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Patient's Expectations during Doctor Patient Communication and Doctors Perception about Patient's Expectations in a Tertiary Care Unit in Sri Lanka

Mudiyanse RM, Weerasinghe GSM, Piyasinghe MK, Jayasundara JMH

Understanding patient’s expectations and doctors perception about patient’s expectations during doctor patient communication is valuable in strengthening practices of patient centred communication in any society. A questionnaire with 26 items to evaluate communication expectations of patients was developed by literature survey, expert opinion and several small group discussions. The questionnaire was rephrased to develop a questionnaire to evaluate doctors perception about patient’s communication expectations. Some of the questions were coupled with an open-ended question to express free comments. Questionnaires were validated and pretested after ethical approval. Seven hundred clinic patient’s and 250 doctors were recruited. Close-ended questions were analysed by simple calculation of proportions. A single investigator did thematic analysis of the content of the response to open-ended questions using manual coding and results would be presented in a separate paper. Ninety-one doctors (36%) and 655 patients (93%) have responded. Majority of the patient’s expect social niceties like greeting, social smile, offering a seat, avoiding jargon, adequate time, paraphrasing and empathy. Majority of doctors seem to perceive these expectations of patients. Doctor centred attitudes like giving instructions rather than explanations, asking specific questions rather than open ended questions, doctors avoiding expression of their feelings and avoiding asking patients opinion were accepted by the majority of patients and doctors seems to perceive this attitude of patients. However majority of patients expect patient centred attitudes like expression of empathy and allowing patients to express opinion and doctors perceive these expectations of patients. Over 80% respondents supported decision-making by doctors (item 6), however similar percentage has demanded patient’s involvement in decision-making (item 17). Only 50% of doctors have realized this need. When a significant proportion of patients (29%) feel that doctors do not entertain patient’s point of view only half of the doctors perceive this opinion of patients.