Doctor-patient Relationship Research Articles

Twelve tips for LGBT+-inclusive undergraduate and postgraduate medical education

Sexual and gender minority (LGBT+) populations continue to experience worse health outcomes and reduced healthcare access compared to their cisgender, heterosexual counterparts, perpetuated by a lack of sufficient LGBT+-specific healthcare education within medical schools. Developing educational material that encourages self-reflective, proactive, and affirmative practice has been identified as a mechanism for increasing the quality of doctor-patient relationships and breaking down barriers in healthcare access for LGBT + communities. In this article, we provide twelve tips for those designing and delivering undergraduate and postgraduate medical curricula. We summarise evidence-based approaches to inclusive care, key overarching concepts that curricula should include and common issues to be avoided. We hope these tips provide a standard against which existing curricula and teaching practices can be appraised and form the basis of future educational material.

Bibliometric and visualization analysis of risk management in the doctor-patient relationship: A systematic quantitative literature review.

This paper analyzed the research on risk management in the doctor-patient relationship (DPR) based on a systematic quantitative literature review approach using bibliometric software. It aims to uncover potential information about current research and predict future research hotspots and trends. We conducted a comprehensive search for relevant publications in the Scopus database and the Web of Science Core Collection database from January 1, 2000 to December 31, 2023. We analyzed the data using CiteSpace 6.2.R2 and VOSviewer 1.6.19 software to examine the annual number of publications, countries/regions, journals, citations, authors, and keywords in the field. A total of 553 articles and reviews that met the criteria were included in this study. There is an overall upward trend in the number of publications issued; in terms of countries/regions, the United States and the United Kingdom are the largest contributors; Patient Education and Counseling is the most productive journal (17); Physician communication and patient adherence to treatment: a meta-analysis is the most cited article (1637); the field has not yet to form a stable and obvious core team; the analysis of high-frequency keywords revealed four main research directions: the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the keyword burst analysis revealed several shifts in the research hotspots for risk management in the DPR, suggesting that chronic disease management, is a future research direction for the continued development of risk management in the DPR. The visualization analysis of risk management literature in the DPR using CiteSpace and VOSviewer software provides insights into the current research status and highlights future research directions.

Influence of doctor-patient relationships and health-related factors on the medical satisfaction of patients with Sjögren's disease.

Patients with chronic, incurable conditions rely on their providers to help relieve their symptoms. Dissatisfaction with their care can erode the doctor-patient relationship and reduce the effectiveness of treatment. We investigated the relationships between satisfaction and symptoms, the doctor-patient relationship, and health-related factors in patients with Sjögren's disease (SjD) in Japan. Using a questionnaire survey, we evaluated via multinomial logistic regression associations between satisfaction [satisfied, neither (neither satisfied nor dissatisfied), dissatisfied] and symptoms, prescribed medications, anxiety, distress, expectations from treatments, and doctor-patient relationships. Of 259 patients, 101 (39%) were satisfied, 111 (42.9%) were neither, and 47 (18.2%) were dissatisfied. Patients who were neither or dissatisfied with their current treatment wanted their systemic pain to disappear (adjusted relative risk ratio [aRRR] 3.38, 95% CI 1.66-6.91; aRRR 3.04, 95% CI 1.30-7.15, respectively). Patients who used artificial saliva only were significantly more dissatisfied (aRRR 3.52, 95% CI 1.03-2.04). Both the neither and dissatisfied patients dissatisfied with their doctor's limited understanding of SiD (aRRR 12.69, 95% CI 4.21-38.24; aRRR 32.76, 95% CI 10.09-106.34, respectively) and with the limited opportunities to ask their doctor about their disease (aRRR 0.19, 95% CI 0.06-0.59; aRRR 0.08, 95% CI 0.02-0.24, respectively). Pain and the use of artificial saliva alone markedly affected medical satisfaction and we expected the future advance in these two areas, pain and dryness, will improve satisfaction. It is most important for doctors to better understand SjD.

