Doctor - Patient Communication

often non voluntary

emotionally laden

close co operation communication essential

Health pyschologists - aim to aid the process of communication between Doctor/Patient

Methods used to study communication

Interaction analysis system

Questionaires

Qualitative textual analysis

Trigrigulation

Patient recall influenced by anxiety, medical knowledge

Intellectual level, importants, Primacy effect

WHy are patients dissatisfied

low emotional support

lack of understanding

inadequate prescribing explaining

low compencey

dissapointing diagnosis

Problems - objective knowledge, doesnt include persons health beliefs

Curren consultation, patient centeredness, shared decision making, concordance, respect

Primacy effects - tendancy to remember first items presented in a series

Regency effect - tendancy to remember thing at the end of the list

Compliance/adherence - terms used to describe patient compliing to treatment

Forms of Adherence

repeat prescriptions

taking correct dosage

taking medication of correct times

stopping medication

making and keeping appointments

Forms of adherence - repeat prescriptions

taking correct dosage

taking medication of correct times

stopping medication

making keeping appointments

Types of non adherence

Unintentional or unwitting - unaware of nonadhernece

Intentional or intelligent - choose to find alternative methods

Ask patient, practitioner, other people

Examine biomedical evidence

Monitor medication usage

Combination

Reasons for non-adherence

problem of recall

lack of understanding

low satisfaction

side effects

painful treatment

informational support, stressing importance, simplification, being specific, repetition

Instruction about medication or usage.

Interventions - 

Educational - help patients understand

Behavioural- help remind patients

Cognitive behaviour - Intervention, identify behaviour