Communication in Health Evidence and Examples

  • Created by: Psych951
  • Created on: 02-01-19 15:28

NHS guidelines - Secondary healthcare

  • Good communication between professionals and patients
  • Use evidence-based written information tailored to patients
  • Treatment and care should be appropriate
  • Accessible to people with disabilities or difficulties 
  • Improve understanding specific to individual e.g. exploring culture, recording meetings to listen back to
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General Medical Council - Acute care

  • Explain yourself
  • Keep it open
  • Double check understanding
  • Look for clues
  • Don't make presumptions 
  • Be considerate
  • Make notes
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Wirth 1995 - Physician expectations

  • Physician expectancy was more determinative of health outcomes than the patient's expectacny
  • High physician's and patient's expectancy led to improved health, which relied on effective communication between physician and patient 
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Mule et al 2003 - Physician status

  • Blood pressure increases in the presence of a doctor or nurse 
  • 'White coat effect' 
  • Can lead to organ damage, cardio risk factors etc. 
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GMC 2012 - Complaints

  • 23% increase in complaints about doctor's focus during interactions
  • 69% increase in complaints about communication
  • 45% increase in complaints about a lack of respect from the doctor 
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Hulsman 1999 & Cegela 2003 - Training

  • Hulsman = Most medical schools include communication training in the curriculum e.g. role plays, delivering bad news
  • Cegela = Studies researching the content and effectiveness of medical communication training have insufficient information about the behaviours taught to participants and so more research is required to determine components of training and evaluate programmes 
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Wanzer et al 2014 - Patient-centred

  • Patient-centred communication was positively associated with patient satisfaction with care and communication
  • Communication skills that led to satisfaction were immediacy and focussed listening
  • Patient-centred communication was associated with better health 
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Heisler et al 2002 - Self-management

  • 1314 diabetes patients completed surveys evaluating participatory decision making, communication, understanding of self-care and completion of self-care
  • Higher ratings of decision-making and communication factors were associated with higher understanding and completion of self care - Communication more strongly associated 
  • Higher understanding was strongly associated with self-care - Understanding attenuated the effect of physician styles, suggesting communication and decision styles increased self-management by increasing understanding
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Zachariae et al 2003 - Psychological health

  • Used questionnaires to assess patient's self-efficacy, distress and percieved control - Had a consultation then repeated questionnaires, also reporting information about communication style - Physician estimated patient satisfaction 
  • Better communication associated with higher self-efficacy, satisfaction and lower distress - Enhanced physican ability to predict satisfaction 
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Ley 1998 - Written communication

  • Effective written communication improves patient satisfaction and understanding and sometimes outcomes and self-management 
  • Consider: applicability to audience, consequences of information, percieved effectiveness of recommendations, costs and benefits, familiarity 
  • 43% of people didn't notice short messages and 20% stopped reading after the first line - Average levels of difficulty are too high
  • Improving written communication: Novelty, familiarity and signal words increase noticeability; Clear and contrasted font improves legibility; Personalisation, segmenting, targeting and simplicity increase reading and understanding; Source credibility and two-sided communication improves belief in text 
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Noar et al 2009 - Mass communication

  • 34 campaigns across 23 countries were previously evaluated - Evaluations coded on design and evaluation dimensions
  • Compared to 1986-1998, campaigns: Targeted defined audiences; Designed based on behaviour change; Used behavioural theories; High message exposure; Strong outcome measures; Behavioural measures in outcomes
  • 8/10 had effects on behaviour change or intention 
  • Poor evaluation of outcomes limits understanding of communication effectiveness 
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Neuhauser & Kreps 2003 - E-health

  • Health communication is poor at focusing on change in social context
  • Health promotion via digital mediums can help achieve above - Mass personalisation, convenience and interactivity 
  • Increases behavioural outcomes but still early stages of research - Need to increase understanding of how to recreate complex social reality in virtual space 
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