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BackgroundHealth care interactions may require patients to share with a physician information they believe but is incorrect. While a key piece of physicians’ work is educating their patients, people’s concerns of being seen as uninformed or incompetent by physicians may lead them to think that sharing incorrect health beliefs comes with a penalty. We tested people’s perceptions of patients who share incorrect information and how these perceptions vary by the reasonableness of the belief and its centrality to the patient’s disease. DesignWe recruited 399 United States Prolific.co workers (357 retained after exclusions), 200 Prolific.co workers who reported having diabetes (139 after exclusions), and 244 primary care physicians (207 after exclusions). Participants read vignettes describing patients with type 2 diabetes sharing health beliefs that were central or peripheral to the management of diabetes. Beliefs included true and incorrect statements that were reasonable or unreasonable to believe. Participants rated how a doctor would perceive the patient, the patient’s ability to manage their disease, and the patient’s trust in doctors. ResultsParticipants rated patients who shared more unreasonable beliefs more negatively. There was an extra penalty for incorrect statements central to the patient’s diabetes management (sample 1). These results replicated for participants with type 2 diabetes (sample 2) and physician participants (sample 3). ConclusionsParticipants believed that patients who share incorrect information with their physicians will be penalized for their honesty. Physicians need to be educated on patients’ concerns so they can help patients disclose what may be most important for education. HighlightsUnderstanding how people think they will be perceived in a health care setting can help us understand what they may be wary to share with their physicians. People think that patients who share incorrect beliefs will be viewed negatively. Helping patients share incorrect beliefs can improve care.
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Applying ordered network analysis to video-recorded physician–nurse interactions to examine communication patterns associated with shared understanding in inpatient oncology care settings
ObjectivesThe main aim of this study was to demonstrate how ordered network analysis of video-recorded interactions combined with verbal response mode (VRM) coding (eg, edification, disclosure, reflection and interpretation) can uncover specific communication patterns that contribute to the development of shared understanding between physicians and nurses. The major hypothesis was that dyads that reached shared understanding would exhibit different sequential relationships between VRM codes compared with dyads that did not reach shared understanding. DesignObservational study design with the secondary analysis of video-recorded interactions. SettingThe study was conducted on two oncology units at a large Midwestern academic health care system in the USA. ParticipantsA total of 33 unique physician–nurse dyadic interactions were included in the analysis. Participants were the physicians and nurses involved in these interactions during patient care rounds. Primary and secondary outcome measuresThe primary outcome measure was the development of shared understanding between physicians and nurses, as determined by prior qualitative analysis. Secondary measures included the frequencies, orders and co-occurrences of VRM codes in the interactions. ResultsA Mann-Whitney U test showed that dyads that reached shared understanding (N=6) were statistically significantly different (U=148, p=0.00, r=0.93) from dyads that did not reach shared understanding (N=25) in terms of the sequential relationships between edification and disclosure, edification and advisement, as well as edification and questioning. Dyads that reached shared understanding engaged in more edification followed by disclosure, suggesting the importance of this communication pattern for reaching shared understanding. ConclusionsThis novel methodology demonstrates a robust approach to inform interventions that enhance physician–nurse communication. Further research could explore applying this approach in other healthcare settings and contexts.
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- Award ID(s):
- 2225240
- PAR ID:
- 10540978
- Publisher / Repository:
- BMJ Open
- Date Published:
- Journal Name:
- BMJ Open
- Volume:
- 14
- Issue:
- 6
- ISSN:
- 2044-6055
- Page Range / eLocation ID:
- e084653
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1136/bmjopen-2024-084653
