimodal constructive vs. inhibitive communication strategies for crisis communication of female physicians in senior management positions. Research limitations/implications In the current research the authors did not compare females to males in health management positions, which is their follow-up project, but the authors did examine studies of males and females in management positions in the political sphere, which supported their findings. Therefore, the authors were able to demonstrate theoretical implications of multimodal gendered communication frameworks of feminine leadership. Practical implications Delineating verbal and nonverbal gendered communicative structures of effective management in health sectors can help female physicians assume positions of leadership, serve as guide models for other female physicians and contribute to improving effective communication skills during a crisis. Social implications This study contributes to the attempts of promoting gender equity in medicine and management by presenting effective communication strategies in medical crises that can help to promote female physicians’ messages development, social influence, leadership and management success in the future. Originality/value This article presents constructive, multimodal gendered communication frameworks of female physicians in senior management positions used in television appearances during the global COVID-19 crisis. Most previous studies in this area have examined either verbal or nonverbal communication mode. The value of this multimodal examination provides insights that may enhance constructive communication of female physicians in senior management positions during a crisis.

EXPERT COMMENTARY: Communication between Psychiatrists and Patients Regarding Placebo and Nocebo

&lt;p dir="ltr"&gt;&lt;span&gt;In this insightful commentary, Prof. Dr. Michael Davidson delves into the nuanced dynamics of placebo and nocebo effects in psychiatric treatments, with a focus on communication strategies between psychiatrists and patients. He explores the balance required in presenting the benefits and potential adverse effects of psychotropic drugs while enhancing therapeutic outcomes and minimizing nocebo risks.&lt;/span&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;span&gt;The commentary highlights the critical role of non-specific factors such as physician communication, patient conditioning, and natural disease progression in amplifying treatment efficacy. Prof. Davidson also underscores the ethical and practical dilemmas faced by psychiatrists in daily practice, such as the fine line between full disclosure and mitigating nocebo effects, especially in conditions like Major Depressive Disorder (MDD), where placebo response can significantly influence outcomes. By examining established and emerging treatments, including SSRIs, ECT, and psychedelics, Prof. Davidson offers a comprehensive perspective on the evolving clinical skills required to manage placebo and nocebo effects effectively, ensuring both adherence to ethical standards and the best possible patient care.&lt;/span&gt;&lt;/p&gt;&lt;div&gt;&lt;span&gt;&lt;br /&gt;&lt;/span&gt;&lt;/div&gt;

Physicians' Stigma Towards Ethnicity of Patients with Cancer and Its Effects on the Health Outcomes: The Moderating Effect of Ethnic Dissimilar Medical Encounters.

This study aimed to examine the moderating effect of ethnic patient-physician similarity versus dissimilarity on the relationship between physicians' stigma towards ethnicity and physicians' communication behaviors during medical encounters and patients' post-meeting anxiety. A prospective nested study design with 146 encounters, including 146 patients with cancer and 32 oncology/surgery physicians, was conducted between November 2019 and July 2022 in two medical centers. Before the medical encounters, physicians were asked to complete sociodemographic, professional and the Perceived Ethnic Discrimination Questionnaires (PEDQ-CV). Patients completed sociodemographic, clinical characteristics and State-Trait Anxiety Inventory (STAI) questionnaires before and following the encounters. During the medical encounters, structured "real-time" observations of the physicians' behaviors were assessed using the Four Habits Coding Scheme (4HCS). The mixed linear analysis model revealed that the two-way interaction effects between physicians' stigma toward ethnicity and the ethnic similarity between the physician and patient on physician communication behaviors (b = - .822, p < .05) and patients' post-meeting anxiety (b = .580, p < .05) were significant. In ethnic dissimilar medical encounters, physician stigma towards ethnicity was associated with poor communication behaviors and higher post meeting patients' anxiety. However, in ethnic similar medical encounters, physician ethnic stigma was associated with improve communication behaviors and stable levels of anxiety. Our study highlights the significant role of similar versus dissimilar ethnic medical encounters on the effect of ethnic stigma on health outcomes. These findings call for implementing a climate of diversity management to limit the additive effect of stigma towards ethnicity and to provide fair and equal care.

