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Lecture 19

PSY 346 Lecture 19: Doctor-Patient Communication

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PSY 346
Johanna Jarcho

Doctor-Patient Communication Very Complicated Relationship • Interaction between individuals in non-equal positions • Often involuntary • Concerns very important issues • Emotionally laden • Required close cooperation • Can’t be replaced with technology Purpose of Doctor-Patient Communication 1. Create a good interpersonal relationship • Features of a good doctor patient relationship: o Social qualities- manners, be non-judgmental, convey interest o Therapeutic qualities- empathy, mutual respect, trust o Appreciation of expertise- patient: their symptoms, feelings, and behaviors; doctors: diagnosis and treatment 2. Exchange information • Amount of information o Doctors underestimate how much information patients want ▪ 92% of cancer patients wanted all possible information, good or bad ▪ 45% were given all the information they wanted o Doctors withhold information because they fear negative emotional reactions from the patients • Accuracy of information o Study of cancer patients entering hospice ▪ Do not give prognosis: 23% of the time ▪ Give frank prognosis: 37% of the time ▪ Give a more optimistic prognosis 40% of the time o Accuracy of prognosis ▪ Actual survival: 26 days ▪ Doctor estimated survival: 75 days ▪ Doctor communicated survival: 90 days • Cultural biases in information o “It isn’t cancer, is it? I had a friend who died of lung cancer… he always complained of pains in his chest and arms” o “The pain that accompanies lung cancer isn’t this mild. So don’t worry needlessly, just leave everything to use.” He had got used to lying to cancer patients. Lying to them was part of a doctor’s job. –Shusaku Endo, When I Whistle 3. Make medical decision • Most patients want all information • Only 2/3 want to participant in treatment decisions Many Facets of Communication Behavior 1. Content: instrumental vs. affective 2. Modality: verbal vs. non-verbal 3. Privacy behavior 4. Controlling: high vs. low 5. Language: medical jargon vs. everyday terms Definitions for Common Terms, Given by Patients • Abdomen: side, buttocks, heart, bladder • Appendectomy: a cut to the rectum, taking off an arm or leg, something to do with the bowel • Digesting: a sick feeling, belching • Intern: an orderly, boys that help in the hospital, drugstore man, male nurse, a doctor with no degree • Pulse: a bad hurt or sickness, a nerve, temperature • Respiratory: in the arms or legs, venereal, tiredness, a sickness with sweat, hot flashes Mismatch in Doctor-Patient Understanding • 77% of doctors said patients knew their diagnosis o Only 57% of the patients said they were aware • 81% of the doctors said they discussed possible adverse drug effects with patients o Only 10% of the patients said they were told • Doctors asked patients whether they understand what was discussed about 1.5% of the time Effects of Doctor-Patient Communication 1. Satisfaction with their Doctors • 33% of patients are dissatisfied with their doctor/health care • Highest satisfaction: interactions balanced between instrumental and affective communication • Lowest satisfaction interactions with mainly instrumental commu
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