scholarly journals Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Natalia Świątoniowska-Lonc ◽  
Jacek Polański ◽  
Wojciech Tański ◽  
Beata Jankowska-Polańska
Keyword(s):  
Care Management ◽  
Assessment Tool ◽  
Self Care ◽  
Chronically Ill ◽  
Cross Sectional Study ◽  
Patient Communication ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Physician Patient Communication ◽  
Physician Patient

Abstract Background Hypertension (HT) requires patients to continuously monitor their blood pressure, strictly adhere to therapeutic recommendations, and self-manage their illness. A few studies indicate that physician–patient communication and the patient’s satisfaction with the therapeutic relationship may affect the course and outcomes of the treatment process. Research is still lacking on the association between satisfaction with physician–patient communication and adherence to treatment or self-care in chronically ill patients. The aim of the study was to evaluate the relationship between satisfaction with physician–patient communication and self-care and adherence in patients with HT undergoing chronic treatment. Methods The following instruments were used: the Adherence to Refills and Medication Scale (ARMS) for evaluating adherence (12–48 points), the Self-Care of Hypertension Inventory (SCHI) for self-care level (0–100 points), and the Communication Assessment Tool (CAT) for evaluating satisfaction with physician–patient communication. Socio-demographic and clinical data were obtained from patients’ medical records. The research has a cross-sectional and observational study design. Inclusion criteria were as follows: age > 18 years, hypertension diagnosed per European Society of Hypertension (ESH) guidelines, treatment with at least one antihypertensive drug for the past 6 months, and informed consent. Cognitively impaired patients unable to complete the surveys without assistance were excluded (MMSE ≤18). Correlations between quantitative variables were analyzed using Pearson’s or Spearman’s correlation coefficient. Linear regression was performed. Variable distribution normality was verified using the Shapiro-Wilk test. Results The study included 250 patients (110 male, mean age 61.23 ± 14.34) with HT, treated at a hypertension clinic. In the CAT questionnaire individual questions pertaining to satisfaction with physician communication (on the CAT) were rated “excellent” 28.4–50.4% of the time. The best-rated aspects of communication included: letting the patient talk without interruptions (50.4% “excellent” ratings), speaking in a way the patient can understand (47.6%), and paying attention to the patient (47.2%). According to patient reports, physicians most commonly omitted such aspects as encouraging the patient to ask questions (28.4%), involving them in decisions (29.2%), and discussing the next steps (35.2%). The respondents had a low level of adherence to pharmaceutical treatment (16.63 ± 4.6). In terms of self-care, they scored highest in self-care management (64.17 ± 21.18), and lowest in self-care maintenance (56.73 ± 18.57). In correlation analysis, satisfaction with physician–patient communication (total CAT score) was positively correlated with all SCHI domains (self-care maintenance β = 0.276, self-care management β = 0.208, self-care confidence β = 0.286, p < 0.05), and negatively correlated with ARMS scores (indicating better adherence). Conclusions Satisfaction with physician–patient communication has a significant impact on self-care and pharmaceutical adherence in patients with hypertension. The more satisfied the patient is with communication, the better their adherence and self-care. Trial registration SIMPLE: RID.Z501.19.016.

Relative and Cumulative Effects of Hypertension Self-Care Behaviors on Blood Pressure

2019 ◽  
Vol 42 (3) ◽  
pp. 157-164
Author(s):  
Jan Warren-Findlow ◽  
Lisa M. Krinner ◽  
Erin Vinoski Thomas ◽  
Maren J. Coffman ◽  
Benjamin Gordon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Assessment Tool ◽  
Self Care ◽  
Cross Sectional Study ◽  
Activity Level ◽  
Cumulative Effects ◽  
Cross Sectional ◽  
Partial Correlations ◽  
Valid Assessment ◽  
Individual Self