Does Physicians' Clinical Competence, Communication Ability, or Cultural Background Influence Potentially Inappropriate Prescribing of Benzodiazepines and Z-Drugs Among Older Adults With Insomnia?

The objective of this study is to estimate the association between physician's age, sex, clinical and communication competencies, and cultural background on benzodiazepines and Z-drugs (BDZ) prescribing to older adults with insomnia. A cohort of international medical graduates (IMGs) who completed their pre-residency licensure exam in 1998-2004 were linked to all U.S. Medicare patients they provided care to in 2014-2015. Their care records in Parts A, B, and D from all physicians were extracted. The first outpatient visit for insomnia to a study IMG was identified for each patient in that period. The outcome was incident BDZ prescribing by the study physician following the visit. Main exposures were physician age, sex, citizenship at birth, and clinical and communication competency as measured on the licensure exam. The association between physician characteristics and BDZ prescribing, adjusting for physician and patient covariates, was estimated using generalized estimating equations multivariable logistic regression. We analyzed 28 018 patients seen by 4069 unique physicians. IMGs born in all other regions of the world were less likely to prescribe BDZs compared to U.S.-born IMGs, with physicians from the United Kingdom being least likely (OR 0.54 [95%CI 0.34-0.85]). Neither physician's clinical competency nor communication ability were associated with BDZ prescribing (OR per 10% increase, respectively: 0.95 [95%CI 0.88-1.02] and 0.98 [95%CI 0.93-1.04]). Older physicians remain more likely to prescribe BDZ (OR per 5-year increase 1.04 [95%CI 1.00-1.08]). The associations between cultural background and physician's age on BDZ prescribing highlight the potential targets for remedial solutions to reduce the use of potentially inappropriate medications.

APENDIC-RADS: an ultrasound reporting system for the diagnosis of acute appendicitis.

Abdominal ultrasonography is widely used to evaluate suspected cases of appendicitis. Objective descriptions of the direct and indirect signs of appendicitis result in varied assessments of its likelihood. This study introduces the Appendix Imaging Reporting and Data System (APENDIC-RADS) to standardize the reporting of appendix ultrasound findings. This single-center retrospective study included consecutive patients of all ages who underwent abdominal ultrasonography for the investigation of acute appendicitis. The primary outcome was histopathological confirmation of acute appendicitis post-surgery. The imaging findings were classified into five categories: APENDIC-RADS 0, where the appendix cannot be visualized; APENDIC-RADS 1, indicating a normal appendix; APENDIC-RADS 2, describing an appendix that is likely normal but only partially visualized; APENDIC-RADS 3, appendicitis cannot be ruled out due to uncertain features and APENDIC-RADS 4, acute appendicitis. A total of 747 patients were assessed for suspected acute appendicitis using ultrasonography. Of the diagnosed patients, 52% were male, primarily exhibiting symptoms such as nausea and/or vomiting (60%), right iliac fossa pain (54%), and sudden decompression in the right iliac fossa (24%). Stratification into APENDIC-RADS categories revealed a significant variation in the incidence of acute appendicitis, with incidence rates of 4.5% for category 0 and 0.7%, 2.2%, 11.5%, and 93.5% for categories 1 to 4, respectively (p<0.001). The APENDIC-RADS showed excellent discriminative ability, evidenced by an area under the receiver operating characteristic curve of 0.950 (95%CI=0.899-1). APENDIC-RADS categorization demonstrated excellent performance in standardizing the ultrasound-determined probability of acute appendicitis. Its implementation could improve physician communication and standardization of patient management.

Enhancing Patient Experience in Sarcoma Core Biopsies: The Role of Communication, Anxiety Management, and Pain Control.