Anti-Herpes Zoster Vaccination of Fragile Patients in Hospital Setting: A Nudge Intervention in Italy.

A nudge intervention against Herpes Zoster, created and implemented in Italy, is presented in order to administer the Shingrix vaccine on a sample of frail patients, as required by the National Prevention Plan. Individual and contextual factors associated with vaccine adherence were investigated. 300 frail adult subjects underwent a full vaccine cycle with recombinant-Shingrix vaccine (RZV vaccine). Hospital Presidia of the Salerno University Hospital Authority, a Hospital Presidium of the Salerno Local Health Authority, and the Public Health Laboratory of the University of Salerno (Campania) participated in the intervention. An ad hoc questionnaire was administered with the following scales: EQ-5D, PSS-10, MSPSS, and representations of HZ and its consequences. Some variables, such as peer support, doctor-patient relationship, level of education, and perception of health, are important in vaccine adherence and information processing. The following factors emerged from the factor analysis: Trust in collective knowledge and collective responsibility (F1); beliefs about virus risk and vaccine function (F2); information about virus and symptomatology (F3); and vaccine distrust (F4). Factor 4 correlates negatively with social support indices (R = -0.363; p < 0.001). There is a significant relationship between factor 3 and satisfaction with national information campaigns (F = 3.376; gdl = 5; p-value = 0.006). Future vaccination campaigns should be built with the aim of personalizing information and developing contextualized strategies, starting from understanding the stakeholders involved, cultural contexts, and organizational settings.

Factors and Reasons Associated With Appointment Non-attendance in Hospitals: A Narrative Review.

Non-attendance at hospital appointments is an extremely prevalent issue impacting healthcare systems on a daily basis. This phenomenon adversely affects patient health and healthcare providers, leading to delays in diagnosis and treatment, inefficient resource utilization, and increased healthcare expenses. The detrimental impact of non-attendance is not limited to patients who miss appointments, the knock-on effects of extended waiting times and reduced appointment availability are felt throughout healthcare systems. The purpose of this narrative review is to explore the factors underlying appointment non-attendance in hospital settings, to improve healthcare delivery and patient adherence. An extensive review of the existing global literature was conducted. Quantitative studies that explored the relationship between appointment non-attendance and patient characteristics, such as age, gender, marital status, education level, distance from the hospital, and source of referral, were included. Younger patients, males, individuals with lower levels of education, and those living farther from hospitals were more likely to miss appointments. Marital status was significant, with married patients showing better attendance, as was referral source, with general practitioner referrals associated with higher non-attendance. Qualitative studies identifying both patient-centered and hospital-specific reasons, such as forgetfulness, appointment time, protracted waiting times, patient-physician relationship, and patients' knowledge and perception of their health condition, were also included in the review. Lack of appointment reminders, difficulties in managing appointments, and inadequate patient-physician communication were significant hospital-specific reasons given for non-attendance. Patients' lack of awareness regarding the importance of attending appointments and limited understanding of their health conditions were also identified as patient-centered contributors. Non-attendance at hospital appointments is a multifaceted issue influenced by a range of socioeconomic, personal, and systemic factors. Addressing these factors requires a holistic approach that includes patient education, improved communication, and tailored healthcare delivery strategies, especially for vulnerable populations in rural areas. Enhanced reminder systems and streamlined appointment management could serve as pivotal interventions to reduce non-attendance rates, ultimately improving healthcare outcomes and resource utilization.

Beyond words: analyzing non-verbal communication techniques in a medical communication skills course via synchronous online platform.

