Doctor Communication Research Articles

Analysis of the Influence of Flying Doctor Programs in Handling Stunting on Patient Satisfaction at Public Health Centre Panyabungan Jae District Mandailing Natal

This study aims to analyze the effect of the implementation of the flying doctor program in handling stunting on patient satisfaction at the Panyabungan Jae Public Health Center Mandailing Natal Regency. This research is a quantitative study with a cross-sectional study design conducted at the Panyabungan Jae Public Health Center Mandailing Natal Regency in September-October 2022. Data were analyzed using the Chi Square test and logistic regression. The results of the univariate study showed that out of 67 respondents, the majority were aged 26-35 years, namely 31 (46.3%), had high school education, namely 35 (52.2%), worked as housewives, namely 37 (55.2%). Bivariate results showed that there was an effect of flying doctor communication (p=0.000), there was an effect of flying doctor responsiveness in handling stunting (p=0.028), provision of education in stunting management (p=0.000), competency in stunting management on patient satisfaction at the Panyabungan Public Health Center Mandailing Natal Regency for 2022 (p=0.000). The multivariate results show that the variable that influences patient satisfaction at the Panyabungan Jae Public Health Center Mandailing Natal Regency in 2022, is the variable providing education. The conclusion in this study is that all research variables in this study, namely communication of flying doctors, responsiveness, provision of education and competence affect patient satisfaction at the Panyabungan Jae Health Center, Mandailing Natal Regency, and the variables of providing education are the most influential (p = 0.000 OR = 10.935).

O.O.12.4 - Factors mediating doctor communication and patients satisfaction with care and trust in their doctor: Presenter(s): Carlos Campos, University of Auckland, New Zealand

O.O.12.4 - Factors mediating doctor communication and patients satisfaction with care and trust in their doctor: Presenter(s): Carlos Campos, University of Auckland, New Zealand

Care seeking for under-five children and vaccine perceptions during the first two waves of the COVID-19 pandemic in Lagos State, Nigeria: a qualitative exploratory study

ObjectiveTo explore healthcare seeking practices for children and the context-specific direct and indirect effects of public health interventions during the first two waves of COVID-19 in Lagos State, Nigeria. We...

Digitizing tuberculosis treatment monitoring in Wuhan city, China, 2020-2021: Impact on medication adherence.

Digital technologies can improve adherence to tuberculosis (TB) treatment. We studied the impact of digitizing TB treatment monitoring on adherence among TB patients in Wuhan, China, during 2020-2021. We compared an electronic system introduced to monitor TB medication adherence (e-Patient Service System; e-PSS) with the p paper-based standard of care (TB Control Information System; TCIS) in terms of prescribed TB treatment doses taken by patients and patient outcome after six months of follow up. We designed a cross sectional study using retrospective data for all drug susceptible pulmonary TB patients recorded on both systems. The main indicators were: compliant first follow up visit (within 3 days of start of treatment); medication adherence (80% or more of monthly doses taken); and end of treatment success ratio. A total of 1,576 TB patients were recorded in TCIS in July September, 2020 and 1,145 TB cases were included in e-PSS in January March, 2021. The distribution of patient demographic and clinical features was similar between the two groups. A larger proportion from the e-PSS group visited the community doctor in the first three days compared with the TCIS group (48.91 versus 29. 76 % respectively). Medication adherence was also higher in the e-PSS group during the 6 months of treatment than in the TCIS group (84. 28 versus 80.3 3 % respectively). Treatment success was 92.52% in the e-PSS group and 92.07% in the TCIS group. Multivariate logistic regress ion analysis demonstrated that adjusted odds ratios for compliant first follow up visit, medication adherence and favorable treatment outcome in the e-PSS versus TCIS groups were 2.94 (95% 2.47 3.50), 1.33 (95% 1.08 1.63), and 1. 12 (95% CL: 0.79 1.57) respectively. This study revealed improvements in TB care following an intervention to monitor treatment digitally in patients in Wuhan, China.

