{"id":266,"date":"2021-03-04T16:33:39","date_gmt":"2021-03-04T16:33:39","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/suny-hvcc-healthpsychology\/?post_type=chapter&#038;p=266"},"modified":"2021-03-04T16:38:16","modified_gmt":"2021-03-04T16:38:16","slug":"the-patient-practitioner-relationship","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-hvcc-healthpsychology\/chapter\/the-patient-practitioner-relationship\/","title":{"raw":"The Patient-Practitioner Relationship","rendered":"The Patient-Practitioner Relationship"},"content":{"raw":"<header class=\"entry-header\">\r\n<h1 class=\"entry-title\">Patient-Practitioner Interpersonal skills<\/h1>\r\n<\/header>\r\n<div class=\"entry-content\">\r\n<p>Interpersonal skills\u00a0\u2013 skills that are used between people who are attempting to communicate with each other.<\/p>\r\n\r\n<ul>\r\n \t<li>Non-verbal communication\u00a0\u2013 the message is conveyed through a person\u2019s body.<\/li>\r\n \t<li>Verbal communication\u00a0\u2013 it is related to speech.<\/li>\r\n<\/ul>\r\n<p><strong>Non-verbal communication<\/strong><\/p>\r\n\r\n<ol>\r\n \t<li>Paralanguage \u2013 speed, tone, volume, fluency of speech.<\/li>\r\n \t<li>Facial expressions \u2013 how emotions are conveyed.<\/li>\r\n \t<li>Gestures \u2013 hand movements, shrugging shoulders (must be aware of cultural differences.)<\/li>\r\n \t<li>Physical proximity<\/li>\r\n \t<li>Appearance \u2013 dress.<\/li>\r\n<\/ol>\r\n<p>ARGYLE (1975)\u00a0suggested that non-verbal communication is more effective than verbal communication because it:<\/p>\r\n\r\n<ul>\r\n \t<li>Assists speech<\/li>\r\n \t<li>Replaces speech<\/li>\r\n \t<li>Signals attitudes<\/li>\r\n \t<li>Signals emotional states<\/li>\r\n<\/ul>\r\n<p>MCKINSTRY and WANG (1991)\u00a0found out that people, who preferred formally dressed doctors were older in age or from the professional class.<\/p>\r\n\r\n<ul>\r\n \t<li>11% of patients said that doctor\u2019s dress was VERY important<\/li>\r\n \t<li>53% of patients said that doctor\u2019s dress was QUITE important<\/li>\r\n<\/ul>\r\n<p>For more detailed information \u2013<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/03\/mckinstry-and-wang-1991\/\" target=\"_blank\" rel=\"noopener\">McKinstry and Wang (1991)<\/a><\/p>\r\n<p><strong>Verbal Communication<\/strong><\/p>\r\n<p>It is based around speech and used by doctors to gain information about the patient\u2019s condition and communicate the possible treatments available.<\/p>\r\n<p>MCKINLAY (1975)\u00a0found out that health workers and doctors use medical language to look more knowledgeable, important and keep the conversations brief. On the other hand, patients are afraid to ask questions if they don\u2019t comprehend a word because they don\u2019t want to look stupid and uneducated.<\/p>\r\n\r\n<ul>\r\n \t<li>39% of women understood the medical jargon used.<\/li>\r\n \t<li>The women had a far better understanding than the doctors expected.