Effective doctor-patient relationships hinge on robust communication skills, with non-verbal communication techniques (NVC) often overlooked, particularly in online synchronous interactions. This study delves into the exploration of NVC types during online feedback sessions for communication skill activities in a medical education module. A cohort of 100 first-year medical students and 10 lecturers at the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), engaged in communication skills activities via Microsoft Teams. Sessions were recorded, and lecturer NVC, encompassing body position, facial expressions, voice intonation, body movements, eye contact, and paralinguistics, were meticulously observed. Following these sessions, students provided reflective writings highlighting their perceptions of the feedback, specifically focusing on observed NVC. The study identified consistent non-verbal communication patterns during feedback sessions. Lecturers predominantly leaned forward and toward the camera, maintained direct eye contact, and exhibited dynamic voice intonation. They frequently engaged in tactile gestures and paused to formulate thoughts, often accompanied by filler sounds like "um" and "okay." This consistency suggests proficient use of NVC in providing synchronous online feedback. Less observed NVC included body touching and certain paralinguistic cues like long sighs. Initial student apprehension, rooted in feelings of poor performance during activities, transformed positively upon observing the lecturer's facial expressions and cheerful intonation. This transformation fostered an open reception of feedback, motivating students to address communication skill deficiencies. Additionally, students expressed a preference for comfortable learning environments to alleviate uncertainties during feedback reception. Potential contrivances in non-verbal communication (NVC) due to lecturer awareness of being recorded, a small sample size of 10 lecturers limiting generalizability, a focus solely on preclinical lecturers, and the need for future research to address these constraints and explore diverse educational contexts. Medical schools globally should prioritize integrating NVC training into their curricula to equip students with essential communication skills for diverse healthcare settings. The study's findings serve as a valuable reference for lecturers, emphasizing the importance of employing effective NVC during online feedback sessions. This is crucial as NVC, though occurring online synchronously, remains pivotal in conveying nuanced information. Additionally, educators require ongoing professional development to enhance proficiency in utilizing NVC techniques in virtual learning environments. Potential research directions stemming from the study's findings include longitudinal investigations into the evolution of NVC patterns, comparative analyses across disciplines, cross-cultural examinations, interventions to improve NVC skills, exploration of technology's role in NVC enhancement, qualitative studies on student perceptions, and interdisciplinary collaborations to deepen understanding of NVC in virtual learning environments.

12 Tips for Centering Patient Voices through "Lived Experience Panels" in Preclinical Undergraduate Medical Education.

Background: Integrating patient narratives into medical education enhances understanding of person-centered care, empathy, and the human experience of illness. This paper explores the implementation of lived experience panels (LEPs) in preclinical medical education. Aims &amp; Description: Twelve strategies for effective LEP integration are presented, emphasizing thoughtful curation of panelists, timing considerations, vulnerability cultivation, and empowerment of marginalized voices. The paper outlines leveraging virtual platforms, skillful facilitation, student and patient preparation, post-session support, and debriefing mechanisms. Experiences from the University of Texas Branch at Galveston are showcased. Conclusion: The incorporation of LEPs into medical education holds immense potential for benefiting both learners and patients. Ensuring intentional and sensitive inclusion of these panels is paramount for the development of impactful curricula. By incorporating patient voices into medical education, we can nurture empathy, reinforce person-centered care principles, and cultivate authentic connections among learners, ultimately facilitating a transformative shift in the dynamics of the physician-patient relationship.

Factors influencing the decision-making process in breast reconstruction from the perspective of reconstructive surgeons: A qualitative study involving Korean plastic surgeons

BackgroundLittle research has been conducted on factors influencing the decision-making process for immediate breast reconstruction (IBR) options from the perspective of reconstructive surgeons, despite its significant impact on doctor-patient communication and shared decision-making. This study aims to explore the multiple factors and the mechanisms by which they interact using a qualitative methodology. We also address potential barriers to shared decision-making in IBR. MethodsSemistructured interviews were conducted with a purposive sample of reconstructive surgeons. Thematic analysis was used to identify key influences on IBR decision-making process from the perspective of reconstructive surgeons. ResultsFour major themes were identified: 1. Patient clinical scenarios; 2. Nonclinical practice environments; 3. Reconstructive surgeon preferences; and 4. Patient consultation. Reconstructive surgeons demonstrated diverse approaches to patient clinical scenarios. High-volume centers were significantly influenced by nonclinical factors such as scheduling and operating room allocation systems. Reconstructive surgeons often had strong personal preferences for specific IBR options, shaped by their expertise, experience, and clinical environment. Based on the preliminary decision, surgeons provided information with varying degrees of neutrality. Patients varied in their knowledge and participation, resulting in variation in the final decision authority among surgeons. ConclusionsThis study highlights the need to address nonclinical environmental constraints to improve shared decision-making process in IBR. Surgeons should recognize power imbalances in the doctor-patient relationship and be aware of their biases.

