Nationwide survey of patients’ and doctors’ perceptions of what is needed in doctor - patient communication in a Southeast Asian context

Perception of phage therapy and research across selected professional and social groups in Poland

There is no doubt that in the last 15 years phage therapy has re-emerged from the shadow of antibiotics, from the perspective of both scientists and various patient advocacy groups. Despite some important progress, there is little to no data on phage therapy perceptions in key groups, i.e., patients and their relatives, physicians and anyone who could potentially become infected with antibiotic-resistant bacteria. To the best of our knowledge, with 1,098 collected questionnaires, this article constitutes the first large-scale analysis on phage therapy perceptions, interest and knowledge among ordinary people in a country with a long, internationally recognized, tradition of treating patients with phages. In addition to 36 general questions addressed to everyone (including lay people), representatives of the health care sector and science and research sector received individually selected questions. Further, each participant had a chance to take part in a short quiz (consisting of 12 questions) verifying their basic knowledge about bacteriophages, their history, biology and therapeutic connotations. Awareness of antibiotic resistance was very high (above 90%) but contradicted the low level of knowledge about associated risks (12%). Consciousness of phage therapy varied between 8.9% (people taking care of household chores as their primary activity) to 37.7% (people with higher education) and 39.7% (inhabitants of large cities) while the readiness to use such treatments was very high (84.4%) despite the need to pay for it. The level of awareness of bacteriophages and phage therapy was clearly correlated with the acceptance of this type of treatment and the social acceptance to allocate further funds for the development of phage research. Interestingly, physicians were quite reluctant to deepen their knowledge in the field of phage therapy with just over one third (37.5%) ready to do so. With the COVID-19 pandemic in the background, we also explored how the pandemic influenced the interest in experimental therapies in general, which makes this article a potential universal compendium on perceptions of experimental therapies in the coming years.

Dilemmas of care: Healthcare seeking behaviours and antibiotic use among women in rural communities in Nam Dinh Province, Vietnam

Antimicrobial resistance is a silent pandemic to cause an estimated ten million deaths by 2050. Self-medication with antibiotics in low- and middle-income countries has been identified as a driver of antibiotic resistance. Interventions targeting solely individual behaviour change around antibiotic practices are often unsuccessful as they fail to address socio-cultural and structural causes of the problem. Understanding the context of antibiotic use in communities will better inform interventions addressing the misuse and overuse of antibiotics. Vietnam faces a growing threat of antimicrobial resistance due to inappropriate use of antibiotics in the healthcare system, farming and food production, and in the community. To understand the roots of this problem, we conducted qualitative research in 2020, with one component focusing on the community. This included fifteen in-depth interviews with women and four months of participant observation in three districts in Nam Dinh Province to explore the healthcare seeking practices and perceptions of medicine and antibiotic use. We argue that even when participants understood antibiotic resistance and were willing to adjust their care practices with antibiotics, there were cultural and structural challenges demotivating changes. The participants faced what we term "dilemmas of care". For example, while public health messaging promoted appropriate antibiotic practices, the healthcare system did not provide a suitable environment to support appropriate use. Besides, the introduction of biomedicines into the long-standing traditional medical system caused confusions in community health practices, leading to issues such as poor adherence to treatment. At an individual level, participants faced challenges in accessing healthcare knowledge, adhering to social expectations surrounding care, and financial issues. We argue that the misuse of medicines and antibiotics in communities are responses to a deficient healthcare system and unequal access to quality healthcare.

Doctor-patient communication practices: A cross-sectional survey on Indian physicians

Background

Effective communication is a critical and fundamental element of a successful medical practice and exerts a substantial influence on patient contentment, adherence, and disease outcome. This study was planned to identify domains for improvement in doctor-patient communication to enhance good practices in the future.

Methods

A cross-sectional study was carried out involving 500 randomly selected samples of clinicians from government or private medical colleges across India. Data collection about current communication practices was carried out using google questionnaire forms and analysed.

Results

Among the practitioners, there were 315 males and 185 females. The average time spent on patients' consultation is 9.8 minutes. Nearly 80% of doctors do not introduce themselves to the patients, while half of the doctors consistently employ the patient's name throughout discussion. The majority (82.8%) of the doctors listen to the patients attentively and showed empathy and positive attitude towards them. The maximum number of the doctors (55%) check that they comprehend what the patient explains about the disease, explain the need of prescribed tests (78%), and inform the result of the examination to the patient (68.8%). Approximately half of the study participants did not discuss the advantages and disadvantages of given treatments, but 78% of them agreed to do so in the future. More than half of clinicians schedule patient interviews to break unpleasant news. The majority of the doctors (60.8%) communicate the future treatment strategy and prognosis to patients.

Conclusion

Overall, a positive attitude was observed; however, a few domains that needed improvements were discussing awareness of the disease, advantages and disadvantages of treatment, and patient satisfaction.

Breaking bad news: A mix methods study reporting the need for improving communication skills among doctors in Pakistan

BACKGROUND

Effective skills and training for physicians are essential for communicating difficult or distressing information, also known as breaking bad news (BBN). This study aimed to assess both the capacity and the practices of clinicians in Pakistan regarding BBN.

METHODS

A cross-sectional study was conducted involving 151 clinicians. Quantitative component used a structured questionnaire, while qualitative data were obtained through in-depth interviews with 13 medical educationists. The responses were analyzed using descriptive statistics and thematic analysis.

RESULTS

While most clinicians acknowledged their responsibility of delivering difficult news, only a small percentage had received formal training in BBN. Areas for improvement include time and interruption management, rapport building, and understanding the patients' point of view. Prognosis and treatment options were not consistently discussed. Limited importance is given to BBN in medical education.

DISCUSSION

Training in BBN will lead to improved patient and attendants' satisfaction, and empathetic support during difficult times.

Relationships between attitudes toward mental problems, doctor-patient relationships, and depression/anxiety levels in medical workers: A network analysis

OBJECTIVES

At present, the doctor-patient relationship is tense. The prevalence of negative emotions, such as depression and anxiety, among healthcare workers is increasing every year. Negative attitudes of medical workers toward mental problems may aggravate the doctor-patient conflict and psychological problems of medical workers. This study aims to explore the complex network relationships between outpatient medical workers' attitudes toward mental problems, doctor-patient relationships, and their depression/anxiety levels.

METHODS

A total of 578 outpatient medical staff from the Second Xiangya Hospital of Central South University (167 males, 411 females) completed questionnaires on their attitudes toward mental problems, doctor-patient relationships, and depression/anxiety symptoms. Network analysis was conducted separately to construct the "attitude towards mental problems-doctor-patient relationship network" and "depression-anxiety related network".

RESULTS

The edge between "M15 (insulting words)" and "D8 (waste time)" showed the strongest strength in the "attitude towards mental problems-doctor-patient relationship network", and "M15 (insulting words)" had the highest bridge strength in the network. For the analysis of emotional variables, "P1 (anhedonia)" showed the most obvious association with "D10 (communication difficulties)" in the doctor-patient relationship and "M2 (poor quality of life)" in the psychiatric attitudes, and "P1 (anhedonia)" was the key bridge symptom in the network.

CONCLUSIONS

The "insulting words" may be an intervention target for medical workers' attitudes toward mental problems. The "anhedonia" in depression is the potential symptom that needs to be treated. Intervention targeting these variables may be beneficial to improve the mental health level of medical workers and the doctor-patient relationship.