Effective patient-provider communication (PPC) involves conveying sufficient information to a patient such that the treatment is agreed upon and implemented accurately. Furthermore, a patient must feel adequately involved in the treatment process. With the advent of the COVID-19 pandemic, many clinical visits were shifted online. Although telemedicine was successful in meeting pandemic-specific goals, such as lowering personal contact, it changes the communicative context. Both patients and providers get less input from body language (nonverbal communication) and rely more on verbal communication. Furthermore, the number of telemedicine visits conducted remains elevated over pre-pandemic levels. Much of what is known about effective PPC is derived from studies in in-person contexts, with little information available in virtual contexts. Given that even occasional lapses in optimal PPC can have severe effects on patient outcomes, it is essential to understand PPC in various settings to optimize patient outcomes in the long run. This study was a secondary data analysis of the UCF Student Health Services Patient Satisfaction Questionnaire. A total of 6645 survey results from January 2021 to November 2022 were analyzed to compare patient perceptions of PPC variables and overall satisfaction with the clinical visit. The results indicated that there was no statistically significant difference in overall satisfaction and PPC variables between telemedicine and in-person visits. However, the results revealed that different PPC variables contributed to overall satisfaction with telemedicine and in-person visits. Keywords: patient-provider communication, telemedicine, telehealth, COVID-19, patient satisfaction, college

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In spite of a decline in HIV incidence rates among African American women, they still bear the most significant disease burden among U.S. women. Findings from numerous studies indicate probable explanations for the disparity, such as the impact of poverty, limited healthcare access, low literacy, and living in areas with high HIV rates. Additionally, many study results provide insight regarding prevention strategies. However, the aim of this study is to explore African American women’s perceptions regarding what HIV prevention communication, if any, occurred with their reproductive health providers (RHPs). In this study, 20 African American women with unknown HIV status participated in face-to-face interviews designed to explore their perceptions about HIV prevention communication with their RHPs. Audio-taped interviews were transcribed verbatim and coded using NVivo10 software. Guided by constructs of the Health Belief Model, inductive and deductive coding yielded four key themes: (1) patients’ lack of expectation to receive information; (2) failure of RHPs to initiate and offer information; (3) patients’ desire to receive information; and (4) patients’ recommendations regarding their preferred methods to receive HIV prevention communication. Results indicated that RHPs missed prime opportunities to initiate and offer HIV prevention information during routine reproductive health visits with women at greatest risk. These findings and recommendations for practice will be useful when designing, implementing and evaluating HIV prevention patient education protocols. The recommendations provide strategies to help RHPs seize every opportunity to address HIV prevention with this highly vulnerable population.

Syftet med föreliggande studie var att beskriva vad personer med diabetes anser inverka på deras möjlighet och vilja att följa egenvårdsråd (patientperspektivet) och att beskriva omvård-nad som stöder följsamhet (sjukvårdsperspektivet). Studien har genomförts som en litteratur-studie. Det visade sig att alla krav för att hålla sjukdomen under kontroll innebär livsstilsför-ändringar, som kan vara så utmanande för patienten, att han kanske inte kan eller vill vidta dessa. Bristande kunskap om sjukdomen och om dess egenvårdskrav kan göra honom dåligt emotionellt anpassad till denna, det vill säga han har inte accepterat att han har sjukdomen och han vill inte låta dess egenvårdskrav inkräkta på det sociala livet. Detta ger honom för-sämrade möjligheter att hantera sjukdomen på ett bra sätt. Barriärer av olika slag kan uppstå mellan patient och vårdgivare. Det kan röra sig om en upplevd brist på information och stöd när diabetes diagnosticerats eller en känsla av att vara utsatt för läkarens eller sjuksköterskans stereotypa föreställningar och/eller att bli paternalistiskt behandlad. Till barriärer räknas även klinisk misskötsel, det vill säga att läkare/sjuksköterska inte följer vedertagna riktlinjer för be-handling.Vad som kan inverka positivt på följsamheten är patientens stöd av anhöriga eller andra i det sociala nätverket. Omvårdnad som stöder följsamhet visade sig varapatientundervisning, främst om den inriktades på att öka patientens självständighet genom att låta undervisningen pågå under en längre tid, så att patienten hinner integrera sin nya kunskap med det dagliga livet. Med eller utan patientundervisning tar det tid att bygga upp ett socialt stöd och ett förtroende mellan patient och vårdare.

Regular gynecological screenings are critical for women in promotion of health and preventing diseases like cervical cancer. Despite the importance of such examinations, many women fail to adhere to recommended screening protocols. As a result, women experience an increased disease risk. The current study examined the relationship between patient-provider communication quality, skill, and empathy on pelvic exam seeking behavior and exam-related anxiety and satisfaction. Additionally, negative self-concept, perceived poor genital self-image, and various elements of the socio-physical clinic environment were explored to better understand their impact on a women’s care seeking behavior. A total of 350 women 19 through 80 years of age completed a one time, 15-minute online survey regarding their gynecological care seeking behavior. Ordered logistic regression analysis revealed that when controlling for demographic variables and self-concept scores satisfaction was significantly impacted by the quality of provider communication. Specifically, higher quality of communication likely increases satisfaction by 12% (coef = .77; odds ratio= 1.19 at a p< .01). Avoidance was significantly associated with greater provider empathy indicating a 9% decrease in avoidance is likely as empathy scores go up (coef = -.19; odds ratio= 0.96 at a p< .01). When controlling for various demographic factors, self-concept scores and provider communication were not shown to be significantly associated with patient anxiety. These findings suggest that enhancing provider communication quality and empathy may improve satisfaction and lessen patient avoidance. Results also indicate that women who have a more positive evaluation of their genital self-image were more likely to feel greater satisfaction concerning gynecological care. Thematic analysis of open-ended essay questions revealed several themes among 3 main areas: 1). Clinician Communication (active listening, explanation, empathic communication, & pace), 2). Social Environment (hospitality& being relational), and 3). Physical Environment (Privacy, Aesthetics, & Sensate Variables). Detailed explanation, empathetic communication, and not rushing patients through procedures all emerged as important components that may guard against patient anxiety. Results suggest that distress related to gynecological care could be mitigated by easily modifiable improvements to the environment like increasing the temperature of the exam rooms, opting for less harsh lighting, providing a place to hang or set clothing, and more thoughtful placement of baby pictures. Results also suggest that improvements to modesty concerns within the exam room, like larger cloth draping and gowns, may significantly improve the patient experience.

