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MacArthur, Kelly Rhea. "“Doing Gender” in Doctor-patient Interactions: Gender Composition of Doctor-patient Dyads and Communication Patterns". Kent State University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=kent1216054789.
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MacArthur, Kelly. ""Doing gender" in doctor-patient interactions gender composition of doctor-patient dyads and communication patterns /". [Kent, Ohio] : Kent State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1216054789.
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Thesis (M.A.)--Kent State University, 2008.Title from PDF t.p. (viewed Nov. 10, 2009). Advisor: Timothy Gallagher. Keywords: sociology, gender, doctor-patient interactions, doing gender. Includes bibliographical references (p. 78-88).
3
Crowe-Joong, Elizabeth. "Contextualizing patient-doctor relationships in Singapore". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape3/PQDD_0018/NQ53875.pdf.
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Kidd, Jane Margaret. "Patient and doctor satisfaction with medical consultations". Thesis, King's College London (University of London), 1998. https://kclpure.kcl.ac.uk/portal/en/theses/patient-and-doctor-satisfaction-with-medical-consultations(f0db6225-b073-4f17-859f-0b9fe7b5920b).html.
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Iconomou, George. "Doctor-patient communication and outcome in cancer". Thesis, University of Kent, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.283972.
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Irvine, Alastair D. J. "Time preferences and the patient-doctor interaction". Thesis, University of Aberdeen, 2018. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=238373.
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Patients' non-adherence to treatment is a widespread phenomenon in healthcare. Time preferences (how individuals value outcomes over time) are one cause for non-adherence. Using quasi-hyperbolic discounting, two options in the future are weighted consistently. However, when the early option becomes available the weighting changes. This creates the potential for non-adherence. The agency relationship that exists between patients and doctors implies hidden information. When the patient's time preferences are hidden from the doctor, the doctor must choose how to recommend treatments. Exploring how doctors make treatment decisions when time preferences are hidden from them, and how this impacts adherence, is therefore important. The first contribution of the thesis is to outline a model of the patient-doctor interaction incorporating quasi-hyperbolic discounting and hidden information. This shows that doctors should adapt to non-adherence when the probability a patient is present-biased is large enough. Secondly, a national survey of Scottish GPs explores whether doctors have different time preferences for themselves or their patients. Doctors do have the same private and professional time preferences, but value the health state differently between frames. Lastly, a laboratory experiment tests whether students in the role of a doctor adapt to non-adherence in the way predicted by the model. Students find the socially optimal level of treatment on average. Adaptation is stronger when using a performance payment, and results did not vary along demographic characteristics. The thesis highlights the importance of the patient-doctor interaction for generating nonadherence, not just patient preferences. It also shows that GPs' private time preferences may suitably substitute their preferences for patients. Finally, it points towards potential incentives for doctors to improve patient outcomes.
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Webb, Helena. "Doctor-patient interactions during medical consultations about obesity". Thesis, University of Nottingham, 2009. http://eprints.nottingham.ac.uk/10818/.
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The current “obesity epidemic” is a global concern for governments and healthcare organisations. Obesity is seen as a medical problem of excess body weight which can be resolved through interventions to encourage weight loss, most particularly diet and exercise regimes. Much existing sociological work focuses on moral understandings of obesity as a perceived symbol of individual greed and laziness in a culture that prioritises self-control and effort. This neglects the ways in which the condition is actively discussed and managed in relevant settings such as medical encounters. This thesis addresses this research gap by analysing talk during obesity-related medical consultations. Talk is central to all medical encounters and has particular resonance in treatments for obesity where most interventions are carried out by the patient away from the medical gaze. Patients must report on their treatment behaviours in ways that enable practitioners to evaluate them and offer further relevant advice. Talk is not only a means through which treatment is delivered but a form of treatment itself. Fieldwork took place in two UK NHS outpatient clinics specialising in weight loss treatment for obese patients. A sample of 18 patients and 1 doctor consented to have their consultations video-recorded over a period of 9 months. This resulted in 39 recorded interactions which were analysed according to the principles of Conversation Analysis (CA) to identify recurring patterns of interaction. The thesis describes how talk between doctor and patient functions to achieve certain tasks. In particular, it analyses how the specific institutional setting shapes and is shaped by talk. A dominant theme is that clinic interactions frequently invoke normative issues concerning knowledge, responsibility and effort. These issues are consistent with moral dynamics perceived to surround the condition of obesity and patient responsibilities. Doctor and patient collaboratively construct obesity as a moral issue. This has consequences for the conduct of the consultation. The findings extend existing CA knowledge on medical interactions and demonstrate the utility of an interactional approach to the sociological study of obesity. They also have relevance to healthcare policy and practice.
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MA, Hok Ka Carol. "Explaining older-patient and doctor relationship through negotiation". Digital Commons @ Lingnan University, 2006. https://commons.ln.edu.hk/soc_etd/21.
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This thesis attempts to explain the older-patients and doctors’ relationship through negotiation. The relationship between older-patients and their doctors is important because, first, the patient-doctor relationship is basic to the health care system and is a foundation for all patient care; second, populations are ageing and this group often has a higher incidence of chronic illnesses. Therefore, the older patient-doctor consultation becomes of paramount importance in enabling patients and the health care system to manage their illnesses effectively.
This thesis describes a negotiation process (from reception, consultation, to outcome) and outcome patterns between older patients and doctors in medical consultation. It could be explained by the symbolic interaction perspective. Simply, both patients and doctors had gone through many internal thoughts and came to each other with a purpose or an expected outcome before the negotiation (i.e. the styles). Then there were gives and takes during the negotiation process (i.e. the consultation process), establishing a final equilibrium of a relationship falling into the 16 negotiation patterns developed.
The study has been undertaken three principal methods in addition to reviewing the published literature.
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Murray, Esther Louise. "Practice-based evidence : cardiac care and doctor-patient communication". Thesis, City University London, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.492344.
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Depression and anxiety are common in patients with coronary heart disease (CHD). As well as reducing health related quality of life, psychological problems can be a barrier to recovery and to making the necessary lifestyle changes to prevent worsening of cardiac health. A report on cardiac rehabilitation services in South East London (Marks & Filer, 2005) identified gaps in the services provided: not all CHD patients receive psychological support. Reviews of psycho-educational programmes in cardiac rehabilitation (Dusseldorp 1999 and Bennett & Carroll 1994) have found that group interventions can be effective in reducing emotional distress, targeting risk factors and increasing active coping. Cognitive behavioural techniques such as goal setting and evidence checking have been found to be effective when working with CHD patients (Lewin 2002). A psycho-education session based on cognitive behavioural techniques was designed and delivered to CHD patients as part of their usual Phase III cardiac rehabilitation programme in 3 hospitals in South East London. Two types of session were delivered: one individualised and interactive, the other generic and didactic in style. The format and content of the intervention is outlined in a manual and the same manual was used to deliver the session each time. All patients received a written handout summarising the session. Patients were randomly allocated to the control or intervention group. Outcomes were measured by HADS, Dartmouth COOP and a behavioural questionnaire before and after the session. Results showed high levels of patient satisfaction with the intervention in terms of usefulness and feeling comfortable and accepted in the group format. There was no significant difference in HADS scores over time, or between groups. This project is a case study for the complexities of carrying out research with limited resources in the setting of the NHS and highlights the role of practice-based evidence.
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Ali, Diala. "Climate Change, Human Health, and the Doctor-patient Relationship". Thesis, The American University of Paris (France), 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13871660.
