Conference proceeding
Theunissen,
N.C.M., De-Ridder, D.T.D, A.M. van Dulmen (2002) Observing patient-provider
interaction as guided by the self-regulatory model of illness. Accepted
for presentation at the International Conference on Communication in Healthcare,
Warwick, UK, 18-20 September 2002.
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Abstract
According to Leventhal’s Self-regulatory model of illness, patients’ ideas and action plans can play a critical factor in promoting adherence. Previous studies showed that ideas and action plans related to the way patients manage their disorders. However, physicians rarely discuss patients’ ideas or action plans. Many physicians seem unaware of its relevance for successful prescribing, and of the fairly widespread aversion to taking medicines. Patients do seldom articulate this aversion, and even when patients voice their concerns or beliefs these are often not explored. Furthermore, it is important to set specific goals instead of vague, non-quantitative goals, such as “do your best”. In addition, it is important that goals are set that are appropriate for the patient, which is not often reckoned with in daily practise.In this study GPs were trained to communicate about illness ideas or action plans of patients with essential hypertension. Three conditions were performed: (0) care-as-usual consultation; (1) discussing patient’s ideas about their disorder; or (2) discussing patient’s action plans in the management of their disorder. GPs’ and patients’ verbal and non-verbal communication behaviours during these 70 consultations were analysed, using e.g. the Roter Interaction Analysis System (RIAS), and a specially developed system to observe Communication about Illness Rrepresentations and Action Plans (CIRAP). In addition, patient filled in questionnaires assessing the quality of conversation from the patients’ perspective. Findings will be presented and implications for future research will be discussed.