Research shows that health disparities exist among patients of varying races, ethnicities, and cultures in the United States. Numerous studies have suggested that these disparities may be partly associated with physician-patient communication. The larger project that this thesis is a part of is a mixed-methods analysis of physician-patient communication across patient race, ethnicity, and culture. This thesis specifically excluded qualitative studies and focused on how such communication can affect health outcomes. Sixty-nine studies were identified and appraised for quality. Of these, only four associated physician-patient communication with the health outcomes of patients. These studies had inconsistent results, highlighting the gap in research exploring the association between communication, patient ethnicity, and health outcomes.

The increasing diversity of the United States creates a pressing public health need to investigate methods to increase the engagement, retention, and efficacy of mental health services for racial/ethnic minority (REM) youth. Evidence from the adult psychotherapy treatment literature suggests that enhancing therapist cultural competence leads to increases in client satisfaction, alliance, and retention (Constantine, 2002; Sodowsky, Kuo-Jackson, Richardson, & Corey, 1998; Worthington, Soth-McNett, & Moreno, 2007). However, this relationship has not been adequately explored in youth mental health services, due in part, to a lack of valid and reliable measurement. This research project included measure development and initial validation of the Youth Therapist Observational Cultural Competence Scale (YTOCCS) with the aim of creating an observer-rated measure of youth therapist cultural competence. The measure was developed from a review of the theoretical and empirical literature and integrated the surveyed opinions of practicing child therapists, caregivers of REM children involved in the mental health system, and experts in therapist cultural competence. The study used an extreme group design based on child-therapist alliance selecting 32 recordings of 8 unique child-therapist dyads. Three coders were trained using a standardized manual and independently double coded early treatment sessions from an effectiveness trial for individual child cognitive-behavioral therapy conducted in community clinics. The measure demonstrated good reliability as measured by intraclass correlation coefficient, adequate internal consistency, and evidence supported initial validity through demonstrated significant between-group differences. Future studies are warranted to refine the measure and to explore the factor structure of the measure.

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during pregnancy. There is a clear need to enhance patient-provider communication to develop relevant and targeted interventions to reduce excessive GWG. The current study used a mixed-methods approach to assess perspectives of both pregnant and postpartum women, and obstetric healthcare providers (HCPs’). Interviews with pregnant and postpartum women with overweight or obesity prior to pregnancy indicated deference to providers regarding GWG. However, many women indicated suboptimal receipt of GWG information, disagreement with the GWG guidelines, and disapproval of the restrictive weight ranges for women in higher BMI categories. Additionally, parity emerged as a salient topic for women, especially as related to weight retention between pregnancies. HCPs’ survey data suggest systemic barriers to patient-provider communication (e.g. time, training) could serve as targets for future interventions. In sum, maternal overweight and obesity, excessive GWG, and patient-provider interaction are crucial topics to address to improve maternal and fetal outcomes, and decrease healthcare costs.

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when delivering culturally appropriate diabetes care, so a focus on cultural knowledge, intercultural patient-provider communication skills, and cultural assessment were key to this case study. One pilot study was conducted to test the focus group questions with 3 diabetes providers (i.e., certified nurse diabetes educator [CDE], registered nutritionist, and dietitian) who help patients to self-manage their diabetes. The second pilot study was conducted with 5 African immigrant patients who had been diagnosed with Type 2 diabetes. The primary focus groups were conducted with 5 CDEs and 10 patients. The transcribed responses were analyzed and categorized to identify the 17 themes that emerged (9 from the CDEs and 8 from the patients). One implication for social change is that a patient-centered approach to patient-provider communication will mean better health outcomes. To ensure culturally appropriate patient-provider communication, a change in health care delivery is required to incorporate cultural constructs as part of diabetes care and education to accommodate various ethnic and racial groups.

Today over 1.1 million people are living with HIV/AIDS in the United States; over the last 4 decades mortality rates have decreased largely made in part because of advancement in awareness and treatment options. Treatment adherence has long been considered a vital component in decreasing HIV/AIDS related mortality and has proven to reduce the risk of transmission. However not all patients take their medicine as prescribed. This research study, sponsored by The North Central Texas HIV Planning Council explored how Patient and Provider communication impacted treatment adherence. By utilizing a mixed-methods approach survey data and semi-structured interviews were used to collect insights from both Patients and Providers. Data gleaned through the interview process provided a perspective that could not be captured by using quantitative methods alone. The results from this research yielded multiple themes related to patient and provider communication with recommendations as to how The North Central Texas HIV Planning Council could address treatment adherence, such as Providers focus on Patients perceived severity based on their understanding of disease and illness; that side-effects remain a concern for patients and should not be dismissed; and finally that the word AIDS is perceived to be more stigmatized and as such organizations providing HIV/AIDS related services should explore alternative names where the word AIDS in not included.