<\/li>\r\n<\/ul>\r\n<p>For more detailed information \u2013\u00a0<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/03\/mckinlay-1975\/\" target=\"_blank\" rel=\"noopener\">McKinlay (1975)<\/a><\/p>\r\n<p>LEY (1998)\u00a0found out that patient recall of verbal communication was improved by:<\/p>\r\n\r\n<ul>\r\n \t<li>Categorization<\/li>\r\n \t<li>Signposting<\/li>\r\n \t<li>Summarizing<\/li>\r\n \t<li>Repetition<\/li>\r\n \t<li>Use of diagrams<\/li>\r\n \t<li>Primacy effect<\/li>\r\n<\/ul>\r\n<p>For more detailed information \u2013<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/ley-1998\/\" target=\"_blank\" rel=\"noopener\">\u00a0Ley (1998)<\/a><\/p>\r\n\r\n<\/div>\r\n<p><\/p>\r\n\r\n<header class=\"entry-header\">\r\n<h1 class=\"entry-title\">Patient and Practitioner diagnosis and\u00a0style<\/h1>\r\n<\/header>\r\n<div class=\"entry-content\">\r\n<p><strong>Practitioner Style\u00a0<\/strong><\/p>\r\n<p>BYRNE AND LONG (1979)\u00a0found out the features of the doctor-centred style and the patient-centred style and concluded that meaningful dialogue led to more\u00a0<strong>compliance<\/strong>\u00a0by patients.<\/p>\r\n<p>Features of\u00a0<b>doctor-centered\u00a0style<\/b>:<\/p>\r\n\r\n<ul>\r\n \t<li>Impersonal atmosphere<\/li>\r\n \t<li>Intent on establishing the link between the symptoms and organic disorder.<\/li>\r\n \t<li>Patient was passive during consultaion.<\/li>\r\n \t<li>No open discussion on diagnosis and alternatives.<\/li>\r\n<\/ul>\r\n<p>\u00a0Features of\u00a0<b>patient-centered\u00a0style<\/b>:<\/p>\r\n\r\n<ul>\r\n \t<li>Personal atmosphere<\/li>\r\n \t<li>Less controlling role by the doctors<\/li>\r\n \t<li>Open questions, allowing patients to share information<\/li>\r\n<\/ul>\r\n<p>For more detailed information \u2013<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/byrne-and-long-1979\/\" target=\"_blank\" rel=\"noopener\">\u00a0Byrne and Long (1979)<\/a><\/p>\r\n<p>SAVAGE AND ARMSTRONG (1990)\u00a0found out\u00a0that the doctor-led style had a better effect in terms of\u00a0<strong>patient satisfaction<\/strong>\u00a0as measured by:<\/p>\r\n\r\n<ul>\r\n \t<li>their perception of the doctor\u2019s understanding of the problem<\/li>\r\n \t<li>the quality of the doctor\u2019s explanation<\/li>\r\n \t<li>the subjective improvement one week later<\/li>\r\n<\/ul>\r\n<p>For more detailed information \u2013\u00a0<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/savage-and-armstrong-1990\/\" target=\"_blank\" rel=\"noopener\">Savage and Armstrong (1990)<\/a><\/p>\r\n<p><strong>Practitioner Diagnosis\u00a0<\/strong><\/p>\r\n<p>There are occasions where doctors will gather up information wrong and there are two types of errors they can commit:<\/p>\r\n\r\n<ol>\r\n \t<li>Type I error\u00a0\u2013 occurs when the doctor diagnoses someone to be healthy when in fact the patient is physically and\/or psychologically ill. This is also said to be a\u00a0<strong>FALSE POSITIVE.<\/strong><\/li>\r\n \t<li>Type II error\u00a0\u2013 occurs when the doctor diagnoses someone to be ill when they are in fact healthy. This is also said to be a\u00a0<strong>FALSE NEGATIVE.<\/strong><\/li>\r\n<\/ol>\r\n<div id=\"sf-inline-ad-0\" class=\"ata-frame-wrapper\"><\/div>\r\n<p>It is quite obvious which error is more significant and may lead to more complications, however both can cause harm and distress to the patient.<\/p>\r\n<p><strong>Disclosure of I<\/strong><strong>nformation<\/strong><\/p>\r\n<p>For a diagnosis to occur, the patient needs to give information to the doctor. Unfortunately, everyone has their own styles of communication; therefore, it may be difficult to reach a diagnosis that is correct if patients do not contribute effectively.<\/p>\r\n<p>Sarafino (2006)\u00a0noted that it becomes difficult to communicate with patients when they:<\/p>\r\n\r\n<ul>\r\n \t<li>Want to criticize the doctor or become angry.<\/li>\r\n \t<li>Ignore what the doctors is asking or saying.