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      Inter-personal versus content: assessment of communication skills in Iraqi physicians

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          Abstract

          Objectives

          The current study sought to evaluate the communication skills of Iraqi physicians from a patient perspective, differentiating between “interpersonal” and “content” components of communication. In the past century, the doctor–patient relationship has changed considerably, shifting from a paternalistic, physician-dominated approach to a more dynamic and patient-centered. In such a context, effective communication skills have become even more crucial for good medical practice and most accreditation organizations urge medical schools to teach and evaluate communication skills.

          Methods

          A cross-sectional study was conducted at Baghdad Teaching Hospital's three major departments (Surgery, Medicine, Obs/ Gyne). The final sample included 270 participants. A factor analysis was performed and generated two dimensions ("interpersonal" and "content"). Statistical differences between the groups and between the two dimensions of the questionnaire were analysed through t-tests and ANOVA. In addition, a multiple linear regression model was used to study the effect of some variables on the dependent variable "communication".

          Results

          The study showed a significant difference between “interpersonal” and “content” communication, with patients reporting higher satisfaction for the former. Reported satisfaction rates varied amongst the three departments with the Surgery specialty scoring significantly lower than the Medicine and the Obs/Gyne department. The duration of care under the current physician, a higher rank of specialty and the settings (inpatients versus outpatients) were positively and significantly associated with a higher quality of communication skills.

          Conclusions

          These findings have significant implications for training institutions.

          Abstract

          Social Science; Iraq; Doctor's communication-skills; Satisfaction; Patient-centred; Interpersonal; Content.

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          Most cited references52

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          Doctor-patient communication: a review.

          Effective doctor-patient communication is a central clinical function in building a therapeutic doctor-patient relationship, which is the heart and art of medicine. This is important in the delivery of high-quality health care. Much patient dissatisfaction and many complaints are due to breakdown in the doctor-patient relationship. However, many doctors tend to overestimate their ability in communication. Over the years, much has been published in the literature on this important topic. We review the literature on doctor-patient communication.
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            The values and value of patient-centered care.

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              Physician gender effects in medical communication: a meta-analytic review.

              Physician gender has been viewed as a possible source of variation in the interpersonal aspects of medical practice, with speculation that female physicians facilitate more open and equal exchange and a different therapeutic milieu from that of male physicians. However, studies in this area are generally based on small samples, with conflicting results. To systematically review and quantify the effect of physician gender on communication during medical visits. Online database searches of English-language abstracts for the years 1967 to 2001 (MEDLINE, AIDSLINE, PsycINFO, and Bioethics); a hand search was conducted of reprint files and the reference sections of review articles and other publications. Studies using a communication data source, such as audiotape, videotape, or direct observation, and large national or regional studies in which physician report was used to establish length of visit, were identified through bibliographic and computerized searches. Twenty-three observational studies and 3 large physician-report studies reported in 29 publications met inclusion criteria and were rated. The Cohen d was computed based on 2 reviewers' (J.A.H. and Y.A.) independent extraction of quantitative information from the publications. Study heterogeneity was tested using Q statistics and pooled effect sizes were computed using the appropriate effects model. The characteristics of the study populations were also extracted. Female physicians engage in significantly more active partnership behaviors, positive talk, psychosocial counseling, psychosocial question asking, and emotionally focused talk. There were no gender differences evident in the amount, quality, or manner of biomedical information giving or social conversation. Medical visits with female physicians are, on average, 2 minutes (10%) longer than those with male physicians. Obstetrics and gynecology may present a different pattern than that of primary care, with male physicians demonstrating higher levels of emotionally focused talk than their female colleagues. Female primary care physicians engage in more communication that can be considered patient centered and have longer visits than their male colleagues. Limited studies exist outside of primary care, and gender-related practice patterns in some subspecialties may differ from those evident in primary care.
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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                16 October 2020
                October 2020
                16 October 2020
                : 6
                : 10
                : e05145
                Affiliations
                [a ]Psychiatry Unit, Department of Medicine, College of Medicine, University of Baghdad, Iraq
                [b ]Department of Psychotherapy & Counselling, Regent's University London, London, UK
                [c ]Department of Clinical Research-Directorate of Clinical Affairs-Primary Health Care Corporation, Qatar
                [d ]Department of Medicine, College of Medicine, University of Baghdad, Iraq
                [e ]Department of Pathology, College of Medicine, University of Baghdad, Iraq
                Author notes
                []Corresponding author. cucchia@ 123456regents.ac.uk
                Article
                S2405-8440(20)31988-5 e05145
                10.1016/j.heliyon.2020.e05145
                7575849
                4a2f0429-419d-4e00-9e39-66cd9fe5a11c
                © 2020 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 7 July 2020
                : 11 September 2020
                : 29 September 2020
                Categories
                Research Article

                social science,iraq,doctor's communication-skills,satisfaction,patient-centred,interpersonal,content

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