Factors Influencing Word-of-Mouth Behaviour at Outpatient Department YPK Mandiri Hospital, Jakarta

The purpose of this study was to determine the factors that influence the word-of-mouth behavior of patients seeking treatment at YPK Mandiri Hospital, Jakarta. The factors studied were doctor's expertise, doctor's communication, nursing, ancillary, and administration services, hospital reputation, and the physical structure and facilities of the hospital. Data were collected by a questionnaire distributed to patients receiving outpatient treatment. The number of samples obtained is 162 samples. A convenience sampling technique was used in this study. Data analysis was performed using the Partial Least Square-Structural Equation Modelling (PLS-SEM) approach using SmartPLS software. The results showed that doctors’ expertise, doctors’ communication, hospital reputation, and the physical structure and facilities of the hospital are related to word-of-mouth behavior. Nursing, ancillary, and administrative services are not related to word-of-mouth behavior.

Just a GP?

“Just a GP?” People ask this all the time. As if to recover from and evade their own discomfort, they invariably follow up with something like, “Well, we definitely need more community doctors, that’s for sure!” From my experience, this sentiment is usually innocent and stems from

A Triadic Approach to Medical Education: Holistic, Fully Integrated and Exclusive Undergraduate Curriculum

This paper proposes a novel undergraduate medical curriculum that provides three independent programs of General Medicine, General Surgery, and Obstetrics & Gynecology respectively. As proposed, students would be admitted under one of the above three proposed streams and be awarded degrees of MD-General Medical Practice (MD-Med) or MD-General Surgical Practice (MD Surg) or MD-Obstetrics & Gynecological Practice (MD-Obs & G) upon graduation. This curricular model would ensure that students admitted into each specific program are exclusively trained in those respective areas for four years more practically and robustly to become more suitable for specialization in areas within those three streams with better competence upon graduation as compared to the current curricular models. This program would also ensure that existing disciplinary redundancies could be eliminated under the proposed three streams thereby providing a more fulfilling clinical training and experience. This paper offers a totally integrated program in each one of the proposed three specialties under the broad umbrella of Undergraduate Medical Sciences providing a hands-on holistic hospital-based training for each stream aimed at graduating ‘fit to practice’ community doctors endowed with knowledge, skills and attitudes to better serve the community in their respective fields upon graduation. Keywords: Innovative medical curriculum, Integrated medical curriculum, Hospital based medical curriculum, Innovation in Medical education. DOI: 10.7176/JEP/14-5-07 Publication date: February 28 th 2023

Self-care of the elderly with cancer in the community

Self-care is an activity learned by individuals, oriented towards a goal. Cancer is one of the non-communicable chronic diseases that most affects the general population. Colon Cancer is identified as a problem of great magnitude for health systems. It is the third most common cancer in men and the second in women. Multiple predisposing factors are invoked as possible for its development. Aging is usually accompanied by an increase in the burden of chronic diseases, including Colon Cancer. The instruction to this population group aimed at adequate self-care through specific ways, with a coherent and systemic nature, which will form part of the doctor's work system in the community, is considered pertinent. A reconceptualization of self-care is necessary, specifically on the Self-care of the elderly with Colorectal Cancer in the community, so that the community doctor can incorporate into his work system the need to educate the elderly with Colorectal Cancer

Utilization of, satisfaction toward, and challenges for Internet-based healthcare services provided by primary health institutions: Evidence from China.