<\/li>\r\n \t<li>Insist on taking more tests or on being prescribed medication they do not need.<\/li>\r\n \t<li>Want a certificate for an illness they do not have.<\/li>\r\n \t<li>Make sexual remarks towards the doctor.<\/li>\r\n<\/ul>\r\n<p>ROBINSON AND WEST (1992)\u00a0found out that patients are less worried about\u00a0<strong>social judgments<\/strong>\u00a0and disclosing information about symptoms and undesirable behavior of STDs when they are communicating these to a computer.<\/p>\r\n\r\n<ul>\r\n \t<li>Patients gave more information and admitted to having more sexual partners to the computer than to the doctor they met afterwards.<\/li>\r\n<\/ul>\r\n<p><b>Strengths<\/b><strong>:<\/strong><\/p>\r\n<p>+\u00a0Useful\u00a0\u2013 it encouraged the development of communication systems in hospital to make patients more comfortable and make it easier to reach a correct diagnosis.<\/p>\r\n<p>+\u00a0No demand characteristics\u00a0\u2013 the research was carried out in a real hospital with real patients, doctors, meaning that the participants would not\u00a0 change their behavior to conform with the experiment.<\/p>\r\n\r\n<div id=\"sf-inline-ad-1\" class=\"ata-frame-wrapper\"><\/div>\r\n<div id=\"inline-ad-1__controls\" class=\"ata-controls\"><\/div>\r\n<p><strong>Weaknesses:<\/strong><\/p>\r\n<p>\u2013\u00a0Ungeneralizable\u00a0\u2013 the research was only carried out at one clinic, making the results less applicable to the entire population and less reliable.<\/p>\r\n<p>\u2013 Patients may have felt it to be useless to mention everything to the doctors since they had just told the computer.<\/p>\r\n\r\n<\/div>","rendered":"<header class=\"entry-header\">\n<h1 class=\"entry-title\">Patient-Practitioner Interpersonal skills<\/h1>\n<\/header>\n<div class=\"entry-content\">\n<p>Interpersonal skills\u00a0\u2013 skills that are used between people who are attempting to communicate with each other.<\/p>\n<ul>\n<li>Non-verbal communication\u00a0\u2013 the message is conveyed through a person\u2019s body.<\/li>\n<li>Verbal communication\u00a0\u2013 it is related to speech.<\/li>\n<\/ul>\n<p><strong>Non-verbal communication<\/strong><\/p>\n<ol>\n<li>Paralanguage \u2013 speed, tone, volume, fluency of speech.<\/li>\n<li>Facial expressions \u2013 how emotions are conveyed.<\/li>\n<li>Gestures \u2013 hand movements, shrugging shoulders (must be aware of cultural differences.)<\/li>\n<li>Physical proximity<\/li>\n<li>Appearance \u2013 dress.<\/li>\n<\/ol>\n<p>ARGYLE (1975)\u00a0suggested that non-verbal communication is more effective than verbal communication because it:<\/p>\n<ul>\n<li>Assists speech<\/li>\n<li>Replaces speech<\/li>\n<li>Signals attitudes<\/li>\n<li>Signals emotional states<\/li>\n<\/ul>\n<p>MCKINSTRY and WANG (1991)\u00a0found out that people, who preferred formally dressed doctors were older in age or from the professional class.<\/p>\n<ul>\n<li>11% of patients said that doctor\u2019s dress was VERY important<\/li>\n<li>53% of patients said that doctor\u2019s dress was QUITE important<\/li>\n<\/ul>\n<p>For more detailed information \u2013<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/03\/mckinstry-and-wang-1991\/\" target=\"_blank\" rel=\"noopener\">McKinstry and Wang (1991)<\/a><\/p>\n<p><strong>Verbal Communication<\/strong><\/p>\n<p>It is based around speech and used by doctors to gain information about the patient\u2019s condition and communicate the possible treatments available.