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Climate change has become responsible for substantial mortality and morbidity around the world. These numbers are said to rise, as climate change will continue to have both direct and indirect effects on human health, as well as threaten the determinants of health. Some health effects include asthma, respiratory disease, cancer, cardiovascular disease, stroke, health-related illness, human developmental effects, mental illness, neurological disease, vector-borne disease, waterborne disease, and more. Given the implications it carries on human health, climate change should be of fundamental relevance to doctors and future doctors alike. The aim of this thesis is to explore the importance of preparing doctors and student doctors for a climate-changing world. This includes developing skills and insights necessary in a clinical practice and a public health role. The research methods in this thesis is sought to identify if future doctors are being prepared and are willing to take action against climate change and the health implications it poses. The focus is also to identify the perceptions of doctors on climate change and its health risks, as little is known about this. Through theoretical and quantitative evidence, the goal is to provide insight on the role future doctors, who are both prepared and willing to take actions, can play in influencing patients to participate in climate change mitigation.
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Haigler, Susan Lynne. "The persuasive implications of therapeutic touch in doctor-patient relationships /". Thesis, Connect to this title online; UW restricted, 1996. http://hdl.handle.net/1773/8230.
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Mathers, Nigel Joseph. "An investigation of the heartsink patient". Thesis, University of Sheffield, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286945.
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Holst, Mark Anthony. "Japanese doctor-patient discourse : an investigation into cultural and institutional influences on patient-centred communication". Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/5878.
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This thesis investigates how Japanese doctors create and maintain patient-centred consultations through their verbal interaction with patients, and the extent to which features of Japanese interpersonal communication influence the institutional discourse. Audio recordings of 72 doctor-patient interactions were collected at the outpatient department of a Japanese teaching hospital. All consultations involved new cases. There were two kinds of consultations: a preliminary history-taking interview with an intern and a diagnostic consultation given by an experienced doctor. After transcribing the recordings sequences of the discourse were analysed qualitatively on a turn-by-turn basis and a corpus of the data was analysed quantitatively to establish frequencies of discourse features related to patientcentredness. A review of literature (Chapter 2) establishes the standard structure of medical consultations and the relationship of the doctor and patient during consultations in terms of the asymmetry of speaking initiative according to consultation phases. The second part of Chapter 2 is an examination of Japanese communication style, attested to be influenced by culturally specific norms of behaviour that are demonstrable through verbal interactions. Chapter 3 describes the research method, and this is followed by four chapters of analysis. Chapter 4 describes the nature of the two kinds of consultations; the phases they include, and how the participants shift from one phase to the next with phase transition markers. Particular attention is paid to opening and closing phases, as they are most relevant to the establishment and consolidation of a patient-centred relationship. Chapter 5 investigates patterns of questioning by doctors, identifying functional categories of questions to see how they are used to coax information from the patient. Chapter 6 examines how the doctor encourages the patient’s narrative through backchanneling; how the doctor accommodates the patient through sensitive explanations of treatments and procedures; and how the voice of the patient emerges through calls for clarification, and voicing concerns. Chapter 7 highlights discourse sequences that may indicate culturally specific influences, and examines the emergence of laughter as an indicator of Japanese interpersonal interaction. The features of these Japanese consultations are consistent with medical consultations described in English speaking settings regarding phases and the discourse strategies used to achieve patient-centredness. While there appear to be Japanese cultural influences in the interactions consistent with previous cross-cultural studies the author argues that the institutional setting (clinical framework) is more immediately relevant to the conversational dynamics of the interactions than the Japanese cultural setting. Finally, medical consultations involving new cases have more features of service encounters and therefore not controlled by the guidance-cooperation model of doctor-patient interaction.
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Clifford, Julie Veronica. "Computers in general practice consultations : impact on doctor-patient relationships /". Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmc637.pdf.
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Burke, Sarah Elizabeth. "The doctor-patient relationship : an exploration of trainee doctors’ views". Thesis, University of Birmingham, 2008. http://etheses.bham.ac.uk//id/eprint/125/.
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Greater understanding of the ways in which medical trainees perceive the doctor-patient relationship could inform future developments in educational provision. A qualitative study was conducted, using a case study approach to explore the perceptions of postgraduate trainees in two medical specialties, general practice (GP) and otolaryngology (ear, nose and throat surgery, ENT), in the West Midlands region of the United Kingdom. Following a scoping exercise in 2002, interviews with 20 trainees (10 GP and 10 ENT) in 2004 and questionnaires from 16 ENT and 89 GP trainees in 2007 explored trainees’ views of the doctor-patient relationship, including perceptions of the nature of that relationship and how they had learnt to develop relationships with patients. Five conceptual frameworks that participants drew upon when talking about the doctor-patient relationship were identified: paternalism; guided decision-making; partnership; clinical and consumerism. Trainees described a fluid doctor-patient relationship which adapts to differing contexts, taking different forms in different situations and influenced by factors outside the doctor’s control, including time and the patient’s personality. Personal experience and observing senior colleagues were considered to have had the greatest impact on learning. Higher Specialist Training which acknowledges the complexity of the doctor-patient relationship and encourages reflective practice is recommended.
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Qualtere-Burcher, Paul 1963. "Re-thinking the Doctor-Patient Relationship: A Physician’s Philosophical Perspective". Thesis, University of Oregon, 2011. http://hdl.handle.net/1794/12146.
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xii, 163 p.The principle of respect for autonomy has been the center of gravity for the doctor-patient relationship for forty years, replacing the previous defining concept of physician paternalism. In this work, I seek to displace respect for patient autonomy with narrative and phronesis as the skills that must be mastered by the physician to engender a successful therapeutic clinical relationship. Chapter I reviews the current state of affairs in the philosophy of medicine and the doctor-patient relationship and explains how and why autonomy has become so central to physicians' understanding of how to conduct a clinical encounter with a patient. Chapter II argues that "respect for autonomy," while remaining a valid rule to be considered in some clinical relationships, cannot be the central concept that defines the relationship both because it fails to describe accurately human selfhood and also because it empirically lacks universal applicability--many humans, and most seriously ill patients, actually lack autonomy. Shared decision making, an autonomy-based model of the doctor-patient relationship, suffers from this critique of autonomy as well as its own shortcomings in that it maintains a strict fact/value distinction that is untenable. Chapter III introduces narrative philosophy and its extrapolation, narrative medicine, as a possible alternative to an autonomy model of care. I defend a narrative view of selfhood, while recognizing that even if we are in some sense narratively constituted, this still leaves many questions regarding the relationship between story and self, particularly in a clinical encounter. In Chapter IV, I seek to limit the claims of narrative by arguing that story and self can never be fully equated and that narrative must be understood as demonstrating alterity rather than eliminating it. In Chapter V, a new conception of the physician's role in the doctor-patient relationship is presented, combining phronesis, or practical wisdom, with narrative skill in four aspects of the clinical encounter: diagnosis, treatment, assistance in medical decision making, and emotional support of the patient.
Committee in charge: Naomi Zack， Chairperson； Cheyney Ryan， Member； Mark Johnson， Member； Mary Wood， Outside Member
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Britten, Nicola. "Lay views of medicines and their influence on prescribing : a study in general practice". Thesis, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390240.
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Ridd, Matthew John. "Patient-doctor longitudinal care, depth of relationship and detection of patient psychological distress by general practitioners". Thesis, University of Bristol, 2009. http://hdl.handle.net/1983/ca93b257-aac8-4168-917e-48379f4dcd74.
