Review of Related Literature

Research Article #1

How patients perceive the therapeutic communication skills of their general practitioners, and how that perception affects adherence: use of the TCom- skill GP scale in a specific geographical areaBaumann Michele, et al. BMC Health Services Research. 2008

Objective of the Study

to test the structure and test- retest reliability of a measure of how patients perceive the therapeutic communication skills of their doctors using the TCom-skill GP scale,

associated the scale with socio- demographic and health- related characteristics and adherence

Methodology

invited 393 people, aged 18-70 years, living in the same geographic area, for a 2- month period check- up at a preventive medical center in Northeastern France.

answer a self- administered questionnaire regarding TCom- skill GP comprising 15 items, with responses ranging from 0= never and 9= always

Methodology socio- demographic and health related

characteristics two validated questions on perceived

adherence: a. “Do you take the doses prescribed by your GP?” and b. “Do you take your medicine at the time recommended by your GP?”, were responses ranged from 0= never, 9- always

The number of consultations with a GP over the previous 3 months was also determined.

Results

Results showed that the average age of the respondents was 47 years (SD 14) and 50.4% were males

The TCom- skill GP score was one- dimensional and had high internal coherence (Cronbach α 0.92).

The reliability was good, with an intra- class correlation coefficient of 0.74 [0.66- 0.82]

Results

Univariate analysis and multiple regression model showed no association exist between the scale and sex, living alone, being employed, or the current employment

advancing age and the number of consultations with the GP during the previous 3 months yielded significant results on both analyses

between the scale and adherence, both the simple and multiple regression models showed strong associations between the two entities: the higher the TCom- skill score, the higher the adherence

The older the patient, the more likely he/ she would be adherent, but when the scale score would be considered in conjunction with this, the effect was already insignificant.

Conclusion

TCom- skill GP scale probably has value in the assessment of the quality of doctor- patient relationships and therapeutic communications.

Research Article #2

Association between patients’ recommendation of their GP and their evaluation of the GP

Vested, Peter et al. The Research Unit for General Practice, Institute of Public Health, University of Aarhus, Denmark. 2008

Objective of the Study

Search associations between 23 items in the Europep questionnaire which measures patient evaluation of general practice and the patients’ recommendation of their general practitioner

Methods

50, 191 patients, aged 18 years and above, and 690 GPs

GPs were divided into three groups:121 GPs distributed 130 questionnaires to consecutive patients, 391 GPs each distributed 100 questionnaires to consecutive patients and 191 GPs questionnaire were sent directly from DanPEP secretary to 150 patients.

The patients completed the questionnaires at home and returned them to the secretariat.

The EuroPEP questionnaire evaluates five domains namely: doctor- patient relationship, medical care, information and support, organization of services and accessibility

patients assessed their GPs in a five- point scale ranging from 1=poor, through 3= acceptable to 5= excellent. 2 and 4 had no response text. Also, patients could answer “not applicable/ relevant

A reference statement: “I can strongly recommend my GP to my friends” was answered with the following options: “strongly disagree”, “disagree”, “neither nor”, “agree”, and “strongly agree”, also “not applicable/ relevant

Results

There were 12 items that comprised the 10 most strongly associated items from both analyses :Six items from the doctor- patient

relationship Two of five items from medical care all items from information and support

organization of services No association with accessibility

Conclusion

patient would likely recommend their GP if the latter is emphatic, patient- oriented , informative and coordinating , competent or skilled

Lesser degree with accesibility