Background/Objectives: This study evaluates the effectiveness of communication strategies and pain management protocols to enhance patients' experiences during sarcoma core biopsies. Recognizing the complexity and anxiety associated with sarcoma diagnoses, this research aims to assess the utility of the Invasive Procedure Assessment (IPA) tool, focusing on its ability to identify areas for improvement through Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs). Methods: Conducted at two Integrated Practice Units (IPUs) within the Swiss Sarcoma Network, this study involved 282 consecutive patients who underwent core biopsies. One week post-procedure, patients completed the IPA questionnaire, which included PROMs and PREMs. Statistical analyses explored correlations between physician communication, patient understanding, anxiety, pain, and overall satisfaction. Results: The IPA tool effectively captured patient perspectives on sarcoma core biopsies. A significant positive correlation (rho = 0.619, p < 0.0001) was found between effective physician communication and patient understanding, which was associated with reduced anxiety and pain. Higher anxiety levels strongly correlated with increased pain perception (rho = 0.653, p < 0.0001), emphasizing the need for anxiety management. Patients with malignant tumors reported lower overall satisfaction compared to those with benign tumors (p = 0.0003), highlighting the need for tailored communication and pain management strategies. The data also suggested that clear communication might mitigate overly negative subjective impressions, such as concerns about wound complications. Conclusions: Effective communication and anxiety management are essential for improving patient satisfaction during sarcoma core biopsies. The study emphasizes the need for personalized care strategies tailored to tumor characteristics and patient demographics. Future research should validate these findings in diverse healthcare settings and explore the broader application of the IPA tool across different cultural and demographic contexts.

CTNI-40. PSYCHOLOGICAL DOMAINS CORRELATE WITH ADHERENCE IN TTFIELDS TREATMENT OF GLIOBLASTOMA

Abstract INTRODUCTION Adherence is critical to the success of the treatment with Tumor Treating Fields (TTFields) for Glioblastoma Multiforme (GBM). Previously found factors influencing treatment adherence in general are social support, belief in the efficacy of treatment, communication with physicians, anxiety, and depression. We propose those five factors predict adherence to TTFields treatment since, to our knowledge, no systematic data exists for this treatment. METHODS We conducted a longitudinal study and included 25 patients with newly diagnosed GBM who received treatment with TTFields. Participants were invited to take part in six structured interviews, each four weeks apart, during their treatment with TTFields, assessing the five factors expected to influence treatment adherence over time. RESULTS We found a significant impact of communication, anxiety, and depression on treatment adherence with TTFields. Furthermore, also the time point during treatment (days of treatment) was significantly related to adherence. Better physician communication and a higher level of anxiety were associated with higher adherence and higher depression with less adherence. A higher belief in efficacy showed a trend toward significantly improving treatment adherence. When results were separately compared for early, middle, and later 90-day treatment phases, factors seemed to be differentially influential, with belief in efficacy being significantly relevant in the first, efficacy, communication, and anxiety in the second, and depression in the third phase of treatment with TTFields. CONCLUSIONS Our findings not only confirm the predictive role of psychosocial factors in treatment adherence but also provide specific targets for psychological interventions. This suggests that by addressing these factors, healthcare providers can potentially increase treatment adherence among GBM patients. Moreover, our results indicate that these interventions may be most effective when tailored to the specific phase of treatment, offering a practical approach for healthcare providers.

Integrating Art in Medical Visualization Techniques

The incorporation of art with medical visualisation techniques offers a significant improvement in the communication of medical information. Traditional methods of medical illustration were primarily concerned with anatomical precision, but introducing artistic aspects can expand knowledge, increase emotional resonance, and produce more effective visual storytelling. This study investigates how artistic principles such as composition, colour theory, and dynamic symmetry can enhance the clarity and effectiveness of medical images. Medical visualisation can go beyond simple representation by combining scientific rigour and artistic flair, resulting in a more profound link between the spectator and the medical facts, which improves patient understanding, physician communication, and educational outcomes. Case studies are offered to demonstrate the multidisciplinary approach’s potential, as well as the obstacles and opportunities it brings for future research. Keywords: Medical visualization, Medical illustration, Artistic integration, Data visualization, Visual communication in medicine

Healing Through Dialogue: Exploring Culturally Sensitive Physician-Patient Communication in Urban and Peri-urban Minna, Nigeria, for Addressing Postpartum Depression