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Continuity of patient care is often described as a core value in general practice yet changes in primary care in the United Kingdom have eroded the traditional model of the patient seeing the same doctor and developing a relationship with them over time. Such patient-doctor continuity is especially valued by patients and GPs when, among other situations, the problem is psychological. However, evidence that continuity benefits patient care is limited, possibly because research has focused on its longitudinal rather than its interpersonal characteristics. Using a previously described model of patient-doctor continuity, two hypotheses were tested. First, that longitudinal care and depth of relationship would be associated. Second, that patient-doctor continuity (in particular depth of relationship) would be associated with GP detection of patient psychological distress. A novel measure of patient-doctor depth of relationship was developed and psychometrically evaluated through ten pre-pilot interviews and two pilot rounds involving 529 participants. This measure was then used in a cross-sectional study of routine GP consultations. Of the 643 eligible patients who attended the 31 participating GPs, 541 (84.1%) returned a questionnaire and 490 (76.2%) gave permission to review their medical records. An association between the number of encounters between patient and study GP and the probability of having a deep relationship appeared to be curvilinear, with an average odds ratio of 1.5 (95% CI 1.2 to 1.8). However, neither depth of relationship nor longitudinal care were associated with GP detection of psychologically distressed patients, as defined by the General Health Questionnaire (GHQ). Indeed, patient-doctor continuity appeared to be associated with GP over-reporting of psychological distress. The causality of the association between patient-doctor longitudinal care and depth of relationship, and the value of depth of relationship to patients with psychological problems, warrants further investigation.
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Johnson, David John. "The doctor-patient relationship : an analysis of framing in general practice". Thesis, Loughborough University, 1986. https://dspace.lboro.ac.uk/2134/31913.
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Utilizing a research technique involving semi-structured interviews and video-recordings of doctor patient consultations within British general practice, an empirically based 'ideal type' is created. This ideal type is seen to rest upon questionable assumptions, and although actors have expectations for behaviour which are consistent with the ideal type, deeper analysis of patient expectations shows them to be aware of the inapplicability of the ideal type in certain consultations. From this perspective one would expect change to be occurring. However using the concept of frames, a detailed analysis of the interaction between doctor and patient illustrates the social constraints and power structure of the consultation as playing a significant role in the maintenance of the status quo.
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Wahlqvist, Mats. "Medical students' learning of the consultation and the patient-doctor relationship /". Göteborg : Göteborg University, 2007. http://hdl.handle.net/2077/3762.
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Ford, Joseph. "Empathy in doctor-patient palliative care consultations : a conversation-analytic approach". Thesis, Loughborough University, 2017. https://dspace.lboro.ac.uk/2134/27661.
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This thesis analyses doctors empathising with patients in palliative care interactions. Historically, palliative care has treated not only patients physical pain but their emotional pain, as well. Although the importance of empathy (defined for the purposes of this thesis as The doctor s expressed understanding of the patient s emotional experience ) has been emphasised in this environment, however, there has been no prior research showing how palliative care doctors actually empathise with their patients in practice. Drawing upon 37 recordings of doctor-patient consultations collected in a UK hospice, this thesis addresses this omission by using conversation analysis (CA) to analyse several facets of empathy in this environment. The analysis begins in chapter four by considering the ways in which doctors can empathise with patients. It shows how doctors can empathise semantically, either by reworking what the patient has themselves said or by showing understanding on a normative basis. It also considers non-semantic ways of displaying empathy (e.g. response cries), showing how these are fundamentally different to the semantic type of empathic display. Overall, this chapter shows that empathy is not restricted to particular formats but, rather, is dependent upon the content of the doctor s turn. The analysis then moves on consider the wider context of doctors empathic responses. Chapter five, first of all, analyses cases where patients emotions become the topic of the interaction, either because the doctor asks about them directly or because the patient raises an emotionally-implicative topic. The emphasis here is on how palliative care doctors can talk to patients about, and empathise with, their emotions without necessarily having to do anything about those emotions. Chapter six then focuses on cases where patients emotions are discussed alongside the more task-driven aspects of the consultation, either because the patient s physical condition has had an emotional impact on them or because their presenting problem is inherently emotional. In contrast to chapter five, then, the source of the patient s emotions here can be treated by the doctor without the emotions being topicalised. The final two chapters of the analysis focus on doctors empathising with patients not in response to something that the patient has said but in the service of some task. Chapter seven shows how doctors can empathically bridge the gap between their medical and the patient s experiential perspectives at moments where it becomes clear that there is a disparity between the two. These include moments where the patient expresses expectations that go beyond what can realistically be provided, moments where the patient might take offence at the doctor s advice and moments where the doctor must reassure patients about their symptoms without seeming to criticise their emotional responses to those symptoms. Chapter eight, meanwhile, shows how doctors can empathically demonstrate that their practice is being driven by a due consideration of the patient s feelings. Specifically, it shows how doctors can draw upon patients feelings in helping them come to a decision about a treatment, cite those feelings when accounting for a treatment that they have recommended and frame a difficult topic as an outgrowth of sentiments that the patient has already expressed. In conclusion, this thesis shows how empathy is not clearly demarcated in palliative care. While there are cases where patients emotions are discussed and empathised with for the sake of discussing and empathising with them, more commonly, empathy and emotion are interwoven alongside and into the task-driven aspects of consultations. This thesis thus shows the interactional manifestation of palliative care s underlying philosophy, with patients emotional pain addressed alongside their physical pain in an integrated, holistic way.
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Simon, Sarah. "The Role of Doctor-Patient Race Concordance in U.S. Health Disparities". VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/3010.
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It has been established that much of the disparity in health outcomes between blacks and whites can be explained by accounting for education and income. Once education and income have been taken into consideration, research has found racial disparities in health outcomes for low-income populations are small, and in some cases no longer significant. For middle and upper income populations, however, a significant racial disparity in health outcomes persists even after accounting for education and income. Seeking to explain this variation, I analyze the literature concerning health disparities, race and class, the prevalence and distribution of black physicians, and issues and trends surrounding physician-patient communication and discrimination. I find that black physicians tend to be concentrated in low-income, minority-dense areas, therefore, the likelihood of a black middle or upper class person seeing a doctor of their same race may be less than that for lower class blacks. I hypothesize that doctor-patient racial concordance, and the associated possibility of diminished communication and cultural hurdles endured by black patients visiting a black doctor, may explain some of this variation in the magnitude of racial health disparities along the education/income spectrum, explaining the larger racial health disparities in middle and upper-income populations. Using data from the 2006 Commonwealth Fund Health Care Quality Survey (N=1591), I conducted bivariate (chi-sq/t-tests) and step-wise multivariate, logistic regression statistical tests to explore if doctor-patient racial concordance affects the self-rated health of American adults. This analysis showed concordance as a significant predictor of self-rated health in the unadjusted model, but not in the full model. Simply put, concordance is a significant predictor of self-rated health, but not independent of socioeconomic factors. My modeling is consistent with the literature in showing education and income as the most significant predictors of health status.
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Cheng, Kimmy. "Asymmetrical doctor-patient relationship in Hong Kong : a discourse analytical study". HKBU Institutional Repository, 2011. http://repository.hkbu.edu.hk/etd_ra/1255.
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Dales, Jill. "Doctor and new patient communication : the influence of a priori assumptions". Thesis, University of Newcastle upon Tyne, 2015. http://hdl.handle.net/10443/2950.