Psychological Factors Influencing Attitudes towards Euthanasia, Assisted Suicide and Palliative Care among Medical Students and Doctors in Training.

Background: This study aimed to analyse the attitudes of medical students, Polish and classical philology students and trainee doctors towards the legalisation and practice of euthanasia and assisted suicide, to explore their beliefs about palliative care and to identify the cognitive, behavioural and emotional factors influencing these attitudes. Methods: An anonymous 22-question survey was sent by email to 670 participants, who comprised students of medicine, students of Polish and classical philology and trainee physicians. Results: Out of the 670 people invited to the survey, 313 (46.72%) responded; 215 (68.69%) and 112 (35.80%) participants supported the legalisation of euthanasia and assisted suicide, respectively. No differences were found between the respondent groups studied. The respondents' attitudes were influenced by religion, place of residence and professed values in the doctor-patient relationship. Among the medical students and trainee doctors surveyed, the declared willingness to perform euthanasia was lower, with 90 (43.7%) people, than the support for its legalisation, with 135 (65.5%) people. Significantly higher support for palliative care was expressed by fifth- and sixth-year medical students and trainee doctors, with 88 respondents (89.89%), less support was expressed by first- and fourth-year medical students, with 74 respondents (68.5%), and the lowest support was observed among Polish and classical philology students, with 63 respondents (58.9%). Conclusions: The legalisation of euthanasia and assisted suicide was supported by more than two-thirds and one-third of all the respondents, respectively, with the majority of medical students and trainee doctors surveyed expressing uncertainty or lack of readiness towards their practice. More than 70% of all the respondents showed a positive opinion towards palliative care, with the lowest support being among Polish and classical philology students.

RIGHT AND DUTY OF PHYSICIAN-PATIENT IN MEDICAL CONTEXT

In my duties, the rights of others are included, and in my rights, the duties of others are also included. Just as we can see in the education field where the teacher's duty is to give the right education and it is the right of the learner to get the right education, in the same way, the learner's duty to respect the teacher and the teacher's right to respect of his autonomy. Duty and right are the two parts of one coin (life). Generally, there are some duties to protect human rights (education, information, health, freedom of speech and expression) same some duties (duty of care, not to harm, to benefit, to give good faculties, respect others, to speak the truth) prescribed by medical ethics towards the Patient and Physician to protect rights (right to life, respect to autonomy and dignity, right to health, right to cure, right to select the cases). So we see here, that the Physician's duties become the rights of the Patient, for example, the Physician's duty is to do best for the Patient's health, and the Patient's right is the right to health. In the medical field, the Physician's duty is to respect the Patient's choice and Patient's right is to select an excellent medical option. We always discussed the Patient's rights (Respect, dignity, and autonomy) and the Physician's duties (Doing his best for the Patient's health) and obligations ( not harming the Patient) instead of the Physician's rights (Rights to reject and select treatment and cases) and the Patient's duties ( Respecting the physician and following the physician’s suggestion, Prescriptions) and obligations ( not harming the Physician), If we start to give priority to duties of patients and the rights of physicians, then we will create an actual , mutual partnership model which will connect truly both parties and give equal importance and respect ultimately ending all the conflict related to Physician-Patient relationship. We can also fill the gap in thoughts and motives between both because if both begin to realize their responsibilities and obligations and respect each other's rights, all the clashes between them will come to an end. In this paper, I will discuss the duties and rights of doctors and patients, which can help bridge the gap between both relations and make them equal participants with each contributing actively and not just passively.

