Academic journal article International Journal of Communication Research

Interrogative Strategies of Doctor - Patient Communication

Academic journal article International Journal of Communication Research

Interrogative Strategies of Doctor - Patient Communication

Article excerpt

1. STRUCTURAL ELEMENTS OF DOCTOR - PATIENT COMMUNICATION AND APPLIED MODELS IN HEALTH COMMUNICATION

Regarded from the perspective of the doctor, the doctor - patient communication aims to clarify the diagnosis. To arrive at a more accurate diagnosis as a proper treatment of the patient's positive response (Treatment compliance), analyzes and laboratory investigations are not only enough, but also the way in which the doctor has the ability to directly communicate with the patient and maintain the communication relationship. The doctor, even from the very first meeting with his patient is placed in a position to discuss how patient develops his/her professional activity, personal life, to describe his condition, his problems facing the suffering that accuses. For this reason, but not only for this, the doctor-patient communication doesn't have a rigid, fixed form, but it changes during the process of communication. Specialists, especially psychologists, draw attention to the changing nature of communication as patient access different states, attitudes and behaviors or the vary social or intimate area under review "to make a case history between doctor and the patient a conversation as an interview will be hosted, which then must turn into a free, uncontrolled open and honest story to the patient (disease clinical narration)".1

The case history is, from the medical point of view, "all information obtained about the history of a disease and the circumstances that preceded it"2. The communication between the doctor and patient should not be limited to obtaining relevant information to establish a diagnosis but it should focus on equal terms, on building a safe, trust environment that the patient is able to perform. The doctor has at hand3 at least two ways to achieve the case history in terms of verbal and nonverbal communication4, query and systematic and detailed observation of signs and symptoms.

The physician should ask the patient questions to an empathie manner and avoid administrative query. Empathy targets an intellectual understanding of patient's experiences while sympathy is identification with the patient at an emotional level. Empathy "indicates the ability to immerse yourself in the other's subjective world, to participate in the experience as far as verbal and nonverbal allow (...) to capture the personal significance of the words spoken to each other rather than to meet their intellectual content (alto-centric sensitivity) (...) and remaining perfectly independent at an emotional level"5. Empathy becomes a very important element in communication with a negative charge, which is why the doctor-patient communication occupies about the same position with the ability6 and according to The Kalamazoo Consensus Statement as essential elements must be included "...allowing the patient to complete an opening statement, eliciting concerns and establishing a rapport with the patient; using open and closed - ended questions to gather and clarify information, along with different listening techniques to solicit information; identifying and responding to the patient's personal situation, beliefs, and values; using language the patient can understand to explain the diagnosis and treatment plan; checking for patient understanding; encouraging patients to participate in decision and exploring the patient's willingness and ability to follow the care plan; and asking for other concerns the patient might have and discussing follow-up activities expected of the patient, before closing the visit."7 All these essential elements of doctor-patient communication, with each performed act of communication, according to participants in the act of communication and communication context, they come into contact with a number of variables8: doctor's characteristics (age, sex, personality type, ethnicity, communication skills) patient's characteristics (age, sex, education, income, health insurance, health status, personality and communication skills with the doctor), environmental features (health insurance system, health services). …

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