This study was designed to investigate what course of action therapists and physicians report they would take in reconciling their conflicting duties to maintain confidentiality and protect third parties from harm in HIV-related situations. The physicians surveyed were licensed to practice medicine in Texas and board certified in Internal Medicine. The therapists surveyed were licensed professional counselors in Texas and members of one of three selected divisions within the Texas Counseling Association. A survey instrument developed by the researcher was mailed to 200 subjects randomly selected from each group.

There is a paucity of information about the various factors that influence the selection of primary care physicians. Also, the relative significance of these factors is not known, making it difficult to properly address ways to improve the information flow to patients when they select a primary care physician.

It is widely acknowledged that patients' emotional expressions and doctors' empathic responses play a key role in providing satisfactory healthcare services and improving doctor-patient relationships. While such affective aspect of medical consultation discourse has been studied in different fields of research with the focus of examining medical consultations that occur in face-to-face settings, this area is extremely under-researched in the field of linguistics, particularly in the non-western context and the online space. While online medical consultation (OMC) has ushered in the new era of e-communication around the beginning of this century, discourse-related research on OMC is still in its infancy and studies on the affective dimension of the OMC discourse in non-western sites are, to my best knowledge, apparently absent in the literature. As China has seen a significant increase in the use of OMC platforms, studying OMC discourse in the China context is not only important but vital. With the support of the Chinese government's "Internet Plus Healthcare" policy issued in 2018, the reliance on the online mode of medical consultation will be further strengthened and the future of OMC service in China will remain promising. In order to have a better understanding of the affective aspect of OMC discourse, this thesis explores the online interaction between doctors and e-patients (including patients' caregivers) from a poststructuralist discourse analysis perspective. The data for this study consists of 300 text-based one-to-one instant messaging OMC cases collected from three popular OMC websites used in China. Each OMC case contains e-patients' emotional expression and doctors' empathic response. The data are analysed by the approach of computer-mediated discourse analysis in terms of two dimensions: the textual dimension and the social practice dimension. At the textual level, the study identifies indirect negative emotional acts by e-patients and empathic acts by doctors (which constitute the affective practice); it also examines the interactional discursive features involved in the affective practice. At the social practice level, it explores the discursive positions of e-patients and doctors within the affective practice context and the power relations that are reflected in the identity positionings. This study finds that the text-based OMC affective practice is rich in various types of emotional expressions and different ways of manifesting empathy, some of which are not mentioned in studies on medial consultation discourse. The study also identifies positions that disrupt the traditional or stereotypical roles of doctor and patient. Besides, it presents dynamic power relations, which problematizes the idea that doctors are always the more powerful party and patients are always powerless in medical encounters. This study sheds light on the importance of examining the affective facet of medical consultation from a discourse analytic perspective, when it comes to identifying non-traditional positions and power relations in clinical communication. The study also provides the implication that e-healthcare platforms, especially those with an e-commercialised model for healthcare services, have potential to produce a type of neo-liberal discourse - the e-commercialised medical consultation discourse - in which patients and caregivers, who are acknowledged as the less powerful group in the traditional healthcare activities, are empowered and privileged

It is widely acknowledged that patients' emotional expressions and doctors' empathic responses play a key role in providing satisfactory healthcare services and improving doctor-patient relationships. While such affective aspect of medical consultation discourse has been studied in different fields of research with the focus of examining medical consultations that occur in face-to-face settings, this area is extremely under-researched in the field of linguistics, particularly in the non-western context and the online space. While online medical consultation (OMC) has ushered in the new era of e-communication around the beginning of this century, discourse-related research on OMC is still in its infancy and studies on the affective dimension of the OMC discourse in non-western sites are, to my best knowledge, apparently absent in the literature. As China has seen a significant increase in the use of OMC platforms, studying OMC discourse in the China context is not only important but vital. With the support of the Chinese government's "Internet Plus Healthcare" policy issued in 2018, the reliance on the online mode of medical consultation will be further strengthened and the future of OMC service in China will remain promising. In order to have a better understanding of the affective aspect of OMC discourse, this thesis explores the online interaction between doctors and e-patients (including patients' caregivers) from a poststructuralist discourse analysis perspective. The data for this study consists of 300 text-based one-to-one instant messaging OMC cases collected from three popular OMC websites used in China. Each OMC case contains e-patients' emotional expression and doctors' empathic response. The data are analysed by the approach of computer-mediated discourse analysis in terms of two dimensions: the textual dimension and the social practice dimension. At the textual level, the study identifies indirect negative emotional acts by e-patients and empathic acts by doctors (which constitute the affective practice); it also examines the interactional discursive features involved in the affective practice. At the social practice level, it explores the discursive positions of e-patients and doctors within the affective practice context and the power relations that are reflected in the identity positionings. This study finds that the text-based OMC affective practice is rich in various types of emotional expressions and different ways of manifesting empathy, some of which are not mentioned in studies on medial consultation discourse. The study also identifies positions that disrupt the traditional or stereotypical roles of doctor and patient. Besides, it presents dynamic power relations, which problematizes the idea that doctors are always the more powerful party and patients are always powerless in medical encounters. This study sheds light on the importance of examining the affective facet of medical consultation from a discourse analytic perspective, when it comes to identifying non-traditional positions and power relations in clinical communication. The study also provides the implication that e-healthcare platforms, especially those with an e-commercialised model for healthcare services, have potential to produce a type of neo-liberal discourse - the e-commercialised medical consultation discourse - in which patients and caregivers, who are acknowledged as the less powerful group in the traditional healthcare activities, are empowered and privileged

