Persuasive communication in medical decision-making during consultations with patients with limited health literacy in hospital-based palliative care

PATIENT EDUCATION AND COUNSELING

卷:105

Article

Geurts, Esther M. A.^1,2,3  Pittens, Carina A. C. M.²  Boland, Gudule⁴  van Dulmen, Sandra^1,5  Noordman, Janneke¹ 

[1] NIVEL Netherlands Inst Hlth Serv Res, Utrecht, Netherlands

[2] Vrije Univ Amsterdam, Athena Inst, Amsterdam, Netherlands

[3] Maastricht Univ, Dept Social Med, Maastricht, Netherlands

[4] Pharos, Dutch Ctr Expertise Hlth Dispar, Utrecht, Netherlands

[5] Radboud Univ Nijmegen, Dept Primary & Community Care, Nijmegen, Netherlands

关键词: Cancer;    Communication;    COPD;    Healthcare providers;    Limited health literacy;    Oncology;    Palliative care;    Patients;    Persuasion;    Shared decision-making;    Qualitative research;   

DOI  :  10.1016/j.pec.2021.08.022

来源: Elsevier

【 摘 要 】

Objective: Both patients in the palliative phase of their disease and patients with limited health literacy (LHL) have an increased risk of being influenced by healthcare providers (HCPs) when making decisions. This study aims to explore to what extent persuasive communication occurs during shared decision-making (SDM) by (1) providing an overview of persuasive communication behaviours relevant for medical decision making and (2) exemplifying these using real-life outpatient consultations. Methods: An exploratory qualitative design was applied: (1) brief literature review; (2) analysis of verbatim extracts from outpatient consultations and stimulated recall sessions with HCPs; and (3) stakeholder meetings. Results: 24 different persuasive communication behaviours were identified, which can be divided in seven categories: biased presentation of information, authoritative framing, probability framing, illusion of decisional control, normative framing, making assumptions and using emotions or feelings. Conclusions: Persuasive communication is multi-faceted in outpatient consultations. Although undesirable, it may prove useful in specific situations making it necessary to study the phenomenon more in depth and deepen our understanding of its mechanisms and impact. Practice implications: Awareness among HCPs about the use of persuasive communication needs to be created through training and education. Also, HCPs need help in providing balanced information. (C) 2021 Published by Elsevier B.V.

【 授权许可】

Free