Gaps in doctor-patient communication. Patients' response to medical advice.
06 Mar 1969-The New England Journal of Medicine (Massachusetts Medical Society)-Vol. 280, Iss: 10, pp 535-540
TL;DR: A study of 800 outpatient visits to Children's Hospital of Los Angeles as discussed by the authors explored the effect of verbal interaction between doctor and patient on patient satisfaction and follow-through on follow-up.
Abstract: Study of 800 outpatient visits to Childrens Hospital of Los Angeles to explore the effect of the verbal interaction between doctor and patient on patient satisfaction and follow-through on...
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TL;DR: The psychometric properties and predictive validity of a structured four-item self-reported adherence measure (alpha reliability = 0.61) are tested, which can be easily integrated into the medical visit and address barriers to medication-taking.
Abstract: Adherence to the medical regimen continues to rank as a major clinical problem in the management of patients with essential hypertension, as in other conditions treated with drugs and life-style modification. This article reviews the psychometric properties and tests the concurrent and predictive va
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TL;DR: A limited set of concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution, including a fundamental distinction between disease and illness and the notion of the cultural construction of clinical reality.
Abstract: Major health care problems such as patient dissatisfaction, inequity of access to care, and spiraling costs no longer seem amenable to traditional biomedical solutions. Concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution. A limited set of such con- cepts is described and illustrated, including a fundamental distinction between disease and illness, and the notion of the cultural construction of clinical reality. These social science concepts can be developed into clinical strategies with direct application in practice and teaching. One such strategy is outlined as an example of a clinical social science capa- ble of translating concepts from cultural anthropology into clinical language for practical application. The implemen- tation of this approach in medical teaching and practice requires more support, both curricular and financial.
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TL;DR: It is concluded that the physician-patient relationship may be an important influence on patients' health outcomes and must be taken into account in light of current changes in the health care delivery system that may place this relationship at risk.
Abstract: Growing interest in the doctor-patient relationship focuses attention on the specific elements of that relationship that affect patients' health outcomes. Data are presented for four clinical trials conducted in varied practice settings among chronically ill patients differing markedly in sociodemographic characteristics. These trials demonstrated that "better health" measured physiologically (blood pressure or blood sugar), behaviorally (functional status), or more subjectively (evaluations of overall health status) was consistently related to specific aspects of physician-patient communication. We conclude that the physician-patient relationship may be an important influence on patients' health outcomes and must be taken into account in light of current changes in the health care delivery system that may place this relationship at risk.
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TL;DR: In this article, the authors link patient treatment adherence to physician-patient communication and meta-analysis allows estimates of the overall effects both in correlational research and in experimental interventions involving the training of physicians.
Abstract: Background:Numerous empirical studies from various populations and settings link patient treatment adherence to physician-patient communication. Meta-analysis allows estimates of the overall effects both in correlational research and in experimental interventions involving the training of physicians
1,975 citations
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01 Jan 1958
2,891 citations
Journal Article•
01 Jun 1958
TL;DR: The ten-year collaborative research directed by Hollingshead and Redlich has already produced some twenty-five papers; and the general drift of their work is very well known, but in "Social Class and Mental Illness" most of the major data are given for the first time in detail.
Abstract: Social Class and Mental Illness: A Community Study. By August B. Hollingshead and Fredrick C. Redlich. Price, $7.50. Pp. 442. John Wiley & Sons, Inc., 440 Fourth Ave., 1958. The ten-year collaborative research directed by Hollingshead, a sociologist, and Redlich, a psychiatrist, has already produced some twenty-five papers; and the general drift of their work is very well known. But in "Social Class and Mental Illness" most of the major data of their project are given for the first time in detail. (A second volume, entitled "Social Class, Family Dynamics, and Mental Illness," by Jerome Myers and Bertram Roberts, will soon be published.) The entire project represents trends of capital importance that are affecting the nature and destiny of psychiatry. One trend is the sociologizing of psychiatric research\p=m-\meaningthe incorporation of sociological perspectives into the study of mental disease and its treatment. The parallel and conjoint researches of sociologists and psychiatrists have supported the movement toward a social psychiatry, itself a close relative of what has come to be called, rather broadly, of course, "milieu therapy." All of this increasing emphasis upon the possible (its supporters claim, the actual) importance of social factors in mental illness is itself linked with the continuous change in the position of psychiatry itself as a profession. If psychiatry were a stationary profession,
1,591 citations
TL;DR: A number of communication barriers between pediatrician and patient9s mother were found to contribute significantly to patient dissatisfaction: notably lack of warmth and friendliness on the part of the doctor and use of medical jargon.
Abstract: Eight hundred patient visits to the walkin clinic of the Childrens Hospital of Los Angeles were studied by means of tape recording the doctor-patient interaction and by follow-up interview. Seventy-six percent of the patient visits resulted in satisfaction on the part of the patient9s mother; in 24% there was dissatisfaction. A number of communication barriers between pediatrician and patient9s mother were found to contribute significantly to patient dissatisfaction: notably lack of warmth and friendliness on the part of the doctor, failure to take into account the patient9s concerns and expectations from the medical visit, lack of clearcut explanation concerning diagnosis and causation of illness, and use of medical jargon.
975 citations
TL;DR: A TEN-DAY blood level of penicillin is necessary to eradicate Group A beta-hemolytic streptococci from the pharynx and the question always arises when medication is given by mouth whether it actually reaches the patient's stomach, particularly in the amount and for the duration prescribed.
Abstract: A TEN-DAY blood level of penicillin is necessary to eradicate Group A beta-hemolytic streptococci from the pharynx.1 , 2 For implementation of this objective the American Heart Association recommends either a single injection of benzathine penicillin G, injections of procaine penicillin with aluminum monostearate every third day for three doses or penicillin, 200,000 to 250,000 units, given three times daily by mouth for a full ten days, even if the patient becomes afebrile and asymptomatic.3 The question always arises when medication is given by mouth whether it actually reaches the patient's stomach, particularly in the amount and for the duration prescribed. . . .
344 citations
341 citations