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Doctor-patient communication is fundamental to the therapeutic relationship necessary to achieve mutual understanding of the implications and impact of illness, diagnostic and treatment decisions, and health outcomes. It is recognised that both patient and doctor come with their own perspectives, beliefs and agendas. This quasi-ethnographic study explores the influence of the doctor’s own a priori assumptions on their communication with a new patient. Methods Cognitive interviewing was used prior to consultations to explore the doctor’s thoughts triggered by the referral information. The relevant subsequent consultations were audio recorded, as were loosely structured interviews after the consultation, during which the doctor reflected on what had been said and why. All data was subjected to qualitative thematic analysis. Conclusion The source, content and format of referrals are significant and doctors approach the information about the patient with their own perspectives, beliefs and experiences. The existence of assumptions and stereotypes appear to be triggered when processing the information. Doctors begin to develop the communication with the patient, based on their expectations of themselves and of the patient, before the patient is seen. During the consultation, some a priori assumptions were observed to be significant. A priori assumptions are influential to the communication with the patient and can result in communication not anticipated by the clinician. The relationship achieved with the patient during the consultation can be understood in the context of the concepts of recognition and presence.
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Tong, Yao S. M. Massachusetts Institute of Technology. "Narrative as an aid for the doctor-patient relationship in China". Thesis, Massachusetts Institute of Technology, 2017. http://hdl.handle.net/1721.1/113548.
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Thesis: Massachusetts Institute of Technology, Department of Comparative Media Studies/Writing, 2017."September 2017." Cataloged from PDF version of thesis.
Includes bibliographical references (pages 93-97).
In recent years, the incidence of violence against Chinese doctors has increased dramatically, with the scale, frequency and viciousness of attacks shocking the world. The challenging doctor-patient relationship remains a complicated issue with no single cause. When the tension intensifies, some news media tend to blame the doctors, using misleading narratives to create sensationalism, thereby aggravating the antagonism between the society and medical professionals. Much scholarship has focused on exploring the social, economic, political, legal, and medical aspects of the doctor- patient relationship. In contrast, little research has been done to interrogate the media's role in contributing to the tension. Additionally, although most studies are concerned with proposing suggestions, no study has posed an intervention to combat the twisted depictions of doctors and to abate the worsening doctor-patient tension. To this end, this thesis examines the role of the media to provide an explanatory analysis of its influence on the doctor-patient relationship, and then leverages on the power of narrative to offer an intervention as an aid to the current doctor-patient tension. User feedback has been collected and analyzed to measure the effectiveness of this project. The aim of this intervention is to help promote perspective taking, increase awareness, and foster understanding toward medical professionals in China.
by Yao Tong.
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Bi, Hongwei. "A doctor-patient communication tool (DPCT) Ryodoroku application on the web". CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2044.
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McCormick, Laura J. "Women and Thyroid Disease: Treatment Experiences and the Doctor-Patient Relationship". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1362.
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Thyroid disease, a chronic illness, affects nearly 200 million people worldwide and is more common among women than in men. Numerous factors make diagnosing and treating thyroid disease in women challenging. The standard blood test for diagnosing thyroid disease and determining treatment effectiveness is inconsistent in its accuracy. Many women with thyroid disease are misdiagnosed or struggle with symptoms even once receiving treatment. Although thyroid disease is highly prevalent among women and the doctor-patient relationship is known to influence treatment outcomes, there is a gap in the literature regarding the treatment experiences of women with thyroid disease and the doctor-patient relationship. The purpose of this phenomenological study was to explore female thyroid patients' experiences of treatment and the doctor-patient relationship. Sixteen female thyroid patients, ages 18 and older and members of an international online support group, were individually interviewed via online chat. Data interpretation was guided by social constructionism and feminist theory and was accomplished via Moustakas's analytic method. Themes related to the doctor-patient relationship were identified, including the culture of the medical profession, diagnostic bias, and gender differences in communication. Emergent themes included patient education level, patient self-advocacy behaviors, and the use of natural thyroid medication. The results of this study may contribute to positive social change by enhancing doctors' understanding of thyroid disease in women and the influence of the doctor-patient relationship in determining positive treatment outcomes, thus equipping doctors with enriched knowledge for providing their female thyroid patients with the highest quality of care.
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Frederikson, Lesley G. "The role of information in medical consultation". Thesis, University of York, 1992. http://etheses.whiterose.ac.uk/2511/.
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Alsos, Ole Andreas. "Mobile Point-of-Care Systemsin Hospitals: Designing for the Doctor-Patient Dialogue". Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for datateknikk og informasjonsvitenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-15136.
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NEVES, MARIANA GUERRA BARSTAD CASTRO. "THE DOCTOR-PATIENT RELATIONSHIP FROM THE ATTACHMENT THEORY S PERSPECTIVE: THINKING PATHWAYS". PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2018. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=34746@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIROCOORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTITUIÇÕES COMUNITÁRIAS DE ENSINO PARTICULARES
A relação médico-paciente consiste numa díade que é hierarquicamente assimétrica. Uma parte cuida e a outra recebe cuidado, análogo ao que ocorre nas relações de apego. O médico teria o papel de figura de apego, possibilitando ativar o seu sistema de cuidado. O objetivo deste estudo é analisar como o sistema de cuidado está inserido na relação médico-paciente, analisando o estilo de apego do médico, além de relacioná-lo à capacidade de cuidado que o médico tem com seu paciente. Foram entrevistados onze hematologistas do Rio de Janeiro e São Paulo com experiência no SUS utilizando um roteiro de entrevista semiestruturado e foi aplicado o instrumento de autorrelato EVA (Escala de Vinculação do Adulto). Após análise de conteúdo das entrevistas e análise por clusters do EVA, os médicos entrevistados apresentaram apego seguro, com aspectos defensivos evitativos e amedrontados. Quatro categorias também foram estabelecidas: experiências pessoais com medicina e/ou hematologia; especificidade da hematologia; como lidar com as questões sobre perdas; e cuidado com o outro. Conclui-se que o presente trabalho prioriza o lado do médico nesta relação, e a importância do atendimento às suas necessidades psicológicas e relacionais. Com isso, intervenções podem ser propostas à equipe de saúde, de forma a cuidar de maneira consistente destes profissionais e aprimorar sua relação com o paciente e seus familiares.
The doctor-patient relationship consists of a hierarchically asymmetrical dyad. One side cares and the other receives care, analogous to the attachment relationship. The doctor would have the attachment figure s role, being able to activate his or her caregiving system. The purpose of this study is to analyze how the care system is inserted in the doctor-patient relationship, analyzing the attachment style of the physician in addition to relating it to the care ability that the doctor has with his/her patient. Eleven hematologists from Rio de Janeiro and São Paulo with experience in SUS were interviewed using a semi-structured interview script and the self-report instrument AAS-R (Adult Attachment Scale-Revised) was applied. After content analysis of the interview and a cluster analysis of the AAS-R, all the doctors presented secure attachment, with avoidant-dismissing and avoidant-fearful defensive aspects. Four categories were also analyzed: personal experiences with medicine and/or hematology; hematology s specificity; how to deal with loss; and caring towards other. We concluded that the present it is important to prioritize the doctor s stance in the relationship, and to attend their psychological and relational needs. In that manner, interventions in the healthcare team can be proposed, providing the proper care to the healthcare professional, and, hence, improve their relationship with patients and their family members.
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Moore, John Oliver. "CollaboRhythm : new paradigms in doctor-patient interaction applied to HIV medication adherence". Thesis, Massachusetts Institute of Technology, 2009. http://hdl.handle.net/1721.1/55194.
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Thesis (S.M.)--Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2009.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 74-78).