New recommendations for hypertension (HTN) diagnosis and treatment highlight the role of self-care activities in managing blood pressure (BP). This cross-sectional study investigated the predictive validity of the Hypertension Self-Care Activity Level Effects (H-SCALE) measure and examined the relative and cumulative effects of HTN self-care adherence on BP. We pooled baseline data from three studies ( N = 79), resulting in a gender and racially balanced sample. Partial correlations determined the relative effects of individual self-care behaviors on BP. We modeled the relationship between adherence to self-care behaviors and BP control using logistic regression. Physical activity had the greatest correlation with systolic BP. Adherence to each additional self-care behavior increased the odds of systolic BP control by 88% (95% confidence interval (CI) = [1.20, 2.96]) and diastolic BP control by 74% (95% CI = [1.10, 2.75]). Results provide further evidence that the H-SCALE is a valid assessment tool and should be adopted by clinicians to aid in improving BP management.

scholarly journals Entrustment in physician-patient communication: a modified Delphi study using the EPA approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ayesha Younas ◽  
Rehan Ahmed Khan ◽  
Raheela Yasmin
Keyword(s):  
Delphi Study ◽  
Assessment Tool ◽  
Patient Communication ◽  
Extensive Literature ◽  
Assessment Framework ◽  
Specific Patient ◽  
Modified Delphi ◽  
Physician Patient Communication ◽  
Competency Based ◽  
Physician Patient

Abstract Background Competency based curricula across the globe stress on the importance of effective physician patient communication. A variety of courses have been used to train physicians for this purpose. However, few of them link competencies with practice resulting in confusions in implementation and assessment. This issue can be resolved by treating certain specific patient communication related tasks as acts of entrustment or entrustable professional activities (EPAs). In this study, we aimed to define a competency-based framework for assessing patient physician communication using the language of EPAs. Methods A modified Delphi study was conducted in three stages. The first stage was an extensive literature review to identify and elaborate communication related tasks which could be treated as EPAs. The second stage was content validation by medical education experts for clarity and representativeness. The third stage was three iterative rounds of modified Delphi with predefined consensus levels. The McNemar test was used to check response stability in the Delphi Rounds. Results Expert consensus resulted in development of 4 specific EPAs focused on physician-patient communication with their competencies and respective assessment strategies all aiming for level 5 of unsupervised practice. These include Providing information to the patient or their family about diagnosis or prognosis; Breaking Bad news to the patient or their family; Counseling a patient regarding their disease or illness; Resolving conflicts with patients or their families. Conclusions The EPAs for Physician-patient communication are a step toward an integrative, all-inclusive competency-based assessment framework for patient-centered care. They are meant to improve the quality of physician patient interaction by standardizing communication as a decision of entrustment. The EPAs can be linked to competency frameworks around the world and provide a useful assessment framework for effective training in patient communication. They can be integrated into any post graduate curriculum and can also serve as a self-assessment tool for postgraduate training programs across the globe to improve their patient communication curricula.

scholarly journals Dukungan Sosial Berhubungan Dengan Self Care Management Pada Lansia Hipertensi Di Puskesmas Sedayu II

2019 ◽  
Vol 10 (2) ◽  
pp. 700-712
Author(s):  
Mahfud Mahfud ◽  
Bari Barasila ◽  
Sofyan Indrayani
Keyword(s):  
Social Support ◽  
Care Management ◽  
Self Care ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Coefficient Corrélation ◽  
Relationship Of ◽  
The Relationship