The rapid development of "Internet plus healthcare" in China has provided new ways for the innovative development of primary healthcare. In addition, a series of favorable policies have been issued to promote Internet-based healthcare services in primary health institutions. The aim of this study was to describe the utilization of, satisfaction toward, and challenges faced by Internet-based healthcare services provided by primary health institutions in China. A self-designed structured questionnaire was employed to collect related data in January 2022 through Credamo. The questionnaire mainly included sociodemographic characteristics, health-related information, utilization of, satisfaction toward, and challenges faced by Internet-based healthcare services provided by primary health institutions. Descriptive analysis was used to describe the sociodemographic characteristics, utilization, satisfaction, and challenges by subgroups. The Wilcoxon rank-sum test was carried out to examine the differences in satisfaction with Internet-based healthcare services between participants who ever received these services and those who did not. A multiple logistic regression model was also used to examine the factors influencing the utilization of Internet-based healthcare services provided by primary health institutions. A total of 10,600 residents were included in the final analysis, of whom 5,754 (54.3%) were women. Overall, 51.3% (5,434) of the total participants ever used Internet-based healthcare services provided by primary health institutions. Among those who used Internet-based healthcare services, the most widely used services were procedure-related consultation services (63.7%). The satisfaction among those who ever used it was significantly higher than that among those who did not (84.7 vs. 45.4%; p-value < 0.001). One of the biggest challenges (69.3%) expressed by the residents was that it was difficult for the elderly to use Internet-based services, followed by community doctors with low capacity of providing primary care online (49.0%) and residents were worried about the information security and privacy protection (48.5%). Younger people, people with lower education levels, and people with chronic diseases were significantly more likely to use Internet-based healthcare services provided by primary health institutions (P < 0.05). Among 10,600 residents surveyed in China in 2022, more than half of the people used Internet-based healthcare services provided by primary health institutions, and most of them were satisfied, although subgroups significant differences existed. The most common use was procedure-related (e.g., online registration and result query), and several challenges of using Internet-based healthcare services exist (e.g., information safety and usage among elderly people). Therefore, it is important to further improve Internet-based primary healthcare services based on the population perception of achieving healthy China in 2030.

Instrumental, Affective, and Patient-Centered Communication Between Cardiologists and Patients with Low Socioeconomic Status: An Observational Study

ABSTRACT One of the essential elements in managing health is having adequate communication with health care providers. Unfortunately, patients with a low socioeconomic status (SES) often experience less adequate communication with their doctor. In the current study, we explore and compare the communication of both doctors and patients from lower and higher sociodemographic backgrounds on three factors: instrumental, affective, and patient-centered communication. In total, 45 cardiology consultations were observed, transcribed, and coded (16 low-SES, 16 middle-SES, 13 high-SES). Our analyses showed that, compared to higher-SES patients, low-SES patients voiced less of their concerns, answered questions of the doctor more often with one word, and expressed less utterances overall. Naturally, we found that doctors expressed more utterances overall toward low-SES patients. For doctors, no differences regarding instrumental, affective, or patient-centered communication were found. These findings suggest that low-SES patients are more passive communicators and communication differences based on SES exist predominantly for patients’ communication. The revealed communication differences may lead to a less adequate interaction and potentially worse patient outcomes, further increasing the socioeconomic health gap. Hence, doctors should become even more aware of socioeconomic patient communication differences so that they can appropriately encourage low-SES patients to become more active communicators.

Senile dementia and psychiatric stigma among community health service providers and relatives of diagnosed and suspected dementia patients: a cross-sectional study.

The number of people suffering from dementia is increasing rapidly in China. Early identification, referral, and intervention for dementia patients within communities are important to public health. However, these measures could be impacted by misconceptions about dementia and associated psychiatric stigma from community health professionals and relatives of dementia patients. A cross-sectional survey was conducted on 249 participants, which included community doctors, community nurses, and relatives of diagnosed and suspected dementia patients in Guiyang, China. Participants were recruited through convenient sampling. The Chinese version of Dementia Knowledge Assessment Scale (DKAS) and the Perceived Psychiatric Stigma Scale (PPSS) were used to evaluate the participants' knowledge of dementia and dementia-related psychiatric stigma. A total of 249 participants completed the questionnaire. The participants had moderate overall knowledge of dementia and the associated psychiatric stigma. Participants who were ≥45 years old, had a low level of education, had a low monthly income, or gained knowledge of dementia through non-media channels had lower awareness of dementia and stronger psychiatric stigma. In the "Communication & behavior" subscale of DKAS, all participants had a low level of awareness. Relatives of diagnosed and suspected dementia patients had higher total PPSS and "Marital preclusion" subscale scores than community doctors and nurses but lower psychiatric stigma based on the PPSS "Self-deprecation" subscale score. Despite their profession, community doctors and nurses did not show an absolute advantage over relatives of diagnosed and suspected dementia patients in the dementia knowledge, and they even showed higher psychiatric stigma in some subscales. The self-deprecation subscale is related to the identification with negative labels such as "people with a mental illness are the weak". This study shows that reducing stigma on the "Self-deprecation" subscale should be a core component of training and educational programs targeted at improving dementia knowledge among community health service providers.

