Doctor-patient communication and the quality of care

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Abstract

In this article a comparison is made between three independent sources of assessment of medical consultations. A panel of 12 experienced general practitioners rated 103 consultations with hypertensive patients on the quality of psychosocial care. There was a wide consensus between the judges, resulting in a high reliability score. Two contrasting groups were formed: consultations that were rated high and those rated low in quality of psychosocial care. A comparison was made between this general assessment of the quality of psychosocial care and a more detailed assessment of the same consultations on nine much used communication variables made by trained psychologists. Knowledge about doctor-patient communication proved to predict very well as to which quality group the consultations belonged. A very high percentage (95%) was predicted accurately, solely on the basis of these nine communication variables. Affective behaviour, and especially nonverbal affective behaviour had the strongest predictive power. In the last part of the study a third source of assessment, i.e. patients' satisfaction was compared with both other sources. Much lower relationships were found, although most were in the predicted direction. Affective behavior seems to be the most important in determining patient's satisfaction. The implications of these findings are discussed.

References (74)

  • D. Locker et al.

    Theoretical and methodological issues in sociological studies of consumer satisfaction with medical care

    Soc. Sci. Med.

    (1978)
  • M. Balint

    The Doctor, His Patient and the Illness

    (1957)
  • A.R. Barro

    Survey and evaluation of approaches to physician performance measurement

    J. Med. Assoc.

    (1973)
  • T.S. Inui et al.

    Outcome-based doctor-patient interaction analysis. I. Comparison of techniques

    Med. Care

    (1982)
  • W.B. Carter et al.

    Outcome-based doctor-patient interaction analysis. II. Identifying effective provider and patient behavior

    Med. Care

    (1982)
  • T.S. Inui et al.

    Problems and prospects for health services research on provider-patient communication

    Med. Care

    (1985)
  • J.A. Hall et al.

    Meta-analysis of correlates of provider behavior in medical encounters

    Med. Care

    (1988)
  • J.L. Lebow

    Consumer assessments of the quality of medical care

    Med. Care

    (1974)
  • M.R. DiMatteo et al.

    Sources of Assessment of physician performance; a study of comparative reliability and patterns of intercorrelation

    Med. Care

    (1981)
  • J.M. Bensing et al.

    Ruimte voor de patient (“Room for the patient”)

    Nederlands Tijdschrift voor de Psychologie en haar grensgebieden

    (1982)
  • P.F.M. Verhaak

    Detection of psychological complaints by general practitioners

    Med. Care

    (1988)
  • K.L. White

    The Task of Medicine; Dialogue at Wickenburg

    (1988)
  • S. Maes et al.

    Topics in Health Psychology

    (1988)
  • Z. Ben-Sira

    The stress-resolving component in primary medical care

    Stress Med.

    (1986)
  • A. Donabedian

    Explorations in Quality Assessment and Monitoring. Vol. II., The Criteria and Standards of Quality

    (1982)
  • V.K. Fine et al.

    Empathy in the doctor-patient relationship: skill training for medical students

    J. Med. Educat.

    (1977)
  • M.R. Dimatteo

    A social-psychological analysis of physician-patient rapport: toward a science of the art of medicine

    J. Soc. Issues

    (1979)
  • M.R. Dimatteo et al.

    Predicting patient satisfaction from physician's nonverbal communication skills

    Med. Care

    (1980)
  • Z. Ben-Sira

    The function of the professional's affective behavior in client satisfaction: a revised approach to social interaction theory

    J. Hlth soc. Behav.

    (1976)
  • Z. Ben-Sira

    Affective and instrumental components in the physician-patient relationship: an additional dimension of interaction theory

    J. Hlth soc. Behav.

    (1980)
  • Z. Ben-Sira

    Stress potential and esothericity of health problems: the significance of the physician's affective behavior

    Med. Care

    (1982)
  • B.M. Korsch et al.

    Doctor-patient communication

    Sci. Am.

    (1972)
  • C. Van Dorp

    Luisteren naar patienten de Tijdstroom

    (1977)
  • H.S. Friedman

    Nonverbal communication between patients and medical practitioners

    J. soc. Issues

    (1979)
  • M. Klein Buller et al.

    Physicians' communication style and patient satisfaction

    J. Hlth soc. Behav.

    (1987)
  • Royal College of General Practitioners

    What sort of doctor?

    (1985)
  • J.M. Bensing

    Watching doctors: using videotapes for research purposes

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