Social science & medicine
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Social science & medicine · Jan 1990
ReviewA model of empathic understanding and adherence to treatment regimens in practitioner-patient relationships.
Empathic understanding in practitioner relationships is postulated as necessary for adherence to therapeutic regimens. It is considered to be one of the most important practitioner relationship skills leading ultimately to patient health benefit. Research literature from a wide-range of health disciplines including personality theory, social psychology, psychotherapy, psycho-analysis, and practitioner-patient communication highlights the key role of empathic processes in personal health care. ⋯ The model addresses theoretical relationships between practitioners' empathic understanding, patients' knowledge of their illness and motivation to get better, adherence to treatment advice, and outcome. Recent work on the selection and training of medical and nursing staff in empathic skills is reviewed. A number of areas for future research are outlined including the effect of individual practitioner differences in the components of empathy, empathic compatibility in practitioner-patient dyads, fluctuations in levels of practitioner empathy during long-term care, specific practitioner behaviours which communicate empathy, and the relationship between factors of patient satisfaction and the perception of empathic understanding.
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Social science & medicine · Jan 1990
Comparative Study Clinical TrialApplication of the verbal autopsy during a clinical trial.
During a community-based treatment trial of onchocerciasis with ivermectin, verbal autopsies were employed as one method to assess the safety of the drug. The verbal autopsy questionnaire was designed to determine causes of death and mortality differentials in the treated population. During the 8 months of surveillance here reported, 25 individuals died, yet only 9 of these deaths were certified. ⋯ We found that in 80% of the adult deaths, the verbal autopsy and death certificate diagnoses of underlying cause of death agreed. The verbal autopsy was less accurate in diagnosing child deaths which we attribute to the design of the verbal autopsy (being to detect potential drug related deaths in adults) and to the delay between death and interview. We conclude that verbal autopsies are an important addition to surveillance systems in remote areas where the absence or inadequacy of health information systems does not allow a thorough follow-up of all subjects in drug studies.
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Social science & medicine · Jan 1990
Comparative StudyCollaborative practice and provider styles of delivering health care.
The delivery of primary health care involves complex interactive communication between the provider and patient. Describing the manner or style of this communication is important to more completely understand the delivery of primary health care. The purpose of this study was to examine provider's style of interaction with the patient and to compare the styles of nurse practitioners and physicians in joint practice. ⋯ Nurse practitioners, however, exhibited significantly more concern with psychosocial issues than physicians. Type of visit and visit history were also factors associated with provider style. Using the style dimension indices constructed for this study a typology of provider styles was developed.