A Study on Mental Health Service Needs among Older Adults and the Policy Response in China: Experiences in Urban Shanghai

Despite increasing awareness of mental health problems among older adults, limited mental health services are available to meet their needs. The proposed study aimed to evaluate the need for mental health services among older adults in Shanghai, China, and identify gaps in the existing service system to inform policy making. Based on 80 face-to-face interviews amongst several groups of older adults and community officers, doctors and government stakeholders, the study found that (a) the mental health needs of older adults living with family members mainly present as needs for social interaction, sense of belonging, and self-realization; (b) special groups, such as older adults living alone, mainly desire support to address loneliness, older adults with physical disabilities desire social respect, and those with mental disabilities seek social acceptance; and (c) community cadres and other stakeholders have paid little attention to demands related to mental well-being among older people. It is necessary to deliver mental health education to community stakeholders and the public, popularize mental health knowledge, and publicize professional psychological counseling and treatment services. Meanwhile, policy makers should allocate resources to train professional mental health services personnel to meet these growing mental health needs and increase financial support for mental health services for older adults.

“Helping Mentally Ill, a Reward Both in this Life and After”: A Qualitative Study Among Community Health Professionals in Somaliland

This study aimed to describe the experiences of community mental health workers, predominantly female, nurses and doctors providing community-based mental health services in Borama, Somaliland. A qualitative explorative study using focus group discussions was conducted. Data were collected from three focus group discussions with 22 female community health workers, two medical doctors, and two registered nurses and analyzed using content analysis with an inductive approach. Three main categories were identified from the analysis: (1) bridging the mental health gap in the community; (2) working in a constrained situation; and (3) being altruistic. Overall, the community mental health workers felt that their role was to bridge the mental health gap in the community. They described their work as a rewarding and motivated them to continue despite challenges and improving community healthcare workers’ work conditions and providing resources in mental health services will contribute to strengthening mental health services in Somaliland.

Самооценка академических достижений студентов медицинского вуза в зависимости от интерактивных методов обучения

The purpose of the work is to identify the features of self-assessment of academic achievements of medical students depending on interactive teaching methods. The sample consisted of 272 6th year students of the medical and pediatric faculties (of which 76 % were women and 24 % were men) and 3 teachers of the Department of Pedagogy, Psychology and Psychosomatic Medicine of Izhevsk State Medical University of the Ministry of Health of Russia. The study was carried out as part of the study by students of the discipline “Doctor's Communication Skills”, one of the main goals of which is to prepare for the primary accreditation of future doctors. Classes were held in the form of communicative training. All teachers actively use simulation training, but to varying degrees: one teacher focuses on the “Standardized Patient” method, the second one - on the use of a case method with situational tasks from the professional activities of doctors, the third one - actively uses both. Based on the concept of A. V. Zakharova about the types of self-assessment, the authors developed an author's questionnaire aimed at determining the self-assessment of students' academic achievements. Within its framework, the features of retrospective, actual and predictive self-assessment of the academic achievements of students were found. Statistically significant differences in the self-assessment of academic achievements of students depending on the use of interactive teaching methods were revealed. To prepare for primary accreditation, the Standardized Patient methodology is effective. For the formation of professional competencies, it is also significant to use the case method in the classroom in the form of role-playing games and group discussions. Simulation training has a positive effect on the formation of a predictive self-assessment of academic achievements, an increase in the educational and professional motivation of students, and the development of their reflective and productive thinking.

Factors Associated with Patients' Ratings of Hospitals among Japanese Inpatients: A Cross-sectional Study.