The Prevalence of Violence Against Healthcare Workers in Trinidad and Tobago.

Abuse of healthcare workers (HCWs) and lack of public trust threaten the foundation of the physician-patient relationship. This growing global problem creates an even more difficult professional environment and hinders the delivery of high-quality clinical care. The primary aim was to determine the prevalence of violence against Trinbagonian HCWs in the public sector. Secondary objectives included determining risk factors for violence and mistrust between the public and providers. A cross-sectional analysis of 434 HCWs in the public sector of Trinidad and Tobago was conducted using a modified World Health Organization (WHO) data collection tool, distributed via social media and administrative emails, and snowballed for two months. Fifteen semi-structured interviews were conducted regarding trust in the healthcare system with patients selected from communities. Of the 434 respondents, 45.2% experienced violence and 75.8% witnessed violence against HCWs in the past two years. Verbal abuse (41.5%) was most common. Perpetrators were patients (42.2%) and patients' relatives (35.5%). Chi-square analysis highlighted that HCWs with the highest probability of being abused were aged 25-39 (63.8%), had two to five years of work experience (24.9%), specialized in emergency and internal medicine (48.6%), and cared for psychiatric and physically disabled patients (p-value < 0.001). HCWs believed the threat of violence negatively impacted performance (64.5%), and further action was necessary for mitigation (86.4%). Patients interviewed doubted physicians' altruism and competence (80%) and honesty (53.3%), expressed mistrust in their physician (46.7%), and cited poor infrastructure/management (66.7%) and dissatisfaction with care (60.0%) as factors that contributed to violence. Analysis revealed that violence against Trinbagonian HCWs in the public sector deteriorated patient experience and adversely affected psychological well-being, efficiency, and job satisfaction. Results suggested mistrust of HCWs by the population. Interventions should be instituted to support at-risk HCWs and educate the public to avoid recurrence.

Physician Empathy and Chronic Pain Outcomes

Empathy is an aspect of the patient-physician relationship that may be particularly important in patients with chronic pain. To measure the association of physician empathy with pain, function, and health-related quality of life (HRQOL) among patients with chronic low back pain. This cohort study included adult enrollees from the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation national pain research registry. Study dates were from April 1, 2016, to July 25, 2023, with up to 12 months of follow-up. Physician empathy was assessed with the Consultation and Relational Empathy measure and dichotomized to yield very empathic physician and slightly empathic physician groups. Main outcomes were patient-reported pain, function, and HRQOL measured with a numerical rating scale for low back pain intensity, the Roland-Morris Disability Questionnaire for back-related disability, and the Patient-Reported Outcomes Measurement Information System for HRQOL deficits pertaining to anxiety, depression, fatigue, sleep disturbance, and pain interference. Data were collected at 5 quarterly encounters from registry enrollment through 12 months and analyzed with generalized estimating equations, including multivariable models to measure temporal trends and to adjust for baseline and longitudinal covariates. Among the 1470 patients, the mean (SD) age was 53.1 (13.2) years, and 1093 (74.4%) were female. Patients completed 5943 encounters in which multivariable analyses demonstrated that greater physician empathy was inversely associated with pain intensity (β = -0.014; 95% CI, -0.022 to -0.006; P < .001), back-related disability (β = -0.062; 95% CI, -0.085 to -0.040; P < .001), and HRQOL deficits on each measure (eg, pain interference: β = -0.080; 95% CI, -0.111 to -0.049; P < .001). Correspondingly, compared with the slightly empathic physician group, the very empathic physician group reported lower mean pain intensity (6.3; 95% CI, 6.1-6.5 vs 6.7; 95% CI, 6.5-6.9; P < .001), less mean back-related disability (14.9; 95% CI, 14.2-15.6 vs 16.8; 95% CI, 16.0-17.6; P < .001), and fewer HRQOL deficits on each measure (eg, fatigue: 57.3; 95% CI, 56.1-58.5 vs 60.4; 95% CI, 59.0-61.7; P < .001). All physician empathy group differences were clinically relevant, with Cohen d statistics ranging from 0.21 for pain intensity to 0.30 for back-related disability, fatigue, and pain interference. Physician empathy was associated with more favorable outcomes than non-pharmacological treatments, opioid therapy, and lumbar spine surgery. In this cohort study of adult patients with chronic pain, physician empathy was associated with better outcomes over 12 months. Greater efforts to cultivate and improve physician empathy appear warranted.

