Determinants of physicians' communication behaviour in disability assessments.
OBJECTIVE
Knowledge about the determinants of communication behaviour of physicians during face-to-face consultations with patients might increase our understanding of communication behaviour, and provide insight into how training might be able to change their communication behaviour. For physicians who conduct work disability assessment interviews, referred to as 'social insurance physicians', communication with patients is their most important instrument. Therefore, the aim of this study was to understand the determinants of communication behaviour of social insurance physicians, by modelling the following constructs of the Theory of Planned Behaviour: attitudes, social influence, self-efficacy, skills, barriers and intentions concerning their communication with claimants in medical disability assessments.


METHODS
Cross-sectional data were collected by means of questionnaires. Analyses were performed with the LISREL maximum likelihood estimation procedure.


RESULTS
The results showed a well-fitting model in which attitudes had a significant and substantial direct effect on two intentions. Self-efficacy had a significant, but smaller direct effect on one intention.


CONCLUSIONS
Empirical support was found for a model that describes intentions of social insurance physicians, especially intentions to give information and to consider personal aspects. Attitudes were the main determinants of physicians' intentions and therefore these may be a promising focus of communication skills training.
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
H Jolanda
HJ
Van Rijssen
Antonius J M
AJ
Schellart
Johannes R
JR
Anema
Allard J
AJ
Van der Beek
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018868:Insurance, Disability; D033182:Intention; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009426:Netherlands; D010817:Physician-Patient Relations; D020377:Self Efficacy; D012919:Social Behavior; D014938:Work Capacity Evaluation