Wong Hai Ming, Bridges Susan Margaret, McGrath Colman Patrick, Yiu Cynthia Kar Yung, Zayts Olga A, Au Terry Kit Fong
Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong.
Faculty of Education/Centre for the Enhancement of Teaching and Learning, The University of Hong Kong, Pokfulam, Hong Kong.
PLoS One. 2017 Jan 3;12(1):e0169059. doi: 10.1371/journal.pone.0169059. eCollection 2017.
Patients' perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient's perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver's perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients' demographic information and the caregiver's perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes 'disease / treatment', 'treatment procedure related instructions', 'preparation for examination', 'positive reinforcement / reassurance', and 'family / social history' from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme 'Positive reinforcement / reassurance': 'number of related words' (p = 0.002), 'number of related utterances' (p = 0.001), 'percentage of the related words in total number of words' (p = 0.005), 'percentage of the related utterances in total number of utterances' (p = 0.035) and 'percentage of time spent in total time duration' (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver's involvement, such as clinicians' mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study reveals the potential of the application of visual text analytics software in clinical consultations with implications for professional development regarding clinicians' communication skills for improving patients' clinical experiences and treatment satisfaction.
患者的感知满意度是优质医疗服务的关键绩效指标。研究发现良好的沟通能提高患者的感知满意度。本研究的目的是探讨在儿童牙科就诊期间,医患对话中出现的突出主题对护理人员感知的沟通质量的影响。收集并转录了香港菲腊牙科医院儿童牙科诊所62例患者的162段临床牙科咨询视频记录。使用16项牙科患者咨询技能反馈问卷记录患者的人口统计学信息以及护理人员对与临床医生沟通质量的感知。视觉文本分析(Leximancer™)显示,记录视频中的医患对话有五个突出主题,即“疾病/治疗”、“治疗程序相关说明”、“检查准备”、“积极强化/安慰”和“家庭/社会史”,通过主成分分析解释了本研究中概念词总方差的60.2%。在关于突出主题“积极强化/安慰”的五个变量中,沟通质量感知存在显著差异:“相关词汇数量”(p = 0.002)、“相关话语数量”(p = 0.001)、“相关词汇占总词汇数的百分比”(p = 0.005)、“相关话语占总话语数的百分比”(p = 0.035)以及“花费时间占总时长的百分比”(p = 0.023)。如果临床医生的对话中有更大比例通过使用相关关键词表现出积极强化和安慰,那么他们会被认为更以患者为中心且富有同理心。护理人员的参与,例如临床医生提及家长,也被视为对优质临床体验感知的关键因素。该研究揭示了视觉文本分析软件在临床咨询中的应用潜力,对临床医生沟通技能的专业发展具有启示意义,有助于改善患者的临床体验和治疗满意度。