<\/p>\n<p>MCKINLAY (1975)\u00a0found out that health workers and doctors use medical language to look more knowledgeable, important and keep the conversations brief. On the other hand, patients are afraid to ask questions if they don\u2019t comprehend a word because they don\u2019t want to look stupid and uneducated.<\/p>\n<ul>\n<li>39% of women understood the medical jargon used.<\/li>\n<li>The women had a far better understanding than the doctors expected.<\/li>\n<\/ul>\n<p>For more detailed information \u2013\u00a0<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/03\/mckinlay-1975\/\" target=\"_blank\" rel=\"noopener\">McKinlay (1975)<\/a><\/p>\n<p>LEY (1998)\u00a0found out that patient recall of verbal communication was improved by:<\/p>\n<ul>\n<li>Categorization<\/li>\n<li>Signposting<\/li>\n<li>Summarizing<\/li>\n<li>Repetition<\/li>\n<li>Use of diagrams<\/li>\n<li>Primacy effect<\/li>\n<\/ul>\n<p>For more detailed information \u2013<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/ley-1998\/\" target=\"_blank\" rel=\"noopener\">\u00a0Ley (1998)<\/a><\/p>\n<\/div>\n<header class=\"entry-header\">\n<h1 class=\"entry-title\">Patient and Practitioner diagnosis and\u00a0style<\/h1>\n<\/header>\n<div class=\"entry-content\">\n<p><strong>Practitioner Style\u00a0<\/strong><\/p>\n<p>BYRNE AND LONG (1979)\u00a0found out the features of the doctor-centred style and the patient-centred style and concluded that meaningful dialogue led to more\u00a0<strong>compliance<\/strong>\u00a0by patients.<\/p>\n<p>Features of\u00a0<b>doctor-centered\u00a0style<\/b>:<\/p>\n<ul>\n<li>Impersonal atmosphere<\/li>\n<li>Intent on establishing the link between the symptoms and organic disorder.<\/li>\n<li>Patient was passive during consultaion.<\/li>\n<li>No open discussion on diagnosis and alternatives.<\/li>\n<\/ul>\n<p>\u00a0Features of\u00a0<b>patient-centered\u00a0style<\/b>:<\/p>\n<ul>\n<li>Personal atmosphere<\/li>\n<li>Less controlling role by the doctors<\/li>\n<li>Open questions, allowing patients to share information<\/li>\n<\/ul>\n<p>For more detailed information \u2013<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/byrne-and-long-1979\/\" target=\"_blank\" rel=\"noopener\">\u00a0Byrne and Long (1979)<\/a><\/p>\n<p>SAVAGE AND ARMSTRONG (1990)\u00a0found out\u00a0that the doctor-led style had a better effect in terms of\u00a0<strong>patient satisfaction<\/strong>\u00a0as measured by:<\/p>\n<ul>\n<li>their perception of the doctor\u2019s understanding of the problem<\/li>\n<li>the quality of the doctor\u2019s explanation<\/li>\n<li>the subjective improvement one week later<\/li>\n<\/ul>\n<p>For more detailed information \u2013\u00a0<a href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/savage-and-armstrong-1990\/\" target=\"_blank\" rel=\"noopener\">Savage and Armstrong (1990)<\/a><\/p>\n<p><strong>Practitioner Diagnosis\u00a0<\/strong><\/p>\n<p>There are occasions where doctors will gather up information wrong and there are two types of errors they can commit:<\/p>\n<ol>\n<li>Type I error\u00a0\u2013 occurs when the doctor diagnoses someone to be healthy when in fact the patient is physically and\/or psychologically ill. This is also said to be a\u00a0<strong>FALSE POSITIVE.<\/strong><\/li>\n<li>Type II error\u00a0\u2013 occurs when the doctor diagnoses someone to be ill when they are in fact healthy. This is also said to be a\u00a0<strong>FALSE NEGATIVE.