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Abstract
Objective: Hypertension is a common cardiovascular risk factor within the Iranian population, and this may be improved through changes in lifestyle. We aimed at improving hypertension outcomes and health literacy skills among hypertensive patients through communication skills training targeting health providers.
Methods: A randomized controlled trial method was used to enroll 35 health providers and 240 hypertensive patients attending community-based healthcare practices in the Mashhad, Iran. We evaluated the effects of a communication skills intervention for primary care providers compared to usual care controls, on the hypertension outcomes, patient medication adherence, and self-efficacy, assessed at baseline and post-intervention. Bivariate analysis and the regression model were used to assess whether the health provider training improved outcomes.
Results: Majority of participating patients were female (77.3%), less than high school education (80.3%), married (82.3%), and low income (82.3%), with mean age of 37 years. Following the educational intervention, there was a significant improvement (p < 0.05) in patient communication skills, self-efficacy, adherence to medication, and hypertension outcomes in the intervention compared to the control group.
Conclusions: The brief communication skills training for health care providers appear to be an efficient way to improve patient–provider communication skills and hypertension outcome among patients with uncontrolled BP.
Glossary
Content validity: The degree to which the items within a research instrument or measurement tool represent the universe of content for the concept being measured or the domain of a given behavior.
Content Validity. (n.d.) Mosby’s Medical Dictionary, 8th edition. (2009). Retrieved September 13 2017 from http://medical-dictionary.thefreedictionary.com/content+validity.
Content Validity. (n.d.) Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003). Retrieved September 13 2017 from http://medical-dictionary.thefreedictionary.com/content+validity.
Health literacy: A measure of a person’s ability to understand health-related information and make informed decisions about that information. Health literacy includes interpreting prescriptions and following self- care instructions.
Health literacy. (n.d.) Segen’s Medical Dictionary. (2011). Retrieved September 13 2017 from http://medical-dictionary.thefreedictionary.com/health+literacy.
Health literacy. (n.d.) Collins Dictionary of Medicine. (2004, 2005). Retrieved September 13 2017 from http://medical-dictionary.thefreedictionary.com/health+literacy.
Health care: The prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions.
Health care. (n.d.) American Heritage® Dictionary of the English Language, Fifth Edition. (2011). Retrieved September 13 2017 from http://www.thefreedictionary.com/health+care.
Reliability coefficients (Cronbach’s alpha): In statistics (classical test theory), Cronbach’s \alpha (alpha) is used as a (lower bound) estimate of the reliability of a psychometric test. It has been proposed that\alpha can be viewed as the expected correlation of two tests that measure the same construct. By using this definition, it is implicitly assumed that the average correlation of a set of items is an accurate estimate of the average correlation of all items that pertain to a certain construct. Cronbach’s \alpha is a function of the number of items in a test, the average covariance between item-pairs, and the variance of the total score.
Nunnally, J. C. (1978). Assessment of Reliability. In: Psychometric Theory (2nd ed.). New York: McGraw-Hill.
Revelle W Zinbarg R (2009). “Coefficients Alpha, Beta, Omega, and the glb: Commentson Sijtsma”. Psychometrika. 74 (1): 145–154. doi:10.1007/s11336-008-9102-z.
Self-efficacy: In social cognitive theory, a person’s belief in their ability to execute the behaviors necessary to achieve desired outcomes. In contrast to self-confidence, self-efficacy refers to beliefs about specific behaviors in specific situations. self-efficacy level the individual’s beliefs about their expected level of performance attainment, ranging from easy to difficult, such as a tennis player’s beliefs about the percentage of first serves they could successfully make in a match. self-efficacy strength the degree of certainty with which an individual expects to successfully execute a behavior.
