Healthcare Provider Communication Patterns during Consultations about Treating Localized Prostate Cancer.

Yolanda M Hyde, Barbara Germino, Merle Mishel, Richard L Street, Lenora Campbell, Dale Brashers, Thomas P Mccoy
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Abstract

Background: Disparities in mortality in prostate cancer may reflect differences in healthcare providers' communication.

Objective: This study examined physicians' communication with African American and Caucasian men when making decisions about treatment for localized prostate cancer to determine whether information-giving and partnership-building behaviors varied by the age, education level, and race of the patient.

Methods: The study was a secondary analysis of data from a larger study examining decisionmaking among men with prostate cancer. Verbatim transcripts of physician communication with 13 African American and 32 Caucasian patients were coded using a well-established scheme.

Results: Physicians tended to use information-giving and partnership-building behaviors more often with patients who were Caucasian, but this practice was tempered by the patient's age or education level.

Conclusion: Information-giving and partnership-building behaviors should be studied relative to patient outcomes, such as treatment adherence and satisfaction. Communication is a two-way interaction, and patients' perceptions should be included in future studies.

Practice implications: Biases, assumptions, and differential behavior toward patients who are older, minorities, or less educated must be addressed during all healthcare providers' socialization and education. All will benefit from their education in communication and partnership-building with patients.

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治疗局限性前列腺癌会诊期间医疗保健提供者的沟通模式。
背景:前列腺癌死亡率的差异可能反映了医疗服务提供者沟通的差异。目的:本研究考察了医生在决定局部前列腺癌治疗时与非裔美国人和白种人男性的沟通情况,以确定信息提供和伙伴关系建立行为是否因患者的年龄、教育水平和种族而异。方法:该研究是对一项大型研究数据的二次分析,该研究检查了前列腺癌患者的决策。医生与13名非裔美国人和32名白种人患者的逐字交流记录使用一个完善的方案进行编码。结果:医生倾向于对白种人患者更多地使用信息传递和建立伙伴关系的行为,但这种做法受到患者年龄或教育水平的影响。结论:应研究信息提供和伙伴关系建立行为与患者治疗依从性和满意度的关系。沟通是一种双向互动,在未来的研究中应考虑患者的感受。实践意义:在所有医疗保健提供者的社会化和教育过程中,必须解决对老年人、少数民族或受教育程度较低的患者的偏见、假设和差异行为。所有人都将受益于他们在与患者沟通和建立伙伴关系方面的教育。
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