title: Doctor's responses to patients' concerns; an exploration of communication sequences in gynaecology.
abstract: OBJECTIVE
  Like other medical doctors, gynaecologists have difficulty attending to psychosocial issues and concerns. Communication training has proven to be effective in teaching them to spend more time on discussing these factors. However, whether or not they do this in response to patients' utterances remains unclear. The question is how gynaecologists respond to patients' concerns, whether or not they do this adequately and what the effects of a communication training are on the use of these communication sequences.
  
  
  METHODS
  Nineteen gynaecologists participated in a study which examined the effects of a three-day residential communication training. Before and after the training the gynaecologists videotaped series of consecutive outpatient visits. The communication during these visits was rated using the Roter Interaction Analysis System. Gynaecologists' responses to patients' concerns were examined at lag one, i.e. immediately following the patient's concern.
  
  
  RESULTS
  The most prevalent responses made by the gynaecologists were showing agreement and understanding and giving medical information. Affective responses were observed less. At postmeasurement, the gynaecologists responded neither more adequately nor inadequately to patients' concerns.
  
  
  CONCLUSIONS
  The gynaecologists did not respond in a very affective way to patients' concerns. However, the patients did not express many concerns. Future studies should focus on more prevalent communication behaviours and incorporate more lags.
authors.affiliation: NIVEL (Netherlands Institute of Health Services Research), P.O. Box 1568, 3500 BN Utrecht, The Netherlands. S.vandulmen@nivel.nl
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
authors.forename: Matthias
authors.initials: M
authors.lastname: Nübling
authors.forename: Wolf
authors.initials: W
authors.lastname: Langewitz
mesh_terms: D001294:Attitude to Health; D003142:Communication; D006176:Gynecology / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D010817:Physician-Patient Relations