The evaluation of hospital performance often receives great attention. Hospitals refer to patient ratings to undertake quality-improvement activities. However, little is known about the factors that contribute the most to these patient ratings. This study aimed to investigate the association of relevant factors, such as doctors' and nurses' performance, with patients' ratings of hospitals, using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPSⓇ) questionnaire. A cross-sectional study was conducted among patients who were hospitalized in Japan, from January 2020 to September 2021. Patients' hospital rating scale scores between 0 and 10 were collected and dichotomized. A score of 8 or higher was defined as a high rating. A multivariate logistic regression analysis was conducted to investigate the association between patients' ratings of the hospital and other items in the HCAHPSⓇ questionnaire. The frequency of patients' high and poor hospital ratings were 207 (69%) and 93 (31%), respectively, of 300 respondents. A significant association was observed for the patient's age (adjusted odds ratio (AOR): 1.02; 95% confidence interval (CI): 1.00-1.04), doctor's communication (AOR: 10.47; 95% CI: 3.17-34.58), and discharge planning (AOR: 3.53; 95% CI: 1.96-6.36) with a positive patient rating of the hospital. An emphasis on doctor communication and discharge planning is essential in improving patients' ratings of hospitals. Further research is needed to determine the factors that contribute the most to patients' ratings of hospitals.

ACUTE UNCOMPLICATED DIVERTICULITIS: Guidelines on Diagnosis and Management: is everything fine?

The transition from intravenous (IV) antibiotic therapy to oral therapy and the observation that in patients with acute uncomplicated diverticulitis (AUD), treatment with or without antibiotics gave similar results in both hospitalized and outpatients, opened the way for out-of-hospital treatment in selected patients with CT-confirmed diagnosis. Due to economic constraints and a growing demand for hospitalization, home hospital care (HAH) and other community-based services was supported to alleviate the burden on emergency departments (EDs). This resulted in significant cost savings for the National Health Service (NHS) but, in many countries, community services are not uniformly present, leading to health care inequality. Relationships between hospital and community doctors indicate poor professional communication. Shared guidelines could lead to increased adherence. Some conditional recommendations based on low-certainty evidence related to the diagnosis and management of AUD remain controversial. Even after recovery from an episode, the question of whether to pursue conservative management or elective surgery is still open for debate. The outpatient treatment is understood as referring to both patients managed by hospital doctors and those treated by general physicians in their office. On management and outcomes of patients with AUD diagnosis in primary care there is little data. AUD treatment without antibiotics encounters resistance in many countries for multiple reasons, including low implementation and uncertain dissemination of guidelines recommendations. This would require greater control and commitment on the part of Institutional bodies and scientific societies.

Malaria eradication in Nigeria: State of the nation and priorities for action

This paper discusses the National Malaria Strategic Plan (NMSP), the Nigeria End Malaria Council (NEMC), and the National Malaria Elimination Program (NMEP) in Nigeria and their relationship towards achieving the NMSP goal of eradicating malaria by 2025. Malaria is one of the leading causes of morbidity and mortality in Nigeria. Despite implementing the NMSP in times past, the country still has sub-Saharan Africa's highest malaria mortality rate. The NMSP 2021–2025 aims to reduce malaria deaths to less than 50 per 1000 births and achieve a parasite prevalence of less than 10% by 2025. The NEMC was established in 2022 to support the NMEP in achieving the malaria eradication goal by 2030. The paper also identifies challenges to malaria elimination, such as poor accessibility to antimalarials, socio-cultural and behavioral approaches by community members, and data collection by community health workers, nurses, and doctors. The paper suggests a multidisciplinary approach involving social and behavioral scientists to incorporate community members' belief systems into account and encourages data collection and supervisory visits to ensure quality data. The sustainability of interventions and follow-up on interventions and progress reports is also highlighted as a barrier to be overcome. The paper concludes that the successful implementation of the NMSP by the NMEP will require the commitment of the NEMC, relevant stakeholders and a coordinated effort toward eliminating malaria as a public health problem in Nigeria.

