Abstract
Objectives
This study explored the prevalence and degree of misalignment between gastroenterologists and people with inflammatory bowel disease (IBD) and investigated communication features related to misalignment.
Methods
A mixed-methods approach incorporated qualitative and quantitative analyses of consultations and post-consultation patient and doctor interviews. Gastroenterologists at two Australian teaching hospitals and IBD patients participated in this study. Doctor-patient misalignment about topics discussed in consultations was quantified using patient and doctor interviews. Predictors of misalignment were hypothesised through a linguistic analysis of consultations and tested quantitatively.
Results
Data from 69 patients and seven gastroenterologists showed that consultation participants had different perceptions about at least one aspect of care in 36 % of the consultations. Predictors of misalignment included missing the opportunity to clarify an issue or concern and missing the opportunity to explain the rationale for a diagnosis or recommendation.
Conclusion
Staying on the topic until the patient is ready to move on and using so-called related messages in questions and explanations increases the likelihood of doctor-patient alignment.
Practice implications
Generic and IBD-specific clinician- and patient-targeted interventions should cover strategies for adequately discussing patients’ issues and concerns and clinicians’ clinical reasoning. These strategies should also be considered in designing health promotion activities.
This study explored the prevalence and degree of misalignment between gastroenterologists and people with inflammatory bowel disease (IBD) and investigated communication features related to misalignment.
Methods
A mixed-methods approach incorporated qualitative and quantitative analyses of consultations and post-consultation patient and doctor interviews. Gastroenterologists at two Australian teaching hospitals and IBD patients participated in this study. Doctor-patient misalignment about topics discussed in consultations was quantified using patient and doctor interviews. Predictors of misalignment were hypothesised through a linguistic analysis of consultations and tested quantitatively.
Results
Data from 69 patients and seven gastroenterologists showed that consultation participants had different perceptions about at least one aspect of care in 36 % of the consultations. Predictors of misalignment included missing the opportunity to clarify an issue or concern and missing the opportunity to explain the rationale for a diagnosis or recommendation.
Conclusion
Staying on the topic until the patient is ready to move on and using so-called related messages in questions and explanations increases the likelihood of doctor-patient alignment.
Practice implications
Generic and IBD-specific clinician- and patient-targeted interventions should cover strategies for adequately discussing patients’ issues and concerns and clinicians’ clinical reasoning. These strategies should also be considered in designing health promotion activities.
| Original language | English |
|---|---|
| Article number | 108487 |
| Pages (from-to) | 1-11 |
| Number of pages | 11 |
| Journal | Patient Education and Counseling |
| Volume | 130 |
| DOIs | |
| Publication status | Published - Jan 2025 |
Bibliographical note
Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.Keywords
- alignment
- doctor-patient communication
- inflammatory bowel disease
- patient-centred communication