Despite astounding advances in medical knowledge and treatment in recent decades, health outcomes are disappointing and costs continue to rise. The traditional paternalistic and episodic approach to medical care is not meeting the needs of patients. CollaboRhythm is a technological platform that is being developed to enable a more modem collaborative and continuous approach to care by facilitating new paradigms in doctor-patient interaction. It asks the question: Can a system that allows patients to become active participants in their care, through data transparency, shared decision making, education, and new channels of communication, improve patient outcomes? To begin testing the principles of CollaboRhythm, a system to support medication adherence for Human Immunodeficiency Virus (HIV) infection was created. It includes custom applications on a patient cell phone and an interactive device for the home called a Chumby as well as a collaborative workstation in the clinician's office. The applications allow the reporting of medication adherence, viewing of adherence performance including a personalized and dynamic simulation of HIV, and sending of supportive video messages. The system is novel in that it abandons the typical alarm-based method of supporting adherence and instead focuses on a multifaceted approach to generating motivation through awareness, self-reflection, education, and social support. Transparency of data and new communication channels allow efficient and socially engaging collaboration in real-time. The HIV medication adherence system was evaluated in two stages.
(cont.) In the first stage, twelve patient interviews were conducted. The response to the principles of the system was positive with eleven of the twelve patients willing to share their adherence data with their clinician and all twelve agreeing that the HIV simulation and encouraging messages would motivate them to take their medications. Overall, eleven patients were interested in using the system. In the second stage, a one-month pilot deployment was conducted with four patients collaborating with an HIV medication adherence specialist. This stage also yielded encouraging results with three patients maintaining greater than 95% adherence all four patients confident that the system helped them improve their adherence. Important lessons were learned about its limitations, including ramifications of inaccurate reporting. The results from the HIV adherence study suggest that there is merit in the new paradigms in provider-patient interaction facilitated by CollaboRhythm and that some patients are receptive to the idea of becoming more active participants in their care. Evaluations at a larger scale and for a number of clinical scenarios are warranted.
by John O. Moore.
S.M.
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Le, Roux-Kemp Andra. "A legal perspective on the power imbalances in the doctor-patient relationship". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/1330.
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Thesis (LLD (Public Law))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: The unique and intimate relationship that exists between a medical practitioner and his/her client is possibly one of the most important relationships that can come into being between any two people. This relationship is characterised and influenced by the qualities and attributes specific to the nature and historical development of medical care, as well as medical science in general. The doctor-patient relationship is also influenced by the social dynamics of a particular community, environmental factors, technological advances and the general social and commercial evolution of the human race. With regard to medical care and health service delivery, the doctor-patient relationship is furthermore vital to the quality of the care provided, as well as to the outcomes and relative success of the specific medical intervention or treatment. One of the distinct characteristics of the doctor-patient relationship is the power imbalance inherent in this relationship. The medical practitioner has expert knowledge and skill, while the patient finds himself or herself in an unusually dependent and vulnerable position. It is because of this important role that the doctor-patient relationship still plays in health service delivery today; the susceptibility of the relationship to a variety of influences, and the characteristic power imbalances inherent in this relationship, that a study of the doctor-patient relationship in South African medical- and health law is necessary. The characteristic power imbalances will be considered from a legal perspective in this dissertation. This study provides a comprehensive source of the doctor-patient relationship from a legal perspective. Where relevant, references are made to theories and principles from other disciplines, including sociology, economy and medical ethnomethodology. The prevalence and consequences of power imbalances in the doctor-patient relationship are identified and discussed with the aim of bringing these to the attention of both the legal fraternity, and medical practitioners. Specific problem areas are identified and solutions are offered, including the following: • The adverse consequences of power imbalances inherent in the doctor-patient relationship on the medical decision-making process are considered from various perspectives. With regard to these adverse consequences, the doctrine of informed consent is analysed and evaluated in great detail. • The influence of paternalistic notions in health service delivery; the business model of health service delivery and the effects of managed care and consumer-directed health care on the doctor-patient relationship and health service delivery in general are also analysed from a legal perspective, and specifically with regard to the power imbalances inherent in this relationship. • The role of autonomy, self-determination and dignity, as well as the principles of beneficence in medical practice, are reconsidered in an attempt to provide a solution for redressing the power imbalances inherent in the doctor-patient relationship. • The fiduciary nature of the doctor-patient relationship and the special role of trust in the relationship are emphasised throughout the dissertation as the focal point of departure in the doctor-patient relationship and the main constituent in any legal endeavor to redress the power imbalances inherent in it.
AFRIKAANS OPSOMMING: Die unieke en intieme verhouding wat bestaan tussen ‘n mediese praktisyn en ‘n pasiënt is wêreldwyd waarskynlik een van die belangrikste verhoudings wat tussen twee persone tot stand kan kom. Hierdie verhouding word gekenmerk en beïnvloed deur kwaliteite en eienskappe eie aan die besonderse aard en historiese ontwikkeling van gesondheidsorg, sowel as die mediese wetenskap in die algemeen. Die dokter-pasiënt verhouding word verder beïnvloed deur die sosiale dinamika van ‘n bepaalde gemeenskap, omgewingsfaktore, tegnologiese vooruitgang en die algemene sosiale en kommersiële ontwikkeling van die mensdom. Op die terrein van gesondheidsorg en mediese dienslewering is die dokter-pasiënt verhouding voorts ook sentraal tot die kwaliteit van die mediese sorg wat verskaf word, sowel as die uitkomste en relatiewe sukses van die spesifieke mediese behandeling. Een van die kenmerkende eienskappe van die dokter-pasiënt verhouding is die magswanbalans wat daar tussen dokter en pasiënt bestaan. Die mediese praktisyn beskik oor deskundige kennis en vaardighede, terwyl die pasiënt hom- of haarself in ‘n ongewone, afhanklike en kwesbare posisie bevind. Dit is dan veral weens die besondere rol wat hierdie verhouding steeds in hedendaagse gesondheidsorg speel, die beïnvloedbaarheid van hierdie verhouding deur ‘n verskeidenheid faktore, sowel as die kenmerkende magswanbalans inherent in die verhouding, dat ‘n ondersoek na die dokter-pasiënt verhouding in die Suid-Afrikaanse mediese reg noodsaaklik is. Hierdie kenmerkende magswanbalans sal vanuit ‘n regsperspektief verder in hierdie proefskrif ondersoek word. Hierdie studie bied ‘n omvattende bron van die dokter-pasiënt verhouding benader vanuit ‘n regsperspektief, terwyl verwysings na teorieë en beginsels van ander dissiplines soos die sosiologie, ekonomie en mediese etnometodologie ook waar nodig ingesluit word. Die voorkoms en gevolge van ‘n magswanbalans in die dokter-pasiënt verhouding word verder geïdentifiseer en bespreek ten einde dit onder die aandag te bring van beide regslui en medici. Spesifieke probleemareas wat geïdentifiseer is en die oplossings wat daarvoor aan die hand gedoen is sluit die volgende in: • Die nadelige gevolge van die bestaan van ‘n magswanbalans in die dokter-pasiënt verhouding op die mediese-besluitnemingsproses word bespreek vanuit verskillende persepktiewe. Met betrekking tot hierdie nadelige gevolge, word die leerstuk van ingeligte toestemming in besonder geanaliseer en geëvalueer. • Die invloed van ‘n paternalistiese benadering tot gesondheidsorg, die besigheids-model van gesondheidsorg, en die effek van bestuurde- en verbruikersgedrewe gesondheidsorg inisiatiewe op die dokter-pasiënt verhouding en die verskaffing van gesondheidsdienste in die algemeen word ook vanuit ‘n regsperspektief ge-analiseer. Spesifieke aandag word in dié verband gegee aan die invloede van hierdie benaderings en perspektiewe op die magswanbalans inherent aan die dokter-pasiënt verhouding. • Die besondere rol van autonomie, selfbeskikking en menswaardigheid, asook die beginsels van weldadigheid in gesondheidsorg, word heroorweeg in ‘n poging om ‘n meer gelyke distribusie van mag in die dokter-pasiënt verhouding te verseker. • Die fidusiêre aard van die dokter-pasiënt verhouding en die besondere rol wat vertroue in hierdie verhouding speel, word in hierdie proefskrif beklemtoon en word voorts as die basis van die dokter-pasiënt verhouding beskou. Vertroue, as ‘n kenmerk van die dokter-pasiënt verhouding, behoort ook die fokuspunt te wees van enige poging om die magswanbalans in die dokter-pasiënt verhouding aan te spreek.
