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| Interpersonal communication is a key source of |
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| Interpersonal communication is a process critical to |
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| Interpersonal communication is separate from, but interlinked with |
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| “Good Communication” associated with |
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| “improved physical health, more effective chronic disease management, and better health related QOL long after the encounter” |
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| ___+ years of research in this area |
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| Patient involvement ______ [passive :::: extremely active] |
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| Who identified four types of clinician-patient interaction? |
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| provider control, low patient involvement |
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| balance in control, participatory decision making |
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| neither party has control, patient dissatisfaction/non-participation |
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| patients exercise > control |
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| Even though much research exists describing models of these relationships to health outcomes,_________ _________ ____ ____ elements have such effects are not _____ __________ |
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| explanatory mechanisms for why, well understood |
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| Why (in part) has "why" not been studied? |
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| because so many other factors also influence |
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| Much research exists supporting the importance of |
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| Whether indirect or direct, communication may |
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| improve health through various causal mechanisms or pathways |
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| To foster healing relationships, we need to shift |
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| Early on it was hierarchical, physician as “______” to legitimize control of situation |
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| Moving toward patient as _______ or _______ in care |
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| _______ and _______ are important |
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| When patient and clinician expectations for communication are _________, patients are more likely to evaluate the physician more ________ |
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| Strong relationships directly ________ _______ ________ ____-______, through patient’s sense of feeling known, cared for and understood |
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| directly promotes emotional well-being |
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| Strong relationship can ________ ______ ______ through continuity of care, patient satisfaction, and commitment to treatment plans |
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| indirectly improve health |
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| What is important but rarely studied? |
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| Unaddressed emotions can have |
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| negative impact on health related QOL |
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| Clinicians are often not effective at uncovering |
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| Few patients express their _____ explicitly |
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| Physicians do not recognize or are uncomfortable discussing _______ ______ |
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| _____ _________ about diagnosis ______ ____ helps patients understand and have greater sense of control |
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| clear communication, specific info |
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| Validating emotional experience and encouraging expression decreases |
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| Self confidence encouraging communication may increase |
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| Physician-patient communication can promote emotional |
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| Uncertainty can have good (allows for ____) and bad (loss of ______ ___ ______) |
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| Difficult to understand decision making because research often doesn’t distinguish _____ _________ for involvement in the decision making process from who assumes responsibility for the decision |
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| Many patients want to be ______ _________ in the discussion but do not want to ________ __________ for the final decision |
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| actively involved, assume responsibility |
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| Decisions can be ________ and various sources may be _____________ – forcing the patient to choose a source / authority |
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| complicated, contradictory |
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| If communication isn’t happening |
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| patients often won’t understand options and clinician won’t understand patient values (which may be inconsistent with scientific treatment) |
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| Enabling patient self-management |
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| Autonomy supporting behavior |
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| Number and importance of dissimilarities between physician and patient |
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| Context as an extrinsic moderator (3) |
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Family & social environment
Media environment
Health care system |
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