Determinants of physicians' communication behaviour in disability assessments

Abstract

Purpose. Knowledge about the determinants of communication behaviour of physicians during face-to-face consultations with patients might increase our understanding of communication behaviour, and provide insight into how training might be able to change their communication behaviour. For physicians who conduct work disability assessment interviews, referred to as ‘social insurance physicians’, communication with patients is their most important instrument. Therefore, the aim of this study was to understand the determinants of communication behaviour of social insurance physicians, by modelling the following constructs of the Theory of Planned Behaviour: attitudes, social influence, self-efficacy, skills, barriers and intentions concerning their communication with claimants in medical disability assessments.

Method. Cross-sectional data were collected by means of questionnaires. Analyses were performed with the LISREL maximum likelihood estimation procedure.

Results. The results showed a well-fitting model in which attitudes had a significant and substantial direct effect on two intentions. Self-efficacy had a significant, but smaller direct effect on one intention.

Conclusions. Empirical support was found for a model that describes intentions of social insurance physicians, especially intentions to give information and to consider personal aspects. Attitudes were the main determinants of physicians' intentions and therefore these may be a promising focus of communication skills training.

Keywords:

• Communication
• disability assessment
• physicians
• insurance medicine
• Theory of Planned Behaviour

Acknowledgements

The authors thank Liesbeth Claassen, MSc, for her valuable advice and support regarding the LISREL analyses, and Marianne Berkhof, MSc, for her assistance in performing the factor analysis to prepare the data for this paper and for her comments on former versions of this paper.

Declaration of interest: This research project was funded by the Dutch ‘Stichting Instituut Gak’, a foundation that initialises and supports innovative projects in the Dutch welfare sector. In addition, support was obtained from the Dutch Institute of Employee Benefit Schemes (UWV). The authors declare that they have no conflict of interest.