Association between doctor-patient familiarity and patient-centred care during general practitioner's consultations: a direct observational study in Chinese primary care practice

Background Patient-centred care is a core attribute of primary care. Not much is known about the relationship between patient-centred care and doctor-patient familiarity. This study aimed to explore the association between general practitioner (GP) perceived doctor-patient familiarity and the provision of patient-centred care during GP consultations. Methods This is a direct observational study conducted in eight community health centres in China. Level of familiarity was rated by GPs using a dichotomized variable (Yes/No). The provision of patient-centred care during GP consultations was measured by coding audiotapes using a modified Davis Observation Code (DOC) interactional instrument. Eight individual codes in the modified DOC were selected for measuring the provision of patient-centred care, including ‘family information’, ‘treatment effects’, ‘nutrition guidance’, ‘exercise guidance’, ‘health knowledge’, ‘patient question’, ‘chatting’, and ‘counseling’. Multivariate analyses of covariance were adopted to evaluate the association between GP perceived doctor-patient familiarity and patient-centred care. Results A total of 445 audiotaped consultations were collected, with 243 in the familiar group and 202 in the unfamiliar group. No significant difference was detected in overall patient-centred care between the two groups. For components of patient-centred care, the number of intervals (1.36 vs 0.88, p = 0.026) and time length (7.26 vs. 4.40 s, p = 0.030) that GPs spent in ‘health knowledge’, as well as time length (13.0 vs. 8.34 s, p = 0.019) spent in ‘patient question’ were significantly higher in unfamiliar group. The percentage of ‘chatting’ (11.9% vs. 7.34%, p = 0.012) was significantly higher in the familiar group. Conclusions This study suggested that GP perceived doctor-patient familiarity may not be associated with GPs’ provision of patient-centred care during consultations in the context of China. Not unexpectedly, patients would show more health knowledge and ask more questions when GPs were not familiar with them. Further research is needed to confirm and expand on these findings.

Logros de niños y niñas de educación inicial mediante el juego con bloques de Lego (Achievements of Early Childhood Education children through play with Lego blocks)

El juego, además de ser una de las experiencias que más disfrutan niños y niñas durante su etapa en educación inicial, les permite aprender y desarrollarse en forma integral. De acuerdo con ello, el presente estudio tiene como objetivo indagar en cuáles logros en relaciones espaciales, temporales y socioafectivas son más exitosos los niños y las niñas de educación inicial e identificar su evolución durante 10 semanas de observación. La metodología tuvo dos fases: inicialmente, mediante la ingeniería didáctica, se construyó un código de observación y una vez construido se realizaron las observaciones durante 10 semanas de trabajo. Las actividades fueron realizadas, durante las horas de juego libre, en las escuelas donde la Facultad de Educación de la Universidad Surcolombiana realiza sus prácticas pedagógicas. Los resultados mostraron que es en la actividad socio afectiva donde se obtienen mayores logros desde el comienzo de la experiencia; por otro lado, el principal logro se obtiene en la característica relación temporal, relacionada con la capacidad para anticiparse a los acontecimientos o predecir resultados, específicamente en la capacidad de organizar un plan para llevar a cabo una idea, que se logra en un 87%. Abstract. Playing, in addition to being one of the experiences that children enjoy the most during their stage of early childhood education, allows them to learn and develop in an integral way. In accordance with this, the present study aims to investigate which achievements in spatial, temporal and socio-affective relationships are more successful in early childhood education children and to identify their evolution during 10 weeks of observation. The methodology had two phases: initially, through didactic engineering, an observation code was constructed and once it was ready, observations were made during 10 weeks of work. The activities were carried out, during free play hours, in the schools where the Education Faculty of the Surcolombiana University carries out its pedagogical practices. The results showed that it is in the socio-affective activity where the greatest achievements are obtained from the beginning of the experience; on the other hand, the main achievement is obtained in the characteristic temporal relationship, related to the ability to anticipate events or predict results, specifically in the ability to organize a plan to carry out an idea, is achieved 87%.

An overview of general practitioner consultations in China: a direct observational study

Background General practitioner (GP) consultation has long been considered an important component of general practice, but few studies have focused on its characteristics in China. Objective This study aimed to explore the content and elucidate the characteristics of GP consultations in general practice in China. Methods A multimethod investigation of GP consultations in eight community health centres in Guangzhou and Shenzhen, China was conducted between July 2018 and January 2019. Data from 445 GP consultations were collected by direct observation and audio tape and analysed by a modified Davis Observation Code with indicators for frequencies and detailed time durations. GP and patient characteristics were collected by post-visit surveys. Results The mean visit duration was approximately 5.4 minutes. GPs spent the most time on treatment planning, history taking, negotiating, notetaking and physical examination and less time on health promotion, family information collecting, discussing substance use, procedures and counselling. The time spent on procedures ranked first (66 seconds), followed by history taking (65 seconds) and treatment planning (63 seconds). Besides, patients were very active in the consultation, specifically for topics related to medicine ordering and drug costs. Conclusions This study described the profile of GP consultations and illustrated the complexity of care provided by GPs in China. As patient activation in GP consultations becomes increasingly important, future studies need to explore how to promote the engagement of patients in the whole consultation process other than just requesting for medicine.

Age of Spectators as a Factor Influencing Behavior at Minor League Hockey and Baseball Games

To assess the behavior of 10 age groups of spectators while viewing children's minor league hockey and baseball games the behavior of 272 (males = 142, females = 130) randomly selected hockey spectators and 90 (male = 46, female = 44) randomly selected baseball spectators was assessed on the Spectator Observation Code. The predominant behavior emitted during each 10-sec. observation interval was recorded. During each session, three subjects were observed in serial order for the duration of the hockey or baseball game. Data were analyzed by one-way analysis of variance and Newman-Keuls comparison tests. Significant differences existed for some spectator behaviors when the age of spectator varied.