Abstract
Effective doctor–patient communication is essential for establishing a successful doctor–patient relationship and implementing high-quality health care. In this study, a novel urinary system-simulating physical model was designed and fabricated, and its content validity for improving doctor–patient communication was examined by conducting a randomized controlled trial in which this system was compared with photographs. A total of 240 inpatients were randomly selected and assigned to six doctors for treatment. After primary diagnosis and treatment had been determined, these patients were randomly divided into the experimental group and the control group. Patients in the experimental group participated in model-based doctor–patient communication, whereas control group patients received picture-based communication. Within 30 min after this communication, a Demographic Information Survey Scale and a Medical Interview Satisfaction Scale (MISS) were distributed to investigate patients’ demographic characteristics and their assessments of total satisfaction, distress relief, communication comfort, rapport, and compliance intent. The study results demonstrated that the individual groups were comparable with respect to demographic variables but that relative to patients in the picture-based communication group, patients in the model-based communication group had significantly higher total satisfaction scores and higher ratings for distress relief, communication comfort, rapport, and compliance intent. These results indicate that the physical model is more effective than the pictures at improving doctor–patient communication and patient outcomes. The application of the physical model in doctor–patient communication is helpful and valuable and therefore merits widespread clinical popularization.
Supplementary materials
Questionnaire investigation
Scale 1. Demographic Information Survey Scale
| 1. | Sex. | ∅ |
| ∅ | Male Female | ∅ |
| 2. | Age. | ∅ |
| ∅ | 18–32 33–47 48–62 | ≥63 |
| 3. | Level of education. | ∅ |
| ∅ | Less than middle school | Middle school to high school More than high school |
| 4. | The first diagnosis. | ∅ |
| ∅ | Renal failure Urolithiasis | Obstruction Tumor Other |
| 5. | First hospitalization or not. | ∅ |
| ∅ | First Not the first | ∅ |
Scale 2. The Medical Interview Satisfaction Scale (MISS)
| 1. | The doctor gave me a poor explanation of my illness. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 2. | The doctor told me what my illness is. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 3. | After talking to the doctor, I know how serious my illness is. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 4. | The doctor told me all I wanted to know about my illness. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 5. | I am not really certain how to follow the doctor’s advice. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 6. | After talking to the doctor, I have an idea of how long it will take for me to get cured from the illness | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 7. | The doctor seemed interested in me as a person. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 8. | The doctor seemed warm and friendly to me. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 9. | I felt this doctor did not treat me as an equal. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 10. | The doctor seemed to take my problems seriously. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 11. | I felt embarrassed while talking to the doctor. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 12. | I felt free to talk to this doctor about private matters. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 13. | The doctor gave me a chance to say what was really on my mind. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 14. | I really felt understood by my doctor. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 15. | The doctor did not allow me to say everything I had wanted to say about my problems. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 16. | The doctor did not really understand my reason for coming. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 17. | I would trust this doctor with my life. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 18. | I would hesitate to recommend this doctor to my friends. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 19. | The doctor seemed to know what he/she was doing. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 20. | After talking to the doctor, I feel much better about my problems. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 21. | The doctor has relieved my worries about my illness. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 22. | Talking to my doctor has not at all helped me be relieved of my worries about my illness. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 23. | The doctor has come up with a good plan for helping me. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 24. | The doctor’s visit has not at all helped me. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 25. | The doctor seemed to know what to do for my problem. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 26. | I expect that it will be easy for me to follow the doctor’s advice. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 27. | I intend to follow the doctor’s instructions. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 28. | It may be difficult for me to do exactly what the doctor has told me to do. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
| 29. | I am not sure the doctor’s treatment will be worth the trouble it will take. | |||
| ∅ | Very strongly agree | Strongly agree | Agree | Neutral |
| ∅ | Disagree | Strongly disagree | Very strongly disagree | ∅ |
Subscales
| MISS1 | Distress relief | Qs 1, 2, 3, 4, 6, 20, 21, 22, 23, 24, 25 |
| MISS2 | Communication comfort | Qs 5, 11, 15, 16 |
| MISS3 | Rapport | Qs 7, 8, 9, 10, 12, 13, 14, 17, 18, 19 |
| MISS3 | Compliance intent | Qs 26, 27, 28, 29 |
Acknowledgments
The authors wish to thank MingQi Fan for assistance with statistical analysis and RongHua Wu and YiRong Chen for participating in the study. The authors also gratefully acknowledge financial support from the Scientific and Technological Achievements Fund (2011XZH05, 2012XZH04) and the Clinical Research Fund of the Third Military Medical University of China (2008XLC15).
Disclosure
The authors report no conflicts of interest in this work.