Latar Belakang: Dukungan sosial dapat meningkatkan pengetahuan dan menstabilkan emosional pada pasien hipertensi.Untuk menjaga dan mengatasi hipertensi pada lansia perlu dilakukan dukungan sosial dengan self care managemen hipertensi.Tujuan Penelitian: Tujuan penelitian ini bertujuan untuk mengetahui hubungan dukungan sosial dengan self care manegement pada lansia hipertensi di Puskesmas Sedayu II Bantul Yogyakarta. Penelitian ini merupakan penelitian kuantitatif dengan rancangan penelitian cross sectional. Populasi dalam penelitian ini adalah lansia di Puskesmas  Sedayu II Kabupaten Bantul  yang berjumlah 45 orang.Metode: Instrumen penelitian menggunakan kuesioner dukungan sosial dan kuisioner self care management. Pengolahan data menggunakan uji statistik fisher’s Exact Test.Hasil Penelitian: Didapatkan bahwa dukungan sosial masuk dalam kategori baik yaitu.29 responden (70,7%), sedangkan self care management masuk dalam kategori baik yaitu 28 (69,3%). Hasil penelitian diperoleh nilai dukungan sosial dengan self care management hipertensi dengan p=0,000 dengan nilai keeratan hubungan  koefisien korelasi = 0,514 kategori sedang.Kesimpulan: Ada hubungan antara dukungan sosial dengan self care management pada lansia hipertensi di Puskesmas Sedayu II Bantul Yogyakarta dengan nilai signifikan 0,000 (p00.5).Kata Kunci: Dukungan sosial, self care management, lansia hipertensiBackground: Social support can increase knowledge and emotional stability in hypertensive patients. To maintain and overcome hypertension in the elderly, social support with self care management of hypertension needs to be done.Research Objectives: The purpose of this study aims to determine the relationship of social support with self care management in hypertensive elderly at Puskesmas Sedayu II Bantul Yogyakarta. This research is a quantitative study with cross sectional study design. The population in this study is the elderly in Puskesmas Sedayu II, Bantul Regency with a total of 45 people.Method: The research instrument used a social support questionnaire and a self care management questionnaire. Data processing using statistical fisher's Exact Test.Results: It was found that social support was included in the good category, 29 respondents (70.7%), while self care management was included in the good category, 28 (69.3%). The results obtained by the value of social support with hypertension self care management with p = 0,000 with the value of the correlation coefficient correlation = 0.514 medium category.Conclusion: There is a relationship between social support and self care management in hypertensive elderly in Puskesmas Sedayu II Bantul Yogyakarta with a significant value of 0,000 (p 00.5).Keywords: Social support, self care management, elderly hypertension 

scholarly journals Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties

2016 ◽  
Vol 8 (3) ◽  
pp. 429-434 ◽  
Author(s):  
Kimberly Baker-Genaw ◽  
Maria S. Kokas ◽  
Syed F. Ahsan ◽  
Deborah Darnley-Fisch ◽  
Sean Drake ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Work Group ◽  
Phase 1 ◽  
Essential Elements ◽  
Patient Communication ◽  
Institutional Level ◽  
Physician Patient Communication ◽  
Next Accreditation System ◽  
Objective Structured Clinical Examinations ◽  
Physician Patient

ABSTRACT  Little is known about residents' performance on the milestones at the institutional level. Our institution formed a work group to explore this using an institutional-level curriculum and residents' evaluation of the milestones.Background  We assessed whether beginner-level milestones for interpersonal and communication skills (ICS) related to observable behaviors in ICS-focused objective structured clinical examinations (OSCEs) for postgraduate year (PGY) 1 residents across specialties.Objective  The work group compared ICS subcompetencies across 12 programs to identify common beginner-level physician-patient communication milestones. The selected ICS milestone sets were compared for common language with the ICS-OSCE assessment tool—the Kalamazoo Essential Elements of Communication Checklist–Adapted (KEECC-A). To assess whether OSCE scores related to ICS milestone scores, all PGY-1 residents from programs that were part of Next Accreditation System Phase 1 were identified; their OSCE scores from July 2013 to June 2014 and ICS subcompetency scores from December 2014 were compared.Methods  The milestones for 10 specialties and the transitional year had at least 1 ICS subcompetency that related to physician-patient communication. The language of the ICS beginner-level milestones appears similar to behaviors outlined in the KEECC-A. All 60 residents with complete data received at least a beginner-level ICS subcompetency score and at least a satisfactory score on all 3 OSCEs.Results  The ICS-OSCE scores for PGY-1 residents appear to relate to beginner-level milestones for physician-patient communication across multiple specialties.Conclusions

scholarly journals Are physician-patient communication practices slowly changing in Croatia? – a cross-sectional questionnaire study