<\/strong><\/li>\n<\/ol>\n<div id=\"sf-inline-ad-0\" class=\"ata-frame-wrapper\"><\/div>\n<p>It is quite obvious which error is more significant and may lead to more complications, however both can cause harm and distress to the patient.<\/p>\n<p><strong>Disclosure of I<\/strong><strong>nformation<\/strong><\/p>\n<p>For a diagnosis to occur, the patient needs to give information to the doctor. Unfortunately, everyone has their own styles of communication; therefore, it may be difficult to reach a diagnosis that is correct if patients do not contribute effectively.<\/p>\n<p>Sarafino (2006)\u00a0noted that it becomes difficult to communicate with patients when they:<\/p>\n<ul>\n<li>Want to criticize the doctor or become angry.<\/li>\n<li>Ignore what the doctors is asking or saying.<\/li>\n<li>Insist on taking more tests or on being prescribed medication they do not need.<\/li>\n<li>Want a certificate for an illness they do not have.<\/li>\n<li>Make sexual remarks towards the doctor.<\/li>\n<\/ul>\n<p>ROBINSON AND WEST (1992)\u00a0found out that patients are less worried about\u00a0<strong>social judgments<\/strong>\u00a0and disclosing information about symptoms and undesirable behavior of STDs when they are communicating these to a computer.<\/p>\n<ul>\n<li>Patients gave more information and admitted to having more sexual partners to the computer than to the doctor they met afterwards.<\/li>\n<\/ul>\n<p><b>Strengths<\/b><strong>:<\/strong><\/p>\n<p>+\u00a0Useful\u00a0\u2013 it encouraged the development of communication systems in hospital to make patients more comfortable and make it easier to reach a correct diagnosis.<\/p>\n<p>+\u00a0No demand characteristics\u00a0\u2013 the research was carried out in a real hospital with real patients, doctors, meaning that the participants would not\u00a0 change their behavior to conform with the experiment.<\/p>\n<div id=\"sf-inline-ad-1\" class=\"ata-frame-wrapper\"><\/div>\n<div id=\"inline-ad-1__controls\" class=\"ata-controls\"><\/div>\n<p><strong>Weaknesses:<\/strong><\/p>\n<p>\u2013\u00a0Ungeneralizable\u00a0\u2013 the research was only carried out at one clinic, making the results less applicable to the entire population and less reliable.<\/p>\n<p>\u2013 Patients may have felt it to be useless to mention everything to the doctors since they had just told the computer.<\/p>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-266\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">Public domain content<\/div><ul class=\"citation-list\"><li>Blog  JANUARY 4, 2018u00a0\/u00a0ALEVELPSYCHOLOGYCIE. <strong>Provided by<\/strong>: ALEVELPSYCHOLOGYCIE. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/patient-practitioner-interpersonal-skills\/%20%20%20https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/patient-and-practitioner-diagnosis-and-style\/\">https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/patient-practitioner-interpersonal-skills\/%20%20%20https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/patient-and-practitioner-diagnosis-and-style\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/pdm\">Public Domain: No Known Copyright<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":142337,"menu_order":3,"template":"","meta":{"_candela_citation":"[{\"type\":\"pd\",\"description\":\"Blog  JANUARY 4, 2018u00a0\/u00a0ALEVELPSYCHOLOGYCIE\",\"author\":\"\",\"organization\":\"ALEVELPSYCHOLOGYCIE\",\"url\":\"https:\/\/alevelpsychologycie.wordpress.com\/2018\/01\/04\/patient-practitioner-interpersonal-skills\/   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