Patient dissatisfaction with the physician/patient relationship and medical care is well documented in both the lay press and the medical literature. This problem appears to stem from communication between physician and patient and is drawing increased attention from the communication discipline. Research conducted in interpersonal communication satisfaction theory provides a basis for this study of patient satisfaction with physician/patient communication and its relationship to the perceived quality of medical care. This paper reports two sets of interviews with a total of 108 respondents on the topic of physician/patient communication which resulted in the identification of nine salient issues which appeared to contribute strongly to patient communication satisfaction. These issues are explained in terms of three areas of communication theory: control, empathy and confirmation.

Indiana University-Purdue University Indianapolis (IUPUI) / In relationship-centered care, the relationship formed between physician and patient is critical to the creation of positive patient outcomes and patient satisfaction (Inui, 1996; Laine & Davidoff, 1996; Tresolini, 1994). Medical educators have increasingly utilized Objective Structured Clinical Examinations (OSCEs) to assess medical students’ abilities to utilize a relationship-centered approach in clinical interviewing. OSCEs, however, have recently come under scrutiny as critics contend that the overly scripted and standardized nature of the OSCE may not accurately reflect how medical students build and maintain relationships with patients. Although some studies have looked at how standardized patients help teach medical students interviewing skills, few studies have looked specifically at how the structured nature of the OSCE may influence relationship-building between standardized patients and medical students. Therefore, this study asks the question “How is relationship-centered care negotiated between standardized patients and medical students during a summative diagnostic OSCE?” Using an ethnographic methodology (Bochner & Ellis, 1996), data consists of an ethnographic field journal, transcripts of semi-structured interviews with SPs and medical students, and transcripts of headache and chronic cough videotaped scenarios. Using grounded theory (Strauss & Corbin, 1990, 1998), a back-and-forth thematic analysis was conducted in discovering the saturation of conceptual categories, linking relationships, and in critically comparing interpretive categorical concepts with relevant literature (Josselson & Leeblich, 1999). Findings suggest that standardized patients and medical students hold differing expectations for 1) diagnostic information gathering and 2) making personal connections upon entering a diagnostic summative OSCE. SPs “open up” both verbally and nonverbally when medical students “go beyond the checklist” by asking discrete diagnostic questions and when overtly trying to connect emotionally. Fourth year medical students, however, expect SPs to “open-up” during what they experience as a rushed, time-constrained, and overly structured “gaming” exercise which contradicts their own clinical experiences in being more improvisational during empathetic rapport building. Differences between SPs and medical students’ expectations and communication practices influence how they perform during summative diagnostic OSCEs. Findings may suggest the re-introduction of more relationship-focused OSCEs which positions SPs as proactive patients who reflexively co-teach students about the importance of making personal connections.

Thesis (MPH.) -- University of Limpopo, 2022 / Background: The demand of providing physiotherapy services have increased due to the population growth, an increase in number of aging people, accidents and rising cases of chronic diseases. A sudden increase in number of patients seen by physiotherapists is worthwhile for exploration since overcrowding is a concern in many public hospital facilities in South Africa. The purpose for this study was to profile physiotherapy patients and barriers to obtaining optimal physiotherapy services at Nkensani Hospital. Methodology: A quantitative, cross- sectional study was conducted for profiling of physiotherapy patients and barriers to obtaining optimal physiotherapy services at Nkensani Hospital. A simple random sampling was used to sample 398 patients who were receiving physiotherapy services at Nkhensani Hospital. Data was collected using a designed questionnaire that was administered by the researcher to patients who were receiving physiotherapy services at Nkhensani hospital between November 2020 to February 2021. Data was analysed using the statistical package for social sciences (SPSS) version 25. Results: Approximately 46.3% of the participants were males and 53.7% were females. Majority of the participants had Primary education at 55.5%, followed by those who did not attend school at all, tertiary and secondary education level at 23.1%, 11.3% and 10.1% respectively. Most of the participants were unemployed at 81.2%. The patients who required Physiotherapy services were diagnosed with conditions related to Orthopaedic or Musculoskeletal at 52%, followed by Neurological, geriatric, paediatric and cardio/respiratory conditions at 27%, 13%, 7%and 1% respectively.The barriers to obtaining optimal physiotherapy services by patients were lack of family support, lack of support from friends, the use of traditional medicines, the costs of hiring a caregiver, affordability of services and affordability of transport to hospital. Conclusion: The study reveals that orthopaedic or musculoskeletal conditions are the most prevalent conditions. It is recommended that adequate community health education and intervention services be provided and made affordable and accessible to rural communities. Key concepts: Barrier, Physiotherapy services, Physiotherapist, Physiotherapy patients, Optimal.

No description available.

No description available.

No description available.