Self efficacy. (n.d.) Medical Dictionary for the Health Professions and Nursing. (2012). Retrieved September 13 2017 from http://medical dictionary.thefreedictionary.com/Self+efficacy
Patient–provider communication: Roles for Speech-Language Pathologists and Other Health Care Professionals was written in an effort to bridge the differences between the perspectives of communication vulnerable patients and those who provide their health care services and develop health care policies that guide their care.
Blackstone, Sarah W, Beukelman, David R, Yorkston, Kathryn M, Patient–provider communication: Roles for speech-language pathologists and other health care professionals, Plural Publishing. 2015.
Effective patient–provider communication: It is the successful joint establishment of meaning wherein patients and health care providers exchange information, enabling patients to participate actively in their care from admission through discharge, and ensuring that the responsibilities of both patients and providers are understood. To be truly effective, communication requires a two-way process (expressive and receptive) in which messages are negotiated until the information is correctly understood by both parties. Successful communication takes place only when providers understand and integrate the information gleaned from patients, and when patients comprehend accurate, timely, complete, and unambiguous messages from providers in a way that enables them to participate responsibly in their care.
The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010. For more information about The Joint Commission, please visit http://www.jointcommission.org.
Provider’s communication: It is ability to gather information in order to facilitate accurate diagnosis, counsel appropriately, give therapeutic instructions, and establish caring relationships with patients.
Duffy FD, Gordon GH, Whelan G, et al. Assessing competence in communication and interpersonal skills: the Kalamazoo II report. Acad Med. 2004;79(6):495–507.
Bre´ dart A, Bouleuc C, Dolbeault S. Doctor-patient communication and satisfaction with care in oncology. Curr Opin Oncol. 2005;17(14):351–354.
These are the core clinical skills in the practice of medicine, with the ultimate goal of achieving the best outcome and patient satisfaction, which are essential for the effective delivery of health care.
Brinkman WB, Geraghty SR, Lanphear BP, et al. Effect of multisource feedback on resident communication skills and professionalism: a randomized controlled trial. Arch Pediatr Adolesc. 2007;161(1):44–49.
Acknowledgements
The author wishes to express her gratitude towards the vice president of research in Mashhad University of Medical Sciences, the chiefs of the health centers affiliated with the university and the esteemed patients.
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.
Ethical approval
The study was conducted after approval from the Mashhad University of Medical Sciences Research Committee (ethical number: IR.MUMS.REC.1392.125) with consideration of Helsinki Declaration in all phases of the study (World Medical A. Citation2015). The participants were informed orally and in writing about voluntary participation and the possibility of withdrawing at any time, with no consequences for their treatment and care. Confidential data treatment was guaranteed. Written informed consent was obtained from the participants.
Notes on contributors
Dr Seyedeh Belin Tavakoly Sany, PhD, is a postdoctoral research fellow in Department of Health Education and Health Promotion. Throughout her work history, she works in the areas of environmental health and safety. Her research focuses on evaluation of eco-toxicology and human health risk.
Dr Nooshin Peyman, PhD, is an associate professor in Department of Health Education and Health Promotion. Her research focuses on designing health literacy level-appropriate education. She works with the interdisciplinary team to evaluate the effect of health literacy on patient’s performance of self-care and medication safety.
Fatemeh Behzhad, Ms, is a Master of Health Education and Health Promotion, School of Health, under the advisement of Dr Nooshin Peyman. Her research focuses on designing health literacy level-appropriate education.
Dr Habibollah Esmaeily, PhD, is a professor in Department of Biostatistics and Epidemiology. He specializes in helping graduate students and researchers in psychology, education, economics and the social sciences with all aspects of statistical analysis.
Dr Ali Taghipoor, MD, PhD, is an associate professor in Department of Biostatistics and Epidemiology. He has extensive experience in clinical supervision, educational diagnosis and remediation, and acted as an educational consultant and coach for this project.
Professor Gordon Ferns, MD, PhD, is a professor in University of Brighton Falmer campus. He is specializes in medical education and metabolic medicine particularly related to cardiovascular risk and lipid metabolism.