Miscommunication in Doctor-Patient Communication

The effectiveness of medical treatment depends on the quality of the patient–clinician relationship. It has been proposed that this depends on the extent to which the patient and clinician build a shared understanding of illness and treatment. Here, we use the tools of conversation analysis (CA) to explore this idea in the context of psychiatric consultations. The CA “repair” framework provides an analysis of the processes people use to deal with problems in speaking, hearing, and understanding. These problems are especially critical in the treatment of psychosis where patients and health care professionals need to communicate about the disputed meaning of hallucinations and delusion. Patients do not feel understood, they are frequently non‐adherent with treatment, and many have poor outcomes. We present an overview of two studies focusing on the role of repair as a mechanism for producing and clarifying meaning in psychiatrist–patient communication and its association with treatment outcomes. The first study shows patient clarification or repair of psychiatrists’ talk is associated with better patient adherence to treatment. The second study shows that training which emphasizes the importance of building an understanding of patients’ psychotic experiences increases psychiatrists’ self‐repair. We propose that psychiatrists are working harder to make their talk understandable and acceptable to the patient by taking the patient's perspective into account. We conclude that these findings provide evidence that repair is an important mechanism for building shared understanding in doctor–patient communication and contributes to better therapeutic relationships and treatment adherence. The conversation analytic account of repair is currently the most sophisticated empirical model for analyzing how people construct shared meaning and understanding. Repair appears to reflect greater commitment to and engagement in communication and improve both the quality and outcomes of communication. Reducing potential miscommunication between psychiatrists and their patients with psychosis is a low‐cost means of enhancing treatment from both the psychiatrist and patient perspective. Given that misunderstanding and miscommunication are particularly problematic in psychosis, this is critical for improving the longer term outcomes of treatment for these patients who often have poor relationships with psychiatrists and health care services more widely

Komunikasi Dokter - Pasien

Mistakes in understanding the meaning of medical symbols result in negative impact for the patients. Futhermore, it can cause malpractice. Therefore, communication between a doctor and a patient is very essential to observe. It is because some malpractices occur due to miscommunication. Disease diagnosis through patient-doctor communication is influenced by the some understanding toward the messages. It creates an effective communication. Gap in communication between a docter and a patient can cause misunderstanding as well as misinformation for the patient on his disease. The hesitation of a doctor to inform the patient on the disease well in order to prevent emotional action of the patient and his family

Evaluation of communication between physicians and patients in Astana City Hospital ?1

Introduction: Communication between patients and health care providers is important for the effective functioning of health care systems. Miscommunication often stems from discrepancies in expectations of both healthcare professionals and patients due to cultural and historical influences. We investigated the degree to which health care providers (doctors and nurses) and patients in Kazakhstan believe that interaction between doctors and patients should be doctor- or patient-oriented.Material and methods: We conducted a cross-sectional study of 163 patients and 176 health care providers (71 doctors and 105 nurses) in a general hospital in Astana, Kazakhstan. The subjects completed a structured questionnaire containing the Patient-Practitioner Orientation Scale (PPOS), and scales assessing life and job satisfaction, effort-reward balance of healthcare professionals, and the patients’ perceptions of communication practices.Results: An overwhelming majority of doctors (81.7%), nurses (88.1%), and patients (92.3%) were doctor-oriented. Among health care providers, PPOS was not associated with age, sex, life and job satisfaction, or effort-reward imbalance. Among patients, PPOS was not associated with age, sex, or specialty of health care provider. However, higher PPOS among patients (indicating preference for patient-oriented interaction) was associated with higher satisfaction with communication with health care providers and, less strongly, with their life satisfaction.Conclusion: The main finding of this study is the very small proportion of doctors, nurses and patients who believe that interaction should be patient-oriented. These results highlight the necessity of improvement of communication among health care providers towards patient-oriented approach in order to decrease miscommunication with patients. The fact that most patients prefer doctor-oriented interaction may reflect historical stereotypes; educational/information interventions among patients may also be needed

Linguistic challenges in the fight again HIV and AIDS: an analysisi of Doctor-Patient discourse in Kenyan health centres

The language question has received little attention in the fight against HIV and AIDS in Kenya, yet language has a very fundamental role to play if progress is to be made in responding to this pandemic. The language barrier can completely hinder progress especially in Doctor-patient communication whereby a patient suffering from HIV or AIDS, or indeed any other disease, cannot communicate directly to the doctor in the language he is most competent in. This problem is most prevalent in multilingual nations like Kenya, where knowledge of either the national or official language is the preserve of an educated minority. In linguistically heterogeneous areas, doctors or clinical officers normally require the services of a nurse or close family member for interpretation. This in itself denies the patient the confidentiality they require and may lead to miscommunication or misrepresentation of the ideal picture to either the doctor or the patient. It may also encourage the culture of silence since the patient may shy away from revealing certain personal details related to their condition in the presence of a third party. This has implications for the efficacy of the entire communication process and limits or prevents access to effective treatment for health issues.This paper looks at doctor-patient discourse in some selected health centres in Kenya with a main focus on some of the problems encountered by patients in communicating to doctors and how doctors deal with the language barrier problem in the treatment of HIV and AIDS. It aims at highlighting how linguistic barriers can slow down the efforts made in responding to this global pandemic and makes suggestions on how to manage doctor-patient discourses in a multi-ethnic and multi-lingual setting for efficient communication, especially in the prevention, care and treatment of HIV and AIDS. Key words: HIV, AIDS, language, patient