2013 ◽  
Vol 54 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Luka Vučemilo ◽  
Marko Ćurković ◽  
Milan Milošević ◽  
Jadranka Mustajbegović ◽  
Ana Borovečki
Keyword(s):  
Patient Communication ◽  
Questionnaire Study ◽  
Cross Sectional ◽  
Physician Patient Communication ◽  
Communication Practices ◽  
Physician Patient

scholarly journals Clinical and Socio-demographic Determinants of Self-care Maintenance, Monitoring and Management in US Adults with Type 2 Diabetes Mellitus

2020 ◽  
pp. 105477382091698
Author(s):  
Michela Luciani ◽  
Emanuela Rossi ◽  
Paola Rebora ◽  
Michael Stawnychy ◽  
Davide Ausili ◽  
...  
Keyword(s):  
Low Income ◽  
Care Management ◽  
Secondary Analysis ◽  
Self Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Sociodemographic Determinants ◽  
English Speaking ◽  
Using Data

The aims of this study were to describe self-care in US T2DM patients and to identify clinical and sociodemographic determinants of self-care maintenance, monitoring, and management in US T2DM patients. A secondary analysis was performed using data from a cross-sectional study done to test the psychometric performance of the Self-Care of Diabetes Inventory in US English speaking adults with diabetes. In our sample ( n = 207), self-care maintenance was adequately performed (median = 75), self-care monitoring was borderline (median = 67.6) and self-care management was poor (median = 55.6). Low income ( p = .0019) and low self-care confidence ( p < .0001) were associated with relatively lower self-care maintenance. Not taking insulin ( p = .0153) and low self-care confidence ( p < .0001) were associated with relatively low self-care monitoring. Low self-care confidence ( p < .0001) was associated with low self-care management. Self-care confidence is a strong determinant of self-care. Interventions designed to improve self-care confidence are urgently needed.

scholarly journals Entrustment in Physician -patient communication: a modified Delphi study using the EPA approach

2021 ◽  
Author(s):  
Ayesha Younas ◽  
Rehan Ahmed Khan ◽  
Raheela Yasmin
Keyword(s):  
Delphi Study ◽  
Assessment Tool ◽  
Patient Communication ◽  
Extensive Literature ◽  
Assessment Framework ◽  
Specific Patient ◽  
Modified Delphi ◽  
Physician Patient Communication ◽  
Competency Based ◽  
Physician Patient

Abstract Background Competency based curricula across the globe stress on the importance of effective physician patient communication. A variety of courses have been used to train physicians for this purpose. However, few of them link competencies with practice resulting in confusions in implementation and assessment. This issue can be resolved by treating certain specific patient communication related tasks as acts of entrustment or entrustable professional activities (EPAs). In this study, we aimed to define a competency-based framework for assessing patient physician communication using the language of EPAs. Methods A modified Delphi study was conducted in three stages. The first stage was an extensive literature review to identify and elaborate communication related tasks which could be treated as EPAs. The second stage was content validation by medical education experts for clarity and representativeness.The third stage was three iterative rounds of modified Delphi with predefined consensus levels. The McNemar test was used to check response stability in the Delphi Rounds Results Expert consensus resulted in development of 4 specific EPAs focused on physician-patient communication with their competencies and respective assessment strategies all aiming for level 5 of unsupervised practice. These include Providing information to the patient or their family about diagnosis or prognosis; Breaking Bad news to the patient or their family; Counseling a patient regarding their disease or illness; Resolving conflicts with patients or their families. Conclusions The EPAs for Physician-patient communication are a step toward an integrative, all-inclusive competency-based assessment framework for patient-centered care. They are meant to improve the quality of physician patient interaction by standardizing communication as a decision of entrustment. The EPAs can be linked to competency frameworks around the world and provide a useful assessment framework for effective training in patient communication. They can be integrated into any post graduate curriculum and can also serve as a self -assessment tool for postgraduate training programs across the globe to improve their patient communication curricula.

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