The research was on physician-patient communication. Specifically, the study investigated the communication relationship between physicians and mothers experiencing postpartum depression (PPD) in urban and peri-urban areas of Minna, Nigeria. The study aimed to understand the nature of communication strategies used by physicians, their effectiveness in aiding recovery, and the challenges hindering effective communication. The study fills a research niche on how different forms of communication with patients influence the recovery of postpartum depressed mothers in Minna, Nigeria, and how healthcare professionals may need to promote culture-sensitive communication. The study was anchored on the patient-centered care model. In-depth interviews (IDI) and focus group discussions (FGD) were adopted as the primary research methods. The study had a total of 204 respondents, 196 nulliparous, primiparous, and multiparous women with PPD for FGD, and 8 medical experts for in-depth interviews. Findings showed that empathy and informal interactions were used as mothers responded positively to physicians who addressed them with a smile, concern, and active listening. Further findings revealed that effective communication led to better outcomes. Participants felt that open-ended questions, patient involvement in treatment plans, and emotional expressions encouraged by physicians led to improved well-being. The basis for the measurement of effective communication for improved health outcomes was measured through self-reported improvements from the mother. Also, cultural sensitivity, utilisation of interpreters, and readily available information resources in hospitals were identified as crucial for addressing communication and cultural barriers. The researcher concluded that physician communication style significantly impacts PPD recovery and, therefore, recommended that healthcare institutions should create supportive environments and train professionals in cultural sensitivity. Dedicated resources like information desks and support groups can empower mothers with PPD. The implications of the study highlight the importance of communication in PPD treatment and suggest actionable strategies for healthcare institutions to improve their interaction with mothers experiencing this critical mental health condition in Minna and similar settings.

Clinical Utility of Broad Range PCR for Infectious Organisms

Abstract Broad range PCR is used to identify infectious organisms when bacterial, fungal, and mycobacterial cultures are negative despite clinical evidence of infection. We performed a 6-month retrospective chart review to assess the actionability of broad range PCR and identify opportunities to improve the utility of this referral test at our institution. One hundred eleven broad range PCR tests were ordered from July to December 2023. Seventy-five (67.6%) results did not affect patient management, 18 (16.2%) results affected patient management, and the treatment impact of 18 (16.2%) results is unknown because they were from outside consult cases. There were no instances in which antibiotic therapy was completely discontinued due to a negative broad range PCR result. Concurrent in-house microbiology testing yielded a positive result in 15 (13.5%) cases, of which 8 (53%) had a negative broad range PCR result and 2 (13.3%) had a conflicting broad range PCR result. Thirty-eight (34.2%) specimens were formalin fixed paraffin embedded tissue, 29 (26.1%) were fresh tissue, 13 (11.7%) were ESWABS, and the remaining 31 specimens were various fluid types (27.9%). While fresh tissue is the preferred specimen, broad range PCR detected an organism in 20 (53%) formalin fixed paraffin embedded tissue specimens, 11 (37.9%) fresh tissue specimens, 3 (23.1%) ESWAB specimens, and 2 (6.5%) fluid specimens (abscess aspirate and cerebrospinal fluid). Improvements in physician communication and laboratory workflow are necessary to improve the specimen quality and thus the utility of this referral test at our institution.

The impact of physician communication skills on glycemic control in patients with diabetes mellitus

ObjectivesThe purpose of the study was to evaluate the impact of physicians’ communication skills on glycemic control in type I and II diabetes patients.MethodThis cross-sectional study was conducted at the diabetic center at King Saud University Medical City, Riyadh, Saudi Arabia. The Arabic version of the communication assessment tool was used to evaluate the patient’s perception of the physicians’ communication skills.ResultsA total of 348 patients were invited to participate in the study in which 332 filled the questionnaire completely and hence participation rate was 95.4%. The average age of the patients was 44.2 (±19.7) years with an almost equal gender ratio. The percentage of excellent ratings for most of the questions was varying between 70 and 80%. The overall percentage of excellent ratings was 75.3%. Glycated hemoglobin and other metabolic features except for diastolic blood pressure did not have any significant association with the overall mean communication assessment tool score and the percentage of excellent rating.ConclusionStudy findings provided high patient satisfaction with their physicians’ communication skills. However, diabetes and metabolic control were not affected by this satisfaction. Hence, improvement in the communication skills of the physicians is recommended.