Miscommunication in the institutional context of the broadcast news interview : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Palmerston North, New Zealand

This study examined the pattern and relative success of linguistic interaction in the Broadcast News Interview (BNI). BNI is modelled as a genre of institutional communication. The psychological and functional characteristics of the BNI were examined from the viewpoint of how communicative conventions that normally regulate interview performance may, at times, impede effective communication. The BNI is intended to transfer information from an expert witness to an interested, though relatively uninformed audience. The interviewer is supposed to act as both conduit and catalyst. Pragmatic properties of the interlocutors' speech as they orient themselves towards the context of the conversation was analysed in order to reveal the manner in which prior assumptions or beliefs may lead to faulty inferences. The notion of miscommunication is used to describe and explain the faults associated with processes of representing the illocutionary force of an utterance, rather than deficiencies in pronunciation or auditory sensation and perception. Opting for a qualitative analysis, an attempt was made to ground explanations in relevant theoretical models of interpersonal communication and communication failure. Results indicate that the conventions that distinguish the BNI from more mundane types of interaction impede successful communication. The study highlights that participants who wish to attain their communicative goal must be more aware of the functional procedures of the BNI and anticipate impediments to successful communication

The Role of Patient and Physician in Establishing Patient-Physician Communication in the In-Patient Environment

Communication in the in-patient environment is crucial, and the relationship between a patient and physician can enhance patient health and improve overall wellness. Patients need to feel confident with their abilities in order to feel comfortable conversing with physicians, which would thus improve health and treat symptoms more effectively. This communication has decreased over time, hence patients are often are unable to obtain medical information from their healthcare providers. Are there psychological factors involved in a patient’s inability to communicate with a physician? What is the relationship between self-esteem and quality of patient-physician communication? In addition, what can physicians do to ensure increased patient comfort in the medical environment? Various factors can affect the patient’s comfort with the physician, and when addressed, these factors can help improve patient-physician communication. For this paper, articles were analyzed that explored the effects of language barriers on patient-physician communication, and these articles showed that the patient can feel intimidated and later inadequate when forced to be dependent on others to voice his concerns. Articles that showed the role of social support in the medical environment were also analyzed and these showed that a sense of belonging in one’s family or community help a patient find the encouragement needed to help cope with his medical concerns. Lastly, articles were analyzed that connect the role of increased time online to communication. While the patient can be increasingly independent because of the Internet, a large use of such technology decreases patient-physician communication. This also puts the patient at risk of misinformation as he may expose himself to false information and incorrectly treat symptoms. All of these aspects lead to a disparity in self-esteem that decreases the patient’s comfort with the physician. As the patient feels unable to voice his concerns properly to the healthcare provider, the physician needs to take more responsibility in this situation as he has the ability to create a comforting environment for the patient. Physicians need to take a more active role in patients’ lives and provide more resources to communicate their concerns effectively. This will help patients feel a sense of security and comfort in the medical environment, and this change will thus enable patients to work alongside their physicians in managing their health to allow improvement of communication as well as overall patient health

Cross-Cultural Health Communication

Setiap kebudayaan memiliki pandangan yang beragam tentang kesehatan atau penyakit, kehidupan atau kematian. Ada masyarakat yang menganggap penyakit sebagai nasib yang harus diterima secara fatalistik. Ada pula masyarakat yang memandangnya sebagai cobaan dari Tuhan, dsb. Selain itu, terdapat juga perbedaan konsep untuk menamai jenis penyakit tertentu pada sejumlah pengguna bahasa yang berbeda. Nama suatu penyakit dalam suatu bahasa tidak bisa diterjemahkan langsung ke dalam bahasa lain. Dokter berkebangsaan Amerika, misalnya, akan kebingungan bila menangani pasien orang Indonesia yang berpenyakti “raja singa”, karena nama penyakit itu tak bisa diterjemahkan langsung menjadi “king lion”. Keragaman budaya ini berimplikasi pada para petugas kesehatan, perawat, dokter, untuk memahami budaya pasien, yang ditanganinya, yang berasal dari komunitas budaya berbeda. Kekeliruan memahami latar belakang budaya pasien dapat menimbulkan kesalahan dalam mendiagnosis penyakit, menangani pasien, atau menentukan resep obat

Stopping doctor-patient communication gap: The ten essential methods

Background : An effective doctor-patient communication has increasingly being recognized as an important factor in patient care. All means should be oriented towards narrowing communication gap. The essential methods must be searched and doctor must be able to conduct communication session in more pleasing manner. Methodology: This is a systematic review on observations made on doctor-patient relationship on various setting and supported by feedbacks from many scholars who are involved in research, teaching and also papers and studies on the said subject. Results: It is been realized that effective communication is not easily done if its process not well complemented and the gap is left widening. From all possible communication gaps recognized and listed, at least ten have identified to be the most essential methods to be prioritized while counselling or consulting a patient. Conclusion: Effective communication between patient and doctor is the essential prerequisite of good medical practice and especially important for accurate diagnosis and effective treatment. Its mutual benefit can only be observed if all efforts are centered towards managing the communication gap

Escaping the Shadow of Malpractice Law

Abinovich-Einy addresses several constituencies operating at the meeting point of alternative dispute resolution (ADR), communication theory, healthcare policy, and medical-malpractice doctrine. From an ADR perspective, the need for, and barriers to, addressing non-litigable disputes, for which the alternative route is the only one, is explored. It is shown that ADR mechanisms may not take root when introduced into an environment that is resistant to collaborative and open discourse without additional incentives and measures being adopted