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Patient participation in the medical specialist encounter: Does physicians' patient-centred communication matter?

16 December 2022

Patient-centred physician communication is assumed to stimulate active patient participation, thus leading to a more effective and humane exchange during the medical consultation. We investigated the relationship between patient-centred physician communication and patient participation in the specialist physician environment. Participants were 30 residents and internal medicine physicians and 323 of their patients. Participants completed a questionnaire prior to a (video-recorded) follow-up consultation. Physicians' patient-centred communication was assessed by coding behaviours that facilitate or rather hinder patients' ability to express their perspective. Patient participation was determined by assessing (a) their relative contribution to the conversation and (b) their active participation. Relevant baseline characteristics were included in the analyses. Facilitating behaviour of physicians was found to be positively related to patients' contribution to the conversation, as well as to patients' active behaviour. Doctors' inhibitory behaviour was not related to patients' input and was unexpectedly positively related to patients' active behaviour. Physicians' behaviour was particularly related to patients' expressions of concern and guidance. Internal medicine physicians appear to be able to facilitate patients' active participation in the visit. Findings indicate that inhibiting behaviour may not have the expected blocking effect on patient participation: patients expressed their point of view in the same way and expressed even more concerns. Showing inhibitory behaviour may alternatively be the physician's response to increased patient participation in the encounter. The results may provide directions for future medical education and specialised training.

https://www.sciencedirect.com/science/article/abs/pii/027795369190288N?via%3Dihub