Decoding oxygen prescriptions: electronic health record documentation versus patient-reported use

BackgroundLong term oxygen therapy (LTOT) is prescribed for hypoxemia in pulmonary disease. Like other medical therapies, LTOT requires a prescription documenting the dosage (flow rate) and directions (at rest, with activity) which goes to a supplier. Communication with patients regarding oxygen prescription (flow rate, frequency, directions), monitoring (pulse oximetry) and dosage adjustment (oxygen titration) differs in comparison with medication prescriptions. We examined the communication of oxygen management plans in the electronic health record (EHR), and their consistency with patient-reported LTOT use.Study design and methodsA cross-sectional study was conducted in 71 adults with chronic lung disease on LTOT. Physician communication regarding oxygen management was obtained from the EHR. Participants were interviewed on their LTOT management plan. The information from each source was compared.ResultsThe study population was, on average, 64 years, two-thirds women, and most used oxygen for over 3 years. Only 45% of both at-rest and with-activity oxygen prescriptions were documented in the Electronic Health Record (EHR). Less than 20% of prescriptions were relayed to the patient in the after-visit summary. Of those with EHR-documented oxygen prescriptions, 44% of patients adhered to prescribed oxygen flow rates. Nearly all patients used a pulse oximeter (96%).InterpretationWe identified significant gaps in communication of oxygen management plans from provider to patient. Even when the oxygen prescription was clearly documented, there were differences in patient-reported oxygen management. Critical gaps in oxygen therapy result from the lack of consistent documentation of oxygen prescriptions in the EHR and patient-facing documents. Addressing these issues systematically may improve home oxygen management.

Communication and empathy within the patient-physician relationship among patients with and without chronic pain.

Chronic pain may affect the relationship between patients and their treating physicians. This study was designed to compare four aspects of physician communication and physician empathy reported by patients with chronic pain and in chronic pain-free controls. A cross-sectional study was conducted within a national pain research registry from July 2020 through January 2024. Patients with chronic low back pain of greater than 3months duration were matched to chronic pain-free controls utilizing propensity scores derived froma logistic regression model based on 11 variables thatincluded sociodemographic characteristics, cigarette smoking status, history of comorbid medical conditions, and duration of the current patient-physician relationship. Patients reported on the primary outcomes of physician communication utilizing the Communication Behavior Questionnaire (CBQ) and physician empathy utilizing the Consultation and Relational Empathy (CARE) measure. Group means were compared for each aspect of physician communication (patient participation and patient orientation, effective and open communication, emotionally supportive communication, and communication about personal circumstances) and physician empathy, and Cohen's d statistic was utilized to assess the clinical relevance of between-group differences. Secondary exploratory analyses were also performed to compare patients treated by osteopathic physicians vs. allopathic physicians and to determine whether study group X physician type interaction effects were present. The 387 patients in each study group were matched within a caliper width of 0.001 on the propensity score. Overall, patients ranged from 21 to 79 years of age (mean, 50.7 years; standard deviation [SD], 15.1 years), and 617 (79.7 %) of them were female. Patients in the chronic pain group reported poorer scores for all aspects of physician communication and physician empathy than the chronic pain-free controls. All between-group differences were clinically relevant. There were no differences in physician communication or physician empathy according to physician type in the exploratory analyses, and study group X physician type interaction effects were not observed. In this cross-sectional study, patients with chronic pain reported having physicians with poorer communication and less empathy than chronic pain-free controls. Longitudinal research is needed to more clearly determine the temporal relationship between patients' chronic pain and physician communication and physician empathy during medical encounters.

The Encounter of Two Worlds: Divided Narratives of Decision-Making on Cancer Treatment Between Physicians and Patients.