Loneliness in medicine and relational ethics: A phenomenology of the physician-patient relationship

Loneliness in medicine is a serious problem not just for patients, for whom illness is intrinsically isolating, but also for physicians in the contemporary condition of medicine. We explore this problem by investigating the ideal physician-patient relationship, whose analogy with friendship has held enduring normative appeal. Drawing from Talbot Brewer and Nir Ben-Moshe, we argue that this appeal lies in a dynamic form of companionship incompatible with static models of friendship-like physician-patient relationships: a mutual refinement of embodied virtue that draws both persons together. The ideal physician-patient relationship has a dialectical character that fosters each member's improvement of phenomenologically recognizing and embodying moral virtues. A key component of this dynamic is a commitment to the common goal of the patient's health, realized through joint interactivities and conversations over time. The physician's presence to the patient's suffering—understood best as an alienating phenomenological condition for the patient—orients and discloses possibilities for virtuous caregiving by structuring the meanings of the goals, conversations, and joint narrative constitutive of their relationship. Presence to suffering, paradoxically, is perhaps an important prerequisite for this dynamic partnership. These activities dialectically build an interpretive horizon of understanding through which moral goods and character refinement—in and for the other—may become revealed for both persons in their shared being-in-the-world. This analysis of suffering, mood, and revealing of (possible) moral goods has implications for addressing the modern problem of loneliness for patients and physicians, who are increasingly inhibited from building flourishing relationships with each other.

Factors Influencing Drug Prescribing for Patients with Hospitalization History in Circulatory Disease: Patient Severity, Composite Adherence, and Physician-Patient Relationship - A Retrospective Cohort Study.

With countries promoting generic drug prescribing, their growth may plateau, warranting further investigation into the factors influencing this trend, including physician and patient perspectives. Additional strategies may be needed to maximize the switch to generic drugs while ensuring healthcare system sustainability, focusing on factors beyond mere low cost. Emphasizing affordability and clarifying other prescription considerations are essential. This study aimed to provide initial insights into how patient severity, composite adherence, and physician-patient relationships impact generic switching. This study utilized a long-term retrospective cohort design by analyzing data from a national healthcare database. The population included patients of all ages, primarily older adults, who required primary-to-tertiary preventive actions with a history of hospitalization for cardiovascular diseases (CVDs) (International Classification of Diseases, Tenth Revision) during April 2014 to March 2018 (4 years). We focused on switching to generic drugs, with temporal variations in clinical parameters as independent variables. Lifestyle factors (smoking and drinking) were also considered. Adherence was measured as a composite score comprising 11 elements. The physician-patient relationship was established based on the interval between physician change and prescription. Logistic regression analysis and propensity score matching (PSM) were employed, along with complementary analysis of physician-patient relationships, proportion of days covered (PDC), and adherence for a subset of the population. The study included 48,456 patients with an average follow-up of 36.1±8.8 months. The mean age was 68.3 ± 9.9 years, body mass index was 23.4 ± 3.4 kg/m2, systolic blood pressure was 131.2 ± 15.0 mmHg, low-density lipoprotein cholesterol (LDL-C) was 116.6 ± 29.3 mg/dL, hemoglobin A1c (HbA1c) was 5.9% ± 0.8%, and serum creatinine was 0.9 ± 0.8 mg/dL. Logistic regression analysis revealed significant associations between generic switching and systolic blood pressure (odds ratio [OR], 0.996, 95% confidence interval [CI]: 0.993-0.999), serum creatinine levels (OR, 0.837, 95% CI: 0.729-0.962), glutamic oxaloacetic transaminase levels (OR, 0.994, 95% CI: 0.990-0.997), PDC score (OR, 0.959, 95% CI: 0.948-0.970), and adherence score (OR, 0.910, 95% CI: 0.875-0.947). Additionally, generic drug rates increased with improvements in the HbA1c level band and smoking level (P<.01, P<.001). The group with a superior physician-patient relationship after PSM had a significantly higher rate of generic drug prescribing (51.6±15.2%) than the inferior relationship group (47.7±17.7%) (P<.001). Although physicians' understanding influences the choice of generic drugs, patient condition (severity) and adherence also impact this decision. For example, improved creatinine levels are associated with generic drug choice, while stronger physician-patient relationships correlate with higher rates of generic drug utilization. These findings may contribute to the appropriate prescription of pharmaceuticals if the policy diffusion of generic drugs begins to slow down. Thus, preventing serious illness while building trust may result in clinical benefits and positive socio-economic outcomes.

