The general relationship between the physician and the patient is one where communication is used to establish and maintain what will likely become a long-term partnership. Health communication research indicates that physicians who have apt communication skills in the patient-physician relationship develop a platform of trust behaviors. The physician communication behaviors perceived to elicit trust reported by patients are; comfort/caring, agency, competence, compassion and honesty. The objective of the research project was to assess patient perceptions of previously determined physician communication behaviors that predict patient trust through individual surveys (N=162) between foreign-born international medical graduates and American-born non-IMG resident physicians. Patients reported finding a difference in the exhibited communication behaviors between non-IMG and IMG resident physicians, with the exception of comfort/caring. A modified Trust Model guided the research and supported certain prior findings, claiming that effective communication cannot exist in the absence of a solid, trusting physician-patient relationship.

Throughout the process of receiving healthcare, a patient is affected by several factors and processes. To just name a few, how long a patient must wait at the clinic, how friendly the front desk is, how the nurse treats the patient, how effective the physician is with his or her communication, what the cost of a patient's healthcare is, and how clean the clinic is all affect the patient's experience. When clinics excel in these factors, it promotes a favorable relationship between the patient and the clinic. Patients trust the healthcare provider and desire to continue attending that clinic when they need to. Unfortunately, not every clinic can succeed in all these factors. The purpose of this study was to investigate the relative importance of these factors in a patient satisfaction survey at a university health center.

Nurse-Physician Communication Tools to Enhance use of Nursing Evidence-Based Protocols by Tochi Onyenwe Ubani MSN, Walden University, 2011 BSN, Chamberlain College of Nursing, 2009 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2015 In the current health care environment, consumers are demanding collaboration among clinicians even when traditional attitudes minimize nurses' input on the direction of clinical care. Compounding this problem is that nursing practices have not always been derived from randomized clinical trials, but instead from personal experiences. The purpose of this study was to explore the perceptions of nurses, physicians, and administrators on clinical protocols, including the use of nurse evidence-based practice (EBP) in practice settings. The study aimed at fostering clinical decisions anchored on shared knowledge, collegiate interactions, and emotions. A survey designed using nurse-physician communication tools was disseminated among a convenience sample of 50 nurses, 12 physicians, and 3 administrators. Content analysis was applied to survey responses. The findings revealed that effective communication between nurses, physicians, and administrators enhanced the use of nursing EBPs; these findings were used to generate the Nurse-Physician Communication Tools (NPCT) as a mechanism to enhance the translation of nursing EBP in clinical setting. The use of NPCT provided a mechanism for practice changes needed to improve clinical collaboration and enhance use of nursing EBPs in patient care.

OBJETIVOS Valorar la Implicación del Paciente en la Toma de Decisiones (IPTD) en las consultas de Atención Primaria (AP). MATERIAL Y MÉTODOS Estudio observacional de tipo descriptivo y multicéntrico realizado en Centros de Salud de AP. Un observador validado y entrenado en la escala CICAA-D analizó las videograbaciones de las consultas. RESULTADOS Se analizaron 638 encuentros clínicos; en 387(61%) no se apreció una IPTD. En 251(39%), se detectaron distintos grados de IPTD, de los cuales 161(64%) fueron etiquetados como "toma de decisiones participada" y en el resto 90(36%) como "toma de decisiones compartida". CONCLUSIÓN En la práctica observamos que la IPTD puede tener lugar a diferentes niveles: el "participado" (limitado a la discusión de una única opción de tratamiento) y el "compartido" (suele haber más de una opción). Las habilidades comunicativas que el médico emplea son mayores dependiendo del grado de implicación que tenga lugar en la consulta. / OBJECTIVES To explore patient participation in primary health care consultations. DESIGN Cross-sectional study. Setting. 97 general practices (GP). Patients. 658 patients attending their doctors for unselected reasons. Measurements. All the encounters were video-recorded, and were assessed by a rater using the CICAA-D instrument. After the consultation, GPs completed a questionnaire about biomedical and relational information. RESULTS Encounters were successfully video-recorded: 638. Out of these, only 90 interviews clearly showed patient participation. In other 161 interviews patient participation was considered possible. Consultations were less participatory when GPs declared they were more certain about the evolution of the problem and the usefulness of the tests prescribed to reach a diagnosis. CONCLUSIONS GPs ask patients for their opinion and promote discussion about the suggested plan very infrequently. Doctors should bear this in mind and should at least invite their patients to contribute their opinions when suggesting any action plans.