Divided narratives pose long-standing difficulties in physician and patient communication. In decision-making on cancer treatment, divided narratives between physicians and patients hinder mutual understanding and agreement over the illness and its treatment. For effective decision-making on treatments, it is necessary to investigate the similarities and differences in these divided narratives. This study adopted a qualitative research design of narrative inquiry to examine the data, which included interviews with 32 cancer patients and 16 paired physicians in two hospitals in China. Data analysis was conducted using grounded theory to generate findings. Both physicians and patients were concerned about goals and obstacles to their decision-making on cancer treatment. Four common aspects of goal setting were identified from the divided narratives: decision pools, treatment goals, identity practice and preferred identity. Four common obstacles were identified: pains and trust, communication gap, financial issues and complex family. However, the meanings attached to these eight aspects differed between physicians and patients. Cancer treatment decision-making is an encounter of the scientific world and lifeworld. A divided narrative approach can identify the similarities and differences in the decision-making on cancer treatment between physicians and patients. Physicians generally adopt a rational decision-making approach, whereas patients generally adopt a relational decision-making approach. Despite the common concerns in their goals and obstacles, physicians and patients differed in their contextualized interpretations, which demonstrates the physicians' and the patients' pursuit of preferred identities in decision-making. The results of this study provide a new perspective to treatment decision-making, emphasizing the importance of narrative integration in reaching mutual agreement. The findings were shared with 15 cancer patients and caregivers for feedback and advice in June 2024. This study was also presented at the international conferences of COMET (International and Interdisciplinary Conference on Communication, Medicine, and Ethics) and ICCH (International Conference on Communication in Healthcare) 2023 for continuous feedback and comments.

Patient and Physician Communication in the Allogeneic Transplantation Setting: Challenges and Potential Solutions

Allogeneic hematopoietic cell transplantation is a challenging treatment characterized by multiple morbidities, the need for long-term care, and a significant mortality risk. Consequently, close patient and physician communication throughout treatment is crucial. We aimed to review the literature examining patient and physician communication around critical aspects experienced by allogeneic survivors over the transplantation trajectory, such as the informed consent process, transplantation-related morbidity (eg, psychosocial distress, cognitive dysfunction, sexuality), adherence to treatment, and the use of complementary and alternative medicine, as well as interventions and strategies to improve patient and physician communication. We found a paucity of studies examining communication on these topics. Nevertheless, there is evidence of significant communication gaps around morbidities often experienced by allogeneic survivors, such as psychosocial distress, fatigue, and sexual functioning, due to both patient and physician barriers. Similarly, there is a concern that gaps also exist when addressing the informed consent process, cognitive dysfunction, adherence to treatment, and use of complementary and alternative medicine. The use and discussion of patient-reported outcome measures as part of clinical care is associated with patient and physician satisfaction with communication and better detection and management of symptoms. Although other strategies, such as decision aids, question prompt lists, and communication skills training, have improved communication in oncology, they have not been tested in the allogeneic setting. Future research is clearly needed to examine patient and physician communication in the allogeneic transplantation setting and test strategies to improve communication during this challenging treatment.

Experiences and expectations of physician communication: A focus group discussion with Indian patients with type 2 diabetes mellitus.

This pilot study aimed to: (a) understand the experiences of Indian patients with type 2 diabetes mellitus and their expectations of their physicians during a medical consultation, (b) serve as a preliminary study to inform the development of a larger project exploring and improving patients' communication experiences, and (c) assess whether the pilot study findings indicate the viability of using the Relationship: Establishment, Development, and Engagement model of communication as the conceptual framework for the larger project. Using convenience sampling, 11 patients participated in a focus group discussion. Conventional content analysis was used. Two themes were generated: (a) A plethora of negative feelings: experiences of the physician's verbal and nonverbal communication styles, and (b) 'I know what I want': Expectations of communication by patients from their physician. The medical encounter with the physician elicited a range of negative experiences and clear expectations from the patients with type 2 diabetes mellitus. This pilot points to the need for (a) a mixed methods approach to comprehensively examine the communication needs of patients with type 2 diabetes mellitus from their physician, (b) understand physicians' communication practices, and (c) using these findings, culturally adapt and test the Relationship: Establishment, Development, and Engagement to improve physicians' communication skills in India.

53057 Do Female Patients See their Physicians Differently? A Population Based Study Evaluating Perception of Physician Communication by Patients with Hidradenitis Suppurativa

53057 Do Female Patients See their Physicians Differently? A Population Based Study Evaluating Perception of Physician Communication by Patients with Hidradenitis Suppurativa