Interpersonal Skills 4 detailed studies Health Psychology

Smiling a lot can make people happy. Zuckerman et al (1981) divided males and females into three groups. 1.The first group saw a film of a pleasant scene. 2.The second group were shown a film of a neutral scene. 3.The third group were shown a nasty film.

Within each group 1.a third were asked to suppress their facial expressions, 2.a third were asked to exaggerate their facial expressions 3.and the other third were not asked to do anything apart from watching the film.

Results The people who exaggerated their facial expressions showed higher levels of arousal and reported stronger positive or negative emotional reactions, compared with the other two groups. So making patients smile will make them feel happier about themselves. Learning to suppress facial expressions at times of stress could reduce stress.

Savage and Armstrong (1990) Savage and Armstrong (1990) found that patients were more satisfied with a ‘directed consultation’ rather than a ‘sharing consultation’.

Savage and Armstrong (1990) Directed consultation – statements made such as “you are suffering from…”, “it is essential that you take this medication”, “you should be better in …. days”, “come and see me in …. days”. Sharing consultation – “what do you think that is wrong?”, “Would you like a prescription?”, “Are there any other problems?”, “When would you like to come and see me again?”

Savage and Armstrong (1990) 359 randomly selected patients – free to choose their doctor. 200 results used. 2 questionnaires – one immediately and one a week later. Results – overall a high level of satisfaction, but higher for directed group. Higher for ‘satisfaction with explanation of doctor’ and with ‘own understanding of the problem’. More likely to report that they had been ‘greatly helped’.

Mooney, K. M., 2001 Mooney, K. M., 2001, 'Predictors of patient satisfaction in an outpatient surgery clinic’. Plastic Surgical Nursing, 21, 3, 162-4

Aim To investigate which elements of the patient-practitioner relationship lead to satisfied patients.

Method A survey.

Participants An opportunity sample of 345 patients (96 per cent of those asked to participate) attending an out-patient plastic surgery clinic. Informed consent was obtained.

Procedure Following their visit to their doctor, the participants were asked to complete the Visit Specific Patient Satisfaction Questionnaire (VSQ-9), a self-report, nine- item questionnaire that has been tested previously as a valid measure of patient- practitioner relationships and can be completed in about two minutes.

Procedure The participants were required to evaluate items such as how long they waited to get an appointment, time spent waiting at the surgery before the doctor was seen, the explanation given about any procedures undergone, the technical skills (thoroughness, competence and carefulness) of the practitioner and the interpersonal skills (courtesy, sensitivity, friendliness etc.) of the practitioner on a 5-point scale ranging from poor to excellent.

Procedure The responses from each participant were then transferred linearly to a scale, with 100 corresponding to 'excellent' and 0 corresponding to 'poor'. Responses to the nine VSQ-9 items were then averaged to create a VSQ-9 score for each participant.

Results 60 per cent rated their overall level of satisfaction as excellent and 30 per cent as very good. The quality of interaction with the practitioner received the highest individual rating, while those concerned with the facilities and access to services were rated lower. The interpersonal skills of the doctor were found to contribute more to patient satisfaction than the technical skills of the doctor and were considered to be a better predictor of patient satisfaction.

Smucker, D. R., Konrad, T. R., Curtis, P., Carey, T. S., 1998, 'Practitioner self-confidence and patient outcomes in acute back pain', Archives of Family Medicine, 7, 223-8

Aim To investigate the extent to which practitioners' levels of self-confidence act as a predictor of outcome for patients with lower back pain.

Method A correlation, utilizing a questionnaire to measure self-confidence and attitudes and telephone interviews to measure patients' well-being.

Participants 189 doctors and chiropractors, randomly selected from licensing databases in North Carolina, USA, who regularly treated patients for lower back pain. Informed consent was obtained.

Procedure The medical practitioners were sent a postal questionnaire to complete. The questionnaire contained ten items such as, 'I lack the diagnostic knowledge and tools to treat someone with lower back pain', 'I know exactly what to do to treat someone with lower back pain' and 'I feel very comfortable treating people with lower back pain', which assessed their self-confidence (the first four items on the scale) and attitudes (the next four items on the scale) in dealing with patients with lower back pain.

Procedure The last two items dealt with knowledge of the progression from acute to chronic low back pain and patient satisfaction with treatment. The practitioners had to use a 5-point Likert scale (1 = strongly agree, 5 = strongly disagree) to record their level of agreement with each statement. The scores for the first four items were added together to generate a self-confidence score for each practitioner and those for the next four yielded an attitude score. The last two items were treated individually.

Procedure The medical practitioners were also asked to provide contact details of any patients who came to them for treatment for lower back pain and had not yet received any treatment. Additionally, all the patients had to own a telephone and be able to speak English. A total of 1633 patients were recruited and informed consent was obtained from them. The patients were telephoned immediately after their initial visit to their practitioner, and again after two, four, eight, 12 and 24 weeks or until they had fully recovered from this episode of lower back pain.

Procedure The length of time until they had returned to a level of functioning equal to that before the onset of the lower back pain was recorded. The practitioners' self-confidence scores were then compared with the length of time taken by the patients to return to the same level of functioning as prior to the lower back pain.

Results 179 (95 per cent) of the 189 practitioners sent the questionnaire returned it, and of these 162 (86 per cent doctors, 55 chiropractors) completed all ten items. A strong correlation was found between scores on the first four items (measuring self- confidence) and the next four items (measuring attitudes) for both doctors and chiropractors. The relationship between the item dealing with patient satisfaction and the self-confidence score was higher for the chiropractors than the doctors.

Results Despite differences in levels of self-confidence and attitudes among the health practitioners, there was no significant relationship for either of these factors with the length of time it took patients to recover functionality. Thus it is not possible to use a practitioner's level of self-confidence or attitude as an indicator of the speed of recovery from lower back pain.

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