Patient Centred Communication

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Introduction
Patient centeredness has become a core concept in medical care in the past decades in reaction to the earlier doctor-centeredness or disease-centeredness [1]. This is reflected in world-wide stimulating programmes on patient centred care [2, 3].

Over the years many physicians emphasized that the patient is an important participant in the medical encounter and that he or she is to be seen from a bio psychosocial perspective [4-7]. Enid Balint was one of the first to state that patient-centred medicine is 'understanding the patient as a unique human being', referring to patient's individual needs and approach[8]. One of the most comprehensive definitions of patient centredness was made by Stewart et al. [9]. It consists of six …show more content…

Studies on patient centred communication show improved patient satisfaction and adherence, but also improved health outcomes, such as reduced level of discomfort and worries, and an increased mental health [11, 12]. In addition, fewer diagnostic tests and referrals, indicating an increased efficiency of care, are shown [12, 13]. A systematic review by Rathert [14] shows generally positive empirical relationships between patient centred care and health outcomes, others found mixed results regarding this relationship [15, …show more content…

In general, communication skills training has been proven to enhance performance in students [20] and in physicians [21, 22] and is therefore included in a large number of medical schools around the world. When training communication skills, it is important that the effect of training is measured with reliable and systematic instruments. Moreover, evidence shows that communication skills are best trained and retained when learners receive feedback on their performance immediately after the consultation with the patient (i.e. 'direct feedback') [21, 23]. Accordingly, a measurement instrument on patient centred communication should be valid, reliable, and able to provide immediate feedback when used in daily teaching practice, without the need to tape, transcribe and code the consultation first.
Over the years many different instruments to measure patient centeredness in the medical encounter have been proposed [10, 24-27]. These instruments are being used in many different contexts (classroom situation or clinical practice); use different formats (e.g. self observation by physician, patient questionnaire) and all have different validity and reliability properties. As a result, it is unclear which instruments to use in which

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