Interpretation of bad news delivery in medical practice through PRISMA 2020 literature review

Poor communication of bad news can have a significant negative impact on patients, triggering stress, anxiety and deterioration in their overall health status. The aim of this study was to interpret the delivery of bad news in medical practice through a literature review for the proposal of an approach to improve effective communication skills among health professionals. To achieve this end, a literature review was conducted following the guidelines of the PRISMA 2020 methodology, using sources such as PubMed, Lilacs and Scielo. From this search, 16 articles relevant to the topic of study were selected. The findings underline that the ability to adequately communicate bad news is not optional, but an essential competency within professional practice, thus highlighting the importance of this topic in the medical setting. It is concluded that it is crucial for health professionals to be adequately prepared to communicate bad news, which implies the development of protocols and specific recommendations on prognosis and treatment, and the fostering of a doctor-patient relationship based on trust and mutual respect

Promoting new users’ online health consultation services usage behavior strategically

Online consultation services have the potential to reduce the workload of healthcare staff, provide timely care to patients, and improve doctor-patient relationships. The COVID-19 pandemic has accelerated the development of these services and platforms, but it remains to be seen whether the general public will continue to use them after the pandemic is under control. This research proposes a framework to examine the factors contributing to UK adults’ continued usage of online healthcare consultation services after COVID-19 restrictions have been lifted. A total of 430 new users completed surveys, and the results indicate that expectation confirmation, system quality, and information quality can positively impact users’ self-efficacy toward using online consultation services. This, in turn, can influence their continued usage behavior. Furthermore, the results suggest that participants’ perception of health risks can moderate the relationship between self-efficacy and continued usage behavior. The strategic implications of these findings are discussed.

Volatility, Uncertainty, Complexity, and Ambiguity (VUCA) in Healthcare.

Our professional activity is constantly under pressure from a multitude of elements and factors that can be classified into the four components of the VUCA phenomenon-volatility, uncertainty, complexity, and ambiguity-components that define the turbulence and challenges of the external environment. Considering the general elements of this phenomenon, we designed a new VUCA dimension specific to the healthcare field within which we have identified and analyzed all the factors that can influence the main actors of the doctor-patient relationship and the effects that can occur within the healthcare system in which this relationship is born. In this context, we generated the VUCA treatment in healthcare capable of mitigating the impact of this phenomenon; this treatment involves essential elements in overcoming possible crises and vulnerabilities of the medical profession. The VUCA treatment in healthcare requires combating volatility, uncertainty, complexity, and ambiguity through vision, understanding, clarity, and agility, which are grounded in the doctor's need to acquire cross-functional competencies (soft skills). These competencies are applicable by using functional mechanisms and techniques that support the doctor in developing adaptability and anticipation skills, understanding the patient's needs and addressing them, and ensuring the functionality and efficiency of the healthcare system by transferring these elements from micro-management to macro-management levels.

