Communication skills in psychiatry residents-- how do they handle patient concerns? An application of sequence analysis to interviews with simulated patients

Psychotherapy and Psychosomatics
Michela RimondiniC Zimmermann

Abstract

The main focus of the training of psychiatrists is on diagnosis and treatment based on the traditional doctor-centered approach to the psychiatric interview. Less attention is given to the correct handling of patients' emotional concerns, which is crucial for the patient-physician relationship, but also for improving diagnostic and treatment decisions. The aim of this study is to assess psychiatrists' responses to patients' concerns and worries. 118 consultations, conducted by 10 residents in psychiatry with 20 simulated patients, have been coded using the Verona Psychiatric Interview Classification System. Lag1 sequential analysis and a multinomial logit regression analysis were performed to investigate the relationship between patients' expressions of concern and psychiatrists' subsequent interventions in terms of patient-centered skills. Compared to doctor-centered interventions, all patients' expressions of concern increased the probability of passive listening (odds ratios between 2.4 and 4.2). They also increased the occurrence of emotion focusing interventions (odds ratios between 3.3 and 1.7), which however remained rare (4% of residents' total responses). A small although significant increase in the likelihood of activ...Continue Reading

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Citations

Jul 25, 2009·Psychological Medicine·M RimondiniC Zimmermann
Dec 2, 2006·Health Communication·William Evans
Nov 4, 2008·The British Journal of Psychiatry : the Journal of Mental Science·Claudia GossChrista Zimmermann
Mar 7, 2012·International Journal of Speech-language Pathology·Tim Bressmann, Alice Eriks-Brophy
Dec 29, 2015·Journal of Psychiatric and Mental Health Nursing·E C M GriepS van Dulmen
May 29, 2010·Journal of Psychosocial Nursing and Mental Health Services·Michelle ClearyGarry Walter
Jun 26, 2013·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Maria A MazziJozien Bensing
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Jun 5, 2016·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Blake SanfordMaria Kokas
Aug 11, 2007·Patient Education and Counseling·Thijs FassaertJozien Bensing
Oct 8, 2017·Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry·Kamilla PedersenAnne Mette Morcke
Oct 17, 2009·Harvard Review of Psychiatry·Michelle ClearyJan Horsfall
Jul 21, 2010·Journal of Psychiatric Practice·Mary V Seeman
Sep 13, 2017·British Journal of Hospital Medicine·Prasanna de Silva
Apr 3, 2020·BMC Health Services Research·Yoon-Sook KimHyeran Kim

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