Elektronska komunikacija u porodičnoj medicini

Traditional communication between physicians and patients consists of verbal and non-verbal communication. Non-verbal communication can emphasize, modify, or supplement a message that is verbally conveyed and reduce the possibility of misunderstanding. Web applications offer the ability to communicate with physicians and patients outside the healthcare facility. E-mail communication of the selected physician and patient is defined as electronic communication of doctors and patients in a contractual relationship in which the health information provider bears responsibility for the patient's health as his or her chosen physician. A literature review was conducted based on European and American studies reports to determine whether the use of electronic communication in family medicine could contribute to improving the quality of health care. The search for PUBMED, BMJ, JMIR and OVID was performed using the terms: electronic communication, family medicine, email, physician, patient. The most important benefits of electronic communication in family medicine are the simplicity and increased efficiency of communication, the expansion of resources and the ability to communicate, saving time and the ability to print electronic messages. The disadvantages lie in the potential compromise of confidentiality, the lack of monetary compensation and overload of the doctors, the potential for miscommunication, diagnostic error and unrealistic user expectations. Information technology must not replace traditional physician-patient communication. Although the results of the available studies have not provided strong enough evidence to broaden the introduction of electronic communications into everyday practice, adhering to the guidelines of good clinical practice, email and other forms of internet communication could contribute to improving the quality of primary care.

Role of jargon in the patient-doctor communication in the dental healthcare sector-A systematic review and meta-analysis.

Medical terminology is useful for better communication between medical and dental professionals. Overzealous use of this terminology and use of medical terms during patient interaction hamper the complete understanding of the doctor's explanation about their health status. Nowadays, the usage of abbreviations or short terminology in health sectors has become common during all stages like the patient's initial visit, during the diagnosis, and even during the treatment plan stage. The objective was to know the commonly used jargon in the dental profession and to know the effect of the commonly used jargon on patient-doctor communication and treatment outcomes. Three major scientific databases were used as search engines PubMed, Web of Science, and Scopus by following three main search criteria, the common use of jargon in the dental profession, effect of jargon on patient-doctor communication, and treatment outcomes. An approach to meta-synthesis was used in the qualitative research methodology. With the Sandelowski and Barroso approach, meta-synthesis was carried out. Following database searches, during the years 2001 to 2022, 424 studies were gathered. Ten sources were then chosen and used in the analysis stage. Usage of jargon in dental professions has an effect on patient-doctor communication, and to an extent, it also has an effect on the treatment plan which further has its effect on treatment outcome.The correlation ratio (COR) of frequency of jargon is 0.46 (0.34; 0.57), with P value <0.0001, which indicates the presence of these issues in dental healthcare sector. The cautious use of jargon within the health profession will be beneficial in terms of professional communication with the patients and also helps in rendering better treatment to the patients.

A Three-dimensional Finger-tapping Framework for Recognition of Patients with Mild Parkinson's Disease.

Upper limb tremor is a prominent symptom of both Parkinson's disease and essential tremor. Its kinematic parameters overlap substantially for these two pathological conditions, thus leading to high rate of misdiagnosis, especially for community doctors. Several groups have proposed various methods for improving differential diagnosis. These prior studies have attempted to identify better kinematic parameters, however they have mainly focused on single limb features including tremor intensity, tremor frequency, and tremor variability. In this paper, we propose a wearable system for multi-segment assessment of upper limb tremor and differential diagnosis of Parkinson's disease versus essential tremor. The proposed system collected tremor data from both wrist and fingers simultaneously. From this data, we extracted multi-segment features in the form of phase relationships between limb segments. Using support vector machine classifiers, we then performed differential diagnosis from the extracted features. We evaluated the performance of the proposed system on 19 Parkinson's disease patients and 12 essential tremor patients. Moreover, we also assessed the performance cost associated with reducing task load and sensor array size. The proposed system reached perfect accuracy in leave-one-out cross validation. Task reduction and sensor array reduction were associated with penalties of 2% and 9-10% respectively. The results demonstrated that the proposed system could be simplified for clinical applications, and successfully applied to the differential diagnosis of Parkinson's disease versus essential tremor in real-world setting.