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Schroeder, Casey Michelle. "Let's Talk about Sex...Or Not...: Doctor-Patient Communication about Sexual Health". Case Western Reserve University School of Graduate Studies / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=case1427964727.
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Soya, Christine. "The effects of direct-to-consumer antidepressent advertising on doctor-patient relationships". Thesis, Boston University, 2012. https://hdl.handle.net/2144/12638.
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Thesis (M.A.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Objective: This qualitative study looks at how doctors and patients feel direct-to-consumer antidepressant advertising affects the doctor-patient relationship. Methods and Results: I conducted open-ended interviews with eight primary care physicians to understand their feelings about direct-to-consumer antidepressant advertising. I performed a content analysis of eight antidepressant and antidepressant add-on advertisements available on YouTube. I also collected and analyzed comments for each YouTube ad to represent the general public's opinions. Using an ethnomedical framework, I looked at the many factors surrounding direct-to-consumer antidepressant advertising including: the object of concern (depression), the social practice of advertising, patients' cultural specific concerns, doctors' values, and managed care organizations (the institutional level). Conclusions: My study points to both physician and societal perceptions of the current practice of direct-to-consumer antidepressant advertising, and its perceived risks or benefits to the doctor-patient relationship.
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Al-Barwani, Fatima A. M. "The development and evaluation of a patient workstation". Thesis, University of Glasgow, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241715.
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Lombard, Marise. "How can the experiences of stakeholders with doctors inform medical selection and education?" Thesis, Griffith University, 2018. http://hdl.handle.net/10072/381375.
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The practice of medicine is complex and challenging. Medical practitioners
require a range of capabilities to practice effectively and consistently over a long
career. Selection for the capacity to develop these capabilities and education to
build them are becoming increasingly important in a rapidly-changing society
that demands a return on its investment in medical schools and post-registration
training.
Although the range of capabilities required for trainee and graduate doctors is
described in the medical student selection and education literature, the
viewpoints of privileged stakeholders have generally been favoured in
determining them, relative to those most affected by medical practice (and
malpractice). This study attempts to address this question from a more inclusive
stakeholder perspective, linking ‘capabilities’ to ‘doctor experiences’ in ways not
previously reported in independently-refereed research literature. A qualitative
phenomenological approach offered the most suitable paradigm for exploring
the ‘doctor experience’.
A pilot study was conducted to refine the research question and to inform the
main study. For the main study, a total of 107 participants were purposively
recruited to represent the diversity of stakeholders in medical practice. Thirtynine
(39) one-on-one interviews were conducted with doctors (13), patients (11)
and participants identified as ‘key stakeholders’ (15) because of their medical
student selection and education expertise and experience. The remaining 68
stakeholders each participated in one of eight group interviews (as health
professionals, medical educators, academics, health executive managers,
medical students, patients or community representatives).
The interviews focused on first-person accounts of stakeholders’ experience of
their interactions with medical practitioners, which were audio recorded,
transcribed verbatim, anonymised and imported into computer assisted
qualitative data analysis software. The analytical methodology utilised was
based on Smith’s (1996) Interpretative Phenomenological Analysis (IPA).
In order to accommodate the larger-than-usual number of participants for an
IPA study, Smith’s method was somewhat modified. All of the data were first
analysed descriptively to identify broad categories of experience with doctors
and the extent to which particular participants had provided vivid first-person
accounts of those experiences. Participants whose narratives were the most
deeply experiential and provided the richest accounts of particular doctor
capabilities or concerning behaviours were designated ‘signature’ stakeholders
for that category and their transcripts were interrogated with the full IPA
methodology. This involved meaning-making and interpretation through
application of the ‘hermeneutic cycle’. The analysis of these transcripts was
then supported by less intensive interpretation of accounts from other
stakeholders who had made sense of their experiences in similar ways.
Broadly speaking, experiences of doctors were evaluated by participants as
either positive or negative. Positively evaluated experiences focused on doctor
capabilities in the major domains of being ‘patient-centred’ and being a ‘good
communicator’. More specifically, these emphasised ‘ensuring patient safety’,
‘showing genuine concern for patients’, ‘combining competence with caring’,
‘being a good listener’, ‘allowing sufficient time’ and ‘being respectful’.
Negatively evaluated doctor experiences focused on behaviours in the major
domains of being ‘unprofessional’ and ‘compromising the safety of self and others’. More specifically, these related to ‘being disrespectful’, ‘being arrogant’,
‘having impaired judgement’, ‘being a poor communicator’ and ‘being
incompetent’.
The study’s findings were somewhat concordant with the existing literature. My
participants’ positively and negatively evaluated experiences pointed to
capabilities such as a patient-centredness and effective communication that had
previously been identified as desirable in competency frameworks derived from
the opinion of ‘privileged’ stakeholders such as ‘CanMEDS’ and the Australian
Medical Council Graduate Outcome Statements. The study adds to the
literature, however, in that the positively and negatively evaluated experiences
of the broader range of ‘less-privileged’ stakeholders I interviewed prioritised
different patterns of capabilities. They emphasised particularly patientcentredness,
good communication, professionalism and practicing safely,
characterising each of these domains in novel ways.
Potential limitations of the study related to the novelty of the modification to
Smith’s IPA method that I developed in order to balance respect for the
idiographic (distinct and detailed) accounts of my participants with the need to
manage data from a larger-than-usual number of participants for a
phenomenological study. The modified method appeared to serve its purpose,
however, and the range of measures taken to ensure the trustworthiness of its
findings is described. My experience as a health professional and medical
educator may have affected my degree of ‘reflexivity’ or ability to self-examine
the potential implications of these experiences for my research role. It may also
have influenced how participants viewed me, particularly those who were known
to me previously. A further range of measures taken to overcome this potential limitation is also described.
Implications of the study are discussed and recommendations made for future
medical selection and education research and practice. These include
strategies to refine the range and prioritisation of practitioner capabilities, on the
basis of the experience and needs of a broader range of stakeholders, to
enable doctors to practice effectively in today’s society.
The study adds to the existing body of medical selection and education
research. It also gives stakeholders an opportunity to be heard, particularly
those most affected by medical practice and malpractice.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medicine
Griffith Health
Full Text
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Bailey, Julia Vivian. "Doctor-patient communication in consultations for upper respiratory tract infections : a discourse analysis". Thesis, King's College London (University of London), 2007. https://kclpure.kcl.ac.uk/portal/en/theses/doctorpatient-communication-in-consultations-for-upper-respiratory-tract-infections-a-discourse-analysis(48b873c4-38a4-4e73-b619-10cfa3a9504c).html.
