1% of the final number away from dialogues was indeed frontstage, we.age. yourself linking new medical care employee to your patient, whenever you are twenty-eight% was basically backstage dialogues, the spot where the diligent was not physically with it.
The expression number achieved into the session transcripts showed that 65.8% regarding terms was basically spoken by medical professionals, than the 26.3% from the customers and you may seven.9% by the almost every other players (household members, almost every other experts). These types of efficiency underline the doc additionally the diligent depict brand new natural protagonists of the consultation, as appropriate, regardless if having a clearly preponderant role of former. Regarding a verbal attitude, most other professionals appeared to enjoy a secondary character in session form.
The brand new visit off diligent letter. dos.06, an excellent thirty five-year-old male, even offers united states an obvious example of BS dialogues as well as their perception to the patient’s experience:
Doctor step 1: most likely the acoustic window is going to be improved… (on patient:) Sir, is also excite your breathe particular heavens? Okay…similar to this…perfect! Now inhale usually! (For the college student:) Okay, now size they, this is basically the best section!
Doctor step 1: right here, thus far.. it’s a bit dilated. . . . we must find out if one’s heart presents an abnormal disperse right here, during the leftover ventricle
Comparing the two components of FS interactions, physician-patient contacts were largely predominant over others-patient interactions (t(44) = 12,985; p<0.001). Thus, despite the high number of actors within the clinical interview, doctors and patients undoubtedly remain the main protagonists of the consultation, with limited collateral activity. In this context, the word count analysis limited to FS interactions reiterates a preponderance of words spoken by the physician versus those by the patient (t(44) = 9,506; p<0.001): in the relationship between the two protagonists of the consultation, the doctor seems to have a greater weight and a wider narrative space.
Issues and responses
During the visit, physicians were far more prone than patients to ask questions (an average of 48.7 questions per consultation, compared to 7.26 questions for patients), both of the open and closed type (t(44) = 9,02; p<0.001 and t(44) = 11,25; p<0.001, respectively). Fig 1 shows results of word count and questions/answers comparison between doctors and patients.
Of note, doctors were more likely to ask closed rather than open question (t(44) = -11,90; p<0.001). Furthermore, doctors more often used relaunch rather than new questions (t(44) = 2.189; p = .03): physicians most often started from patients' information and previous answers to formulate their questions rather than proposing new issues bypassing their interlocutors' narratives. The following extract of consultation of patient 1.09 (a 51-year old female) provides an example of consultation focused on relaunch questions:
Patient: sure… i am just quite nicely in the same way that i are currently delivering bisoprolol and the cardiologist has grown it to three.75 due to the fact I left which have so it feeling of heaviness on my bust, more than anything else… many extrasystole
Patient: Well… the new extrasystoles have-been around for some ages and also the doc at my jobs place found it, during a regular go to, then i performed all assessments, this new Holter and the like, in addition they located I got thirteen,one hundred thousand each and every day with couplets and triplets and that i visited take drugs. The fresh bisoprolol, a bit but We got step 1.twenty five mg every single day… it appears to be for me every single day… following not too long ago I was… I believe merely my center one… including the cardiovascular system in my mouth… bottom bum bum… solid… following possibly the feeling stopped, often it went on…Simply speaking, I returned with the cardiologist together with extrasystoles had improved actually and therefore i improved the total amount of bisoprolol, i then performed the latest MRI that i delivered you a while in the past now I am very well… but every now and then I get a good heaviness and in breathing, difficulty in breathing deeply… maybe when i go shopping…
Furthermore, the number of Front Stage movements during the visit was significantly higher than the number of Back Stage (BS) dialogues (t(44) = 7,262; p<0
Patient: no-no no… despite regular criteria… possibly I’m at the office and so i feel like which… I’m not sure if it’s just a little stress or if perhaps it’s thanks to this… this fact of your own extrasystoles… I am not sure, as the I feel like this… a little tachycardia… something which sounds inside […]”.