Physician-patient communication about overactive bladder: Results of an observational sociolinguistic study

Overactive bladder (OAB) and urinary incontinence are common problems that have significant impact on quality of life (QOL). Less than half of sufferers seek help from their physicians; many who do are dissatisfied with treatment and their physicians' understanding of their problems. Little is...

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Published in:PloS one 2017-11, Vol.12 (11), p.e0186122-e0186122
Main Authors: Hahn, Steven R, Bradt, Pamela, Hewett, Kathleen A, Ng, Daniel B
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Bladder
Care and treatment
Communication
Consent
Diagnosis
Fecal incontinence
Glaucoma
Gynecology
Medical personnel
Medical research
Medicine and Health Sciences
Migraine
Nursing homes
Patients
People and Places
Pharmaceutical industry
Physician and patient
Physicians
Prescriptions
Quality of life
Researchers
Social isolation
Social Sciences
Studies
Telephone calls
Urinary bladder
Urinary incontinence
Urogenital system
Urology
Womens health
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Bradt, Pamela
Hewett, Kathleen A
Ng, Daniel B
description Overactive bladder (OAB) and urinary incontinence are common problems that have significant impact on quality of life (QOL). Less than half of sufferers seek help from their physicians; many who do are dissatisfied with treatment and their physicians' understanding of their problems. Little is known about the sociolinguistic characteristics of physician-patient communication about OAB in community practice. An IRB-approved observational sociolinguistic study of dialogues between patients with OAB and treating physicians was conducted. Study design included semi-structured post-visit interviews, post-visit questionnaires, and follow-up phone calls. Conversations were analyzed using techniques from interactional sociolinguistics. Communication was physician- rather than patient-centered. Physicians spoke the majority of words and 83% of questions were closed-ended. The impact of OAB on QOL and concerns about and adherence to treatment were infrequently addressed by physicians, who were poorly aligned with patients in their understanding. These topics were addressed more frequently when open-ended questions successfully eliciting elaborated responses were used in ask-tell-ask or ask-tell sequences. Clinical dialogue around OAB is physician-centered; topics critical to managing OAB are infrequently and inadequately addressed. The use of patient-centered communication is correlated with more discussion of critical topics, and thus, more effective management of OAB.
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These topics were addressed more frequently when open-ended questions successfully eliciting elaborated responses were used in ask-tell-ask or ask-tell sequences. Clinical dialogue around OAB is physician-centered; topics critical to managing OAB are infrequently and inadequately addressed. 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PB and DBN are employees of Astellas Pharma Global Development, Inc. the sponsors of the study and the development of the manuscript. KAH is an employee of Ogilvy CommonHealth Behavioral Insights, and thus was a paid consultant to Astellas Pharma Global Development, Inc. in connection with performing this research and with the development of this manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.</notes><notes>Conceptualization: SRH KAH DBN PB.Data curation: SRH KAH.Formal analysis: SRH KAH.Funding acquisition: SRH KAH DBN PB.Investigation: SRH KAH.Methodology: SRH KAH DBN PB.Project administration: SRH KAH DBN PB.Resources: SRH KAH.Supervision: SRH KAH DBN PB.Validation: SRH KAH.Visualization: SRH KAH DBN PB.Writing – original draft: SRH KAH DBN PB.Writing – review &amp; editing: SRH KAH DBN PB.</notes><abstract>Overactive bladder (OAB) and urinary incontinence are common problems that have significant impact on quality of life (QOL). Less than half of sufferers seek help from their physicians; many who do are dissatisfied with treatment and their physicians' understanding of their problems. Little is known about the sociolinguistic characteristics of physician-patient communication about OAB in community practice. An IRB-approved observational sociolinguistic study of dialogues between patients with OAB and treating physicians was conducted. Study design included semi-structured post-visit interviews, post-visit questionnaires, and follow-up phone calls. Conversations were analyzed using techniques from interactional sociolinguistics. Communication was physician- rather than patient-centered. Physicians spoke the majority of words and 83% of questions were closed-ended. The impact of OAB on QOL and concerns about and adherence to treatment were infrequently addressed by physicians, who were poorly aligned with patients in their understanding. These topics were addressed more frequently when open-ended questions successfully eliciting elaborated responses were used in ask-tell-ask or ask-tell sequences. Clinical dialogue around OAB is physician-centered; topics critical to managing OAB are infrequently and inadequately addressed. The use of patient-centered communication is correlated with more discussion of critical topics, and thus, more effective management of OAB.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29140974</pmid><doi>10.1371/journal.pone.0186122</doi><tpages>e0186122</tpages><oa>free_for_read</oa></addata></record>
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subjects Biology and Life Sciences
Bladder
Care and treatment
Communication
Consent
Diagnosis
Fecal incontinence
Glaucoma
Gynecology
Medical personnel
Medical research
Medicine and Health Sciences
Migraine
Nursing homes
Patients
People and Places
Pharmaceutical industry
Physician and patient
Physicians
Prescriptions
Quality of life
Researchers
Social isolation
Social Sciences
Studies
Telephone calls
Urinary bladder
Urinary incontinence
Urogenital system
Urology
Womens health
title Physician-patient communication about overactive bladder: Results of an observational sociolinguistic study
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