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Illnesses such as upper respiratory tract infections (URTls(coughs and colds) are positioned within medical discourse as 'minor' and 'trivial', and consulting doctors with cough and cold symptoms is morally accountable. In this thesis I explore different methodological approaches to understanding doctor-patient consultations for URTls. I critically review quantitative and qualitative approaches to URTI consultation research, and explore qualitative discursive approaches through analyses of consultation data. Data comprise 33 video-taped consultations and post-consultation interviews with inner London general practitioners and patients with cough and cold symptoms, supplemented with ethnographic data. I draw from a range of discursive methodological approaches including conversation analysis, socio-Iinguistic analysis of institutional talk and discursive psychology. I show how discursive approaches can illuminate the complexity and meaning of doctor-patient interaction, exploring the way that coughing is used by patients as an interactional resource. In a detailed micro-analysis, I show that coughing is associated with interactional problems such as misunderstanding and disagreement, and how it also functions as a resource to assert patients' legitimacy. ,. In another detailed analysis, I show that the 'minor' status of coughs and colds (and consequent 'no problem' diagnosis) is associated with interactional difficulty for both doctors and patients: I show how doctors' and patients'legitimacy and 'face' are at stake in a contest to define the meaning of cough and cold symptoms (as significant and treatable, or alternatively, 'no problem'). I discuss conflicts between doctors' and patients' interests: for example, prescribing antibiotics may legitimise the patient but discredit the doctor. . I discuss the way that discourse analytic approaches can contribute richer understandings of doctor-patient interaction through detailed analysis of social transactions in consultation (such as the negotiation of identity and face). I contend that discursive approaches represent valuable and under-utilised resources for research and practice in primary care.
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Brownbridge, Garry. "Doctor-patient communication and the consulting room use of computers in general practice". Thesis, University of Sheffield, 1988. http://etheses.whiterose.ac.uk/3532/.
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This thesis examines the effects of general practitioners' use of a computer during consultations, on doctor-patlent communication and the delivery of care. The IBM Sheffield Primary Care System was used by GPs during routine consultations for the review and update of patients' records. The system also provided an interactive protocol for the management of patients with chronic hypertension. Video recordings were made of over 800 consultations with and without use of the computer. These were used to identify a comprehensive and reliable set of measures of doctor-patient communication. With medical collaboration measures of the standard of delivery of care were also developed. The measures were then used to investigate the effects of computer use. When used for the review and update of records the computer had little effect on doctor-patient communication. Doctors showed more solidarity with patients (e. g. by offering supportive comments), but there was no effect on the amount of information and advice offered or questions asked by either doctor or patient. However, overall, there was a slight impairment of the doctor's interpersonal manner and delivery of care. When the computer was used in direct support of clinical decision-making (i. e. through the hypertension management protocol) there was a marked improvement in the doctors’ clinical performance in terms of the number of relevant verbal and physical examinations conducted and recorded. The findings suggest ways in which future systems should be designed and used to avoid possible adverse consequences for doctor-patient communications. A research framework, including new methodologies, is also offered for the evaluation of future consulting room systems. Similar evaluative studies need to be performed on the more sophisticated systems now available, especially the clinically oriented ones which offer most potential.
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Williams, Susan Margaret. "Doctor-patient communication : a study of input, process and outcome in General Practice". Thesis, King's College London (University of London), 1998. https://kclpure.kcl.ac.uk/portal/en/theses/doctorpatient-communication--a-study-of-input-process-and-outcome-in-general-practice(c7bad17a-3b54-4178-bed6-1fbd37438d25).html.
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Klatt, Maryanna Danis. "The social construct of the doctor-patient relationship : Origins and potential for change /". The Ohio State University, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=osu1486457871784932.
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Langbecker, Danette Helsa. "The evidence-based development of an intervention to address the information needs of adults newly diagnosed with primary brain tumours and their carers". Thesis, Queensland University of Technology, 2011. https://eprints.qut.edu.au/46663/1/Danette_Langbecker_Thesis.pdf.
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Adults diagnosed with primary brain tumours often experience physical, cognitive and neuropsychiatric impairments and decline in quality of life. Although disease and treatment-related information is commonly provided to cancer patients and carers, newly diagnosed brain tumour patients and their carers report unmet information needs. Few interventions have been designed or proven to address these information needs. Accordingly, a three-study research program, that incorporated both qualitative and quantitative research methods, was designed to: 1) identify and select an intervention to improve the provision of information, and meet the needs of patients with a brain tumour; 2) use an evidence-based approach to establish the content, language and format for the intervention; and 3) assess the acceptability of the intervention, and the feasibility of evaluation, with newly diagnosed brain tumour patients. Study 1: Structured concept mapping techniques were undertaken with 30 health professionals, who identified strategies or items for improving care, and rated each of 42 items for importance, feasibility, and the extent to which such care was provided. Participants also provided data to interpret the relationship between items, which were translated into ‘maps’ of relationships between information and other aspects of health care using multidimensional scaling and hierarchical cluster analysis. Results were discussed by participants in small groups and individual interviews to understand the ratings, and facilitators and barriers to implementation. A care coordinator was rated as the most important strategy by health professionals. Two items directly related to information provision were also seen as highly important: "information to enable the patient or carer to ask questions" and "for doctors to encourage patients to ask questions". Qualitative analyses revealed that information provision was individualised, depending on patients’ information needs and preferences, demographic variables and distress, the characteristics of health professionals who provide information, the relationship between the individual patient and health professional, and influenced by the fragmented nature of the health care system. Based on quantitative and qualitative findings, a brain tumour specific question prompt list (QPL) was chosen for development and feasibility testing. A QPL consists of a list of questions that patients and carers may want to ask their doctors. It is designed to encourage the asking of questions in the medical consultation, allowing patients to control the content, and amount of information provided by health professionals. Study 2: The initial structure and content of the brain tumour specific QPL developed was based upon thematic analyses of 1) patient materials for brain tumour patients, 2) QPLs designed for other patient populations, and 3) clinical practice guidelines for the psychosocial care of glioma patients. An iterative process of review and refinement of content was undertaken via telephone interviews with a convenience sample of 18 patients and/or carers. Successive drafts of QPLs were sent to patients and carers and changes made until no new topics or suggestions arose in four successive interviews (saturation). Once QPL content was established, readability analyses and redrafting were conducted to achieve a sixth-grade reading level. The draft QPL was also reviewed by eight health professionals, and shortened and modified based on their feedback. Professional design of the QPL was conducted and sent to patients and carers for further review. The final QPL contained questions in seven colour-coded sections: 1) diagnosis; 2) prognosis; 3) symptoms and problems; 4) treatment; 5) support; 6) after treatment finishes; and 7) the health professional team. Study 3: A feasibility study was conducted to determine the acceptability of the QPL and the appropriateness of methods, to inform a potential future randomised trial to evaluate its effectiveness. A pre-test post-test design was used with a nonrandomised control group. The control group was provided with ‘standard information’, the intervention group with ‘standard information’ plus the QPL. The primary outcome measure was acceptability of the QPL to participants. Twenty patients from four hospitals were recruited a median of 1 month (range 0-46 months) after diagnosis, and 17 completed baseline and follow-up interviews. Six participants would have preferred to receive the information booklet (standard information or QPL) at a different time, most commonly at diagnosis. Seven participants reported on the acceptability of the QPL: all said that the QPL was helpful, and that it contained questions that were useful to them; six said it made it easier to ask questions. Compared with control group participants’ ratings of ‘standard information’, QPL group participants’ views of the QPL were more positive; the QPL had been read more times, was less likely to be reported as ‘overwhelming’ to read, and was more likely to prompt participants to ask questions of their health professionals. The results from the three studies of this research program add to the body of literature on information provision for brain tumour patients. Together, these studies suggest that a QPL may be appropriate for the neuro-oncology setting and acceptable to patients. The QPL aims to assist patients to express their information needs, enabling health professionals to better provide the type and amount of information that patients need to prepare for treatment and the future. This may help health professionals meet the challenge of giving patients sufficient information, without providing ‘too much’ or ‘unnecessary’ information, or taking away hope. Future studies with rigorous designs are now needed to determine the effectiveness of the QPL.