New Insights Into Predictors of Antihypertensive Adherence

Abstract: Background: Low adherence to treatment is the most common cause of uncontrolled hypertension. Evidence suggests that illness perceptions and the physician-patient relationship may have a combined effect on treatment adherence. Aims: We investigated the roles of illness perceptions and the physician-patient relationship in medication and lifestyle modification adherence, and explained them using patients’ experiences with essential hypertension.Method: In this mixed methods explanatory sequential study, we used questionnaires to assess illness perceptions, the physician-patient relationship, and adherence to medication and lifestyle modification guidance ( N = 112) in the first quantitative phase. Based on the results of regression analyses, the second qualitative phase was planned. We collected data from three patients through interviews, observations and journals, and conducted within-case and cross-case analyses. Finally, we integrated quantitative and qualitative findings. Results: The physician-patient relationship was an independent predictor of medication adherence (95% confidence interval [CI]: 0.29 to 5.89), whereas both illness perceptions (95% CI: −0.32 to −0.04) and the physician-patient relationship (95% CI: 1.05 to 9.48) were independent predictors of adherence to lifestyle modification guidance. Qualitative themes, reflecting the patient’s experience of the concepts explored in this study, explained the quantitative results. Mixing methods revealed high consistency between quantitative and qualitative findings. Limitations: Limitations are the inability to infer causal associations among variables and indirect measurement of medication adherence. Conclusion: Shared decision-making on antihypertensive medications promotes medication adherence. Specifically, the illness perception, perceived illness controllability, and non-judgemental patients’ acceptance within a satisfying physician-patient relationship empower patients to adhere to lifestyle modification guidance.

IJCM_417A: Internet health information seeking and its effect on patient-doctor relationship and satisfaction among patients attending a tertiary care hospital in Mangalore

Background: The doctor-patient relationship is a fundamental and essential component of healthcare that plays a critical role in patient outcomes, trust, and overall quality of care. Internet-based health information has been found to have both positive and negative effects on patients. Objectives: To assess the internet health-seeking behaviour among patients, and its effect on the doctor-patient relationship Methodology: In this facility-based cross-sectional study, 110 patients were assessed regarding their internet health-seeking behaviour and its effect on the doctor-patient relationship. Patient-Doctor Depth-of-Relationship Scale and Patient Satisfaction Questionnaire – Short form (PSQ-18) was used to assess the relationship. A comparison of patient satisfaction scores and doctor-patient relationship scores among those who use the internet for seeking health-related information with those who do not was done by independent t-test and P &lt; 0.05 will be considered to be a statistically significant difference. Results: Sixty-seven-point three per cent use the internet for health-related information. Most of the patients felt satisfied with their medical care but there was still some scope of improvement in the domains of communication and the time devoted by the doctor to the patient. The overall level of patient satisfaction was above average. Our study also showed that 77.2% of the study participants had a good relationship with their doctor. Conclusion: In our study, we found that the internet using study participants were found to have an above average satisfaction with their doctors.

Should Medicine be Taught in Leading Medical Languages or the Mother Tongue?

Abstract In non-English speaking developing countries, several debates have arisen over choosing the language of instruction in medical education, whether it should be one of the leading medical languages, such as English, or the mother tongue. In this article, we discuss this debate and provide a brief review of the pedagogical evidence supporting the superiority of the mother tongue as a language of instruction. We also highlight the academic challenges associated with second-language-based medical education and emphasize the impact of language of instruction on the doctor–patient relationship and health care. Finally, we examine the reasons or arguments for not including the mother tongue in medical education. In conclusion, the importance of English as a leading scientific and medical language should not overshadow the crucial role of the native language as the language of instruction in non-English speaking countries. Each country should develop strategies to include the mother tongue in medical education, following the example of developed countries.