Communication in health care
Communication in health care
The Dutch case
Good communication is essential in cure, care and prevention. Yet many health care professionals lack the necessary skills. They are not always aware of the positive and negative impact of their communication on the course and outcome of the consultation.
For patients good communication is an important aspect of the quality of care. As many western health care systems are changing from supply-driven into demand-driven, the interest in patient-doctor interaction is growing. There is also more attention for communication between professionals.
New methods for contact between care providers and patients are emerging and being examined within this research line, like e-consulting, group medical visits and individually tailored web-based interventions.
Patients’ needs for information, support and participation are at the centre in the communication in health care. NIVEL investigates how communication can provide solutions for these needs of specific patients’ group. Patients’ own responsibility with regard to compliance has to be reinforced by stimulating agreement between patient and care providers, by creating a better harmony between care providers and by patients’ empowerment. Explicit attention is paid to the elderly and the immigrants. In all the communication projects, NIVEL uses ICT and Internet more and more as instruments for collecting data or for carrying out interventions.
Health care professionals
On the one hand, there is a lot of evidence on the value of general communication skills for building a good doctor-patient relationship; on the other hand, less is known about how communication can be used for specific targets in the medical and nursing consultation The identification of success and failure factors of targeted communication strategies is still in its infancy. NIVEL’s research activities during the next years will focus on how health professionals communicate, which factors influence the communication and what the effects of intervention of the care providers are to improve communication. Recently, a new research programme has been developed to study the role of communication in placebo/nocebo-effects.
Databank Communication in Health Care
The Databank Communication in Health Care contains over 16000 video registrations of contacts between patients and nurses, medical specialists and general practitioners recorded in the Netherlands as well as in other countries. The databank reflects the changes in health care interactions over the last 25 years. At European level, the databank sets an example for international research on communication between doctor and patient. NIVEL has digitalised the complete video file to conserve the quality. The Databank Communication has already made many research projects possible. The research projects are used for different purposes: as a reflection for the involved professional groups and described in scientific articles and presented at international conferences. The research concerns among other things the balance between affective and instrumental communication, lifestyle recommendation, therapy compliance, the (new) health care system and the influence of patients’ legislation.
In 2001, together with several international partners, NIVEL founded EACH – the European Association for Communication in Healthcare. EACH wants to exchange experience in research on the communication between doctor and patient, to and increase knowledge and expertise in the field of research and education in the communication in health care. For this purpose, several international collaborative studies are being conducted by EACH members, e.g. the concordance study (the Netherlands, Italy, UK) and a study into the effectiveness of situational, cognitive behavioural feedback for patients with fibromyalgia (Norway and the Netherlands).