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Mbedzi, Lufuno Kenneth. "An analysis of the doctor-patient relationship with reference to the celebrity or famous patient-issues pertaining to privacy and confidentiality". Diss., University of Pretoria, 2019. http://hdl.handle.net/2263/76711.
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Nimnuan, Chaichana. "Epidemiological study of functional somatic syndromes in general hospitals". Thesis, King's College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314008.
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Ahlm, Isabelle, i Roa Mansor. "Patienters upplevelser av empati hos läkare i läkar-patientmötet : Intervjuer med bröstcancerpatienter". Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-31453.
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Studien handlade om bröstcancerpatienters upplevelser av empati hos läkare i läkar-patientmötet. Fokus låg på att undersöka i hur stor utsträckning läkarens empatiska förmåga bidrar till upplevelsen av god vård. Metoden var av kvalitativ ansats där semistrukturerade intervjuer utfördes med 12 bröstcancerdrabbade kvinnor. Resultatet gav kategorier tillhörande studiens tre frågeställningar. Frågeställningen om vad som utgör en empatisk läkare belystes av kategorierna (1) sätta sig in i den andres situation, (2) både känsla och handling, (3) kunskap, (4) informativ och (5) god lyssnare. Frågeställningen om icke-empatisk läkare belystes av kategorierna (1) dålig information, (2) opersonlig och (3) dålig förmåga att skapa god behandlingsallians. Frågeställningen om god vård belystes av (1) kontinuitet hos läkare, (2) bli sedd som individ och (3) mer tid hos läkare. I fall av brist på empati upplevde patienterna mindre grad av tillfredställande. God vård och empati är beroende av varandra, den ena kan inte existera utan den andre.
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Cordella, Marisa 1961. "The dynamic consultation : a discourse-analytical study of doctor-patient communication in Chilean Spanish". Monash University, Dept. of Linguistics, 2001. http://arrow.monash.edu.au/hdl/1959.1/8920.
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Kosny, Agnieszka Arlette. "Examining the doctor-patient relationship : knowledge, vulnerability, and power in women's health care narratives /". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0004/MQ42404.pdf.
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Clucas, Claudine. "Influences on, and consequences of, patients' experiences of feeling respected in doctor-patient relations". Thesis, University of Bristol, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.495896.
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This research program focused on studying patients' experiences of feeling respected and in particular the intrapersonal, interpersonal, intragroup and intergroup influences on such experiences. Consequences of feeling respected on patient outcomes were also assessed. The final chapter is a review of the literature on respect at different levels of analysis with emphasis on the example of doctor-patient relations. The second and third chapters focus on patients. With a focus on respect at the intrapersonal level, the second chapter (Study 1) explores patients' meanings of feeling respected. The third chapter (Study 2) provides support for the intrapersonal factors of expectations of the doctor and self-respect influencing respect feelings. It also tests the effect of the doctor's behaviours, an interpersonal influence, on patients' respect feelings. The fourth and fifth chapters focus on the doctor. The fourth chapter (Study 3) provides support for a model of respect as an interpersonal attitude based on the object's inherent worth as a person and respect worthy qualities embraced by the literature. The fifth chapter (Study 4) shows a salient social medical identity to be associated with deindividualization of patients but communication skills' training with individualization of patients, and thus a more respectful attitude towards patients. The sixth chapter (Study 5) shows that patients who self-categorize more strongly as traditional patients feel more respected than patients who self-categorize more strongly as consumerist patients and that respect feelings influence various patient outcomes, including illness perception, patient satisfaction and adherence to advice.
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Tamin, Jacques. "The doctor-patient relationship, confidentiality and consent in occupational medicine : ethics and ethical guidance". Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/the-doctorpatient-relationship-confidentiality-and-consent-in-occupational-medicine-ethics-and-ethical-guidance(586107a4-ffe5-40be-ad19-acb9d329d732).html.
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This thesis seeks to examine the ethical basis for occupational medicine, as it is practised in the United Kingdom (UK). There is empirical evidence of occupational physicians being confused with regard to confidentiality and consent, and variations in their practice. It is argued that the ethical guidance from the General Medical Council and the Faculty of Occupational Medicine on these matters, contributes significantly to such confusion. The doctor-patient relationship, consent for disclosure of a medical report, and medical confidentiality, all in the context of occupational medicine practice, are explored. These issues are addressed in the core part of this thesis in the form of the three published papers. In the first paper, the doctor-patient relationship in occupational medical practice is reviewed, and it becomes apparent that in the UK, the occupational physician carries out different roles and functions, ranging from duties that mirror those of a therapeutic encounter, to those that require the occupational physician to be completely independent for the purposes of a particular type of assessment (for ill-health retirement). The former is compatible with the assumption of a fiduciary relationship between doctor and patient, whereas in the latter situation, it would be incongruous to expect the doctor to be independent and owe the patient a “duty of undivided loyalty” simultaneously. In the second paper, consent for disclosure of information, in particular a medical report, is distinguished from the “informed consent” for treatment or interventional research, and the phrase “permission to disclose” is proposed for the disclosure situations. Although this distinction may not have much significance in therapeutic practice, the output of virtually all occupational physician activities results in the writing of a report, so this difference between the two “consents” has greater relevance. The third paper reviews the ethical, and in particular, legal basis for medical confidentiality with reference to an independently commissioned report. In such a situation, UK courts have been consistent in stating that disclosure of such a report to the commissioning party does not breach confidentiality, and no further consent for such disclosure is required. This conflicts with ethical guidance to occupational physicians on this matter. Such conflict between the law and ethical guidance are a further, and important, source of ethical confusion for occupational physicians. Indeed, a common theme through the three papers is that ethical guidance to occupational physicians is in parts either incongruent, incoherent, or conceptually flawed. This may not be surprising, as current ethical guidance is predicated on a doctor-patient relationship that exists in the usual setting for most doctor-patient encounters, that is, the therapeutic setting. It seems unreasonable to expect that simply transposing such an ethical paradigm into a different setting, with dissimilar roles and obligations, could work in a seamless manner. The occupational physicians’ ethical confusion thus reflects the confusion in their ethical guidance.
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Park, Yujong. "Analyzing medical discourse the organization of doctor-patient interaction in Korean primary care settings /". Diss., Restricted to subscribing institutions, 2009. http://proquest.umi.com/pqdweb?did=1835448471&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Erlich, Linda Pilzer. "The effect of encounters between medical gatekeepers and patients on the doctor-patient relationship". ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/732.
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Research currently indicates patient perceptions of the doctor-patient relationship are central to health outcomes. Theoretically, the current study is grounded in two literatures: the placebo effect and the broader literature examining empirically tested predictors of the doctor-patient relationship. Two factors not yet studied relative to patient perceptions of the doctor-patient relationship include the direct effect of medical gatekeeper characteristics along with the interaction between gatekeeper characteristics and existing healthcare attitudes/behaviors. This quantitative archival study utilized a MultiCare Survey dataset of 10, 579 participants who were general practitioner patients in northwestern United States. This study first examined the individual impact of healthcare attitudes/behaviors as measured by the Health Matters scale and gatekeeper characteristics as measured by the Front Office scale on patient perceptions of the doctor-patient relationship assessed by the Provider and Education scales. Second, this study assessed the interaction of these variables in predicting doctor-patient perceptions. Regression analyses revealed that both healthcare attitudes/behaviors and gatekeeper characteristics individually predicted and interacted to predict doctor-patient perceptions. Findings from the study contribute to social change by identifying the importance of training those individuals who first engage the patient as part of establishing a holistic approach to positive patient relationships.