General Versus Specialized Communication

Patient Provider Communication Today
The importance of the research topic (why is this study important?)
This research topic is important for a sundry of reasons. Communication between patients and providers arguably forms the basis of patient self-care. It is also foundational to the ability of patients to follow the instructions of providers regarding their care. This study, then, provides demonstrable data about the ability of healthcare providers to communicate effectively with patients. This topic is important because the efficacy of providers in this aspect of healthcare is the basis for patients’ ability to follow their directives.
This study is also important because it stratifies the nature of provider-patient care into two different realms. The first pertains to general communication. The second pertains to communication specific to a particular chronic disease, diabetes (Piette et al, 2003, p. 624). Categorizing provider communication into these codifications is necessary to determine the effect of such communication on certain long term afflictions and on general understanding of the healthcare process. Each of these areas of communication relates to the ability of patients to effect self-care. These two stratifications enable the researchers to determine what, if any, differences they produce on the self-care of patients. Also, chronic care issues such as diabetes contribute to high healthcare costs, which relates to this study’s importance.
Overall, this research topic is critical to determining ways to improve self-care. It acknowledges that self-care ideally stems from the provider. However, the basis of its implementation is the degree of communication between the provider and the patient.
The researcher’s interest and objectives (e.g. research questions, goals, hypotheses, etc.)
The interests and objectives of the researchers were multi-faceted. They hoped to ascertain the difference in the effects of general communication and that pertaining to diabetes. However, they wanted to differentiate these factors in regards to a diverse population. They specifically were interested in points of ethnic diversity, that pertaining to education, and that pertaining to type of health care system. The researchers wanted to find out how much differences in the characteristics of patients, providers, and healthcare systems affected the foregoing two types of characteristics. The second research question was predicated on determining the extent to which these variables influenced “diabetes patients’ self-care behaviors” (Piette et al, 2003, p. 624) . The researchers did not have any explicit hypotheses. However, they were fairly convinced that the two different types of communication examined in this study had different repercussions for how patients were able to effect self-care.
• Sampling strategy
The sampling strategy for this study was fairly straightforward. The researchers sought a variety of patients who had diabetes in the state of Virginia. They selected patients from one university based healthcare system, a county health care system, and from three VA health care systems. All of the participants were “identified as part of a study evaluating automated telephone assessments as an adjunct to diabetes management” (Piette et al, 2003, p. 624). The researchers simply used the patients who fit these criteria, although there were multiple points of exclusion. Patients had to be legal adults, speak either English or Spanish, and have a permanent residence. Other points of exclusion included factors such as if patients were afflicted with other fatal conditions, were mentally unstable, were looking to change healthcare systems soon, or had difficulty either seeing or hearing. Other than the aforementioned measures there were no other manifestations of sample strategy deployed by the authors of this study. The sample yielded a balance of Caucasian and non-Caucasian patients. This balance was also reflected in the different categories of health care systems which the researchers analyzed.
Research methodology
The most distinguishable feature about the research methodology was the incorporation of a cross-sectional telephone survey. This enabled the researchers to gauge the efficacy of both diabetes-specific communication and that pertaining to general communication. This survey instrument involved the Interpersonal Processes of Care (IPC) questionnaire, which consisted of 41 times and 14 subscales dependent on a 5-point Likert scale, to assess general communication (Piette et al, 2003, p. 625). The questions predominantly focused on the clarity of the provider as determined by the patient. Of particular emphasis in this instrument was the clarity of the provider when issuing instructions that were not specifically related to diabetes. The researchers designed their own questionnaire to obtain data regarding the effectiveness of provider communication specific to diabetes. Each question focused on highly specified areas of diabetes care management. They also pertained to education pertaining to this condition and to patient adherence. There was a significant difference in what was deployed for the diabetes-specific questions in that they all simply required yes or no responses. Thus, the researchers had to standardize the responses “to a 0-100 range, with higher numbers indicating more extensive diabetes-specific communication” (Piette et al, 2003, p. 626).
Summary of the most important study results
Perhaps the most significant of the studies results was the fact that patients from ethnic minority groups and with lower levels of income evaluated their communication as good as those with higher education levels who were not from historic minority groups. This result helped to elucidate some of the research questions previously identified. Specifically, they indicated that demographic factors pertaining to ethnicity, socio-economic status, and race are not necessarily germane to issues of patient compliance and provider communication. Nonetheless, the most revealing result of the study pertained to the correlation between general communication and that related to diabetes. In instances in which patients had a longstanding relationship with their primary care provider, they indicated that communication was better when that provider was issuing the majority of their care for diabetes. This fact is substantial because it elucidates the core of the comparison between general communication and that pertaining to diabetes. Primary care physicians are typically responsible for general communication. Thus, when patients are able to leverage a relationship for general communication for that related to diabetes, the efficacy of such communication is commendable.
Applicability of results (how can the results of this study be used)
The results of this study are useful for communication effectiveness in health care settings. They suggest that patient provider relationships are critical to implementing effectual communication as well as to improving patient compliance. They also imply that involvement of primary care physicians in even specialized areas such as chronic care management for conditions such as diabetes is beneficial. For specialists, the results of the study indicate that those who are able to form significant relationships with their patients are able to better communicate with them. Additionally, the results imply that true relationships between practitioners and patients may positively impact the issue of patient compliance.
References
Piette, J. Schillinger, D., Potter, M., Heilser, M. (2003). Dimensions of patient-provider communication and diabetes self-care in an ethnically diverse population. Journal of General Internal Medicine. 18, 624-633.