title: Talking openly: using '6D cards' to facilitate holistic, patient-led communication.
abstract: OBJECTIVE
  The study investigates the effectiveness and acceptability of a communication tool (the '6D Cards') in facilitating holistic, patient-led communication in medical consultations.
  
  
  METHODS
  A between-subjects design was employed, whereby patients were randomly allocated to either use the '6D Cards' to initiate conversation or engage in the usual discussion processes.
  
  
  METHODS
  The study was carried out in an outpatient gynaecology clinic at a National Health Service (NHS) public hospital in a small town.
  
  
  METHODS
  Seventy-one patients were given the '6D Cards' and 69 control patients had a normal consultation. All participants were females aged 18 years or older. Participants were consenting patients visiting the clinic during the 3-month data collection period and included both first time and known patients.
  
  
  METHODS
  The Cards contain 40 issues across 6 dimensions ('6D') of health and were designed in consultation with clinical staff. The aim of the '6D Cards' is to give patients the option of discussing broader aspects of their presenting problem.
  
  
  METHODS
  The primary outcome measures were the number and types of issues raised by all patients, with and without the use of the cards and a short acceptability questionnaire, which was completed by all patients following their consultations.
  
  
  RESULTS
  /st> Patients using the cards raised significantly more issues than the control patients. Furthermore, patients raised overall no concerns about the acceptability of the cards.
  
  
  CONCLUSIONS
  The '6D Cards' could be a useful communication tool to enable patients to raise general concerns and issues during their consultations.
authors.affiliation: Playfield Institute (NHS Fife), Stratheden Hospital, Cupar, Fife KY15 5RR, UK. julia.neufeind@nhs.net
authors.forename: Julia
authors.initials: J
authors.lastname: Neufeind
authors.forename: Margaret
authors.initials: M
authors.lastname: Hannah
mesh_terms: D000293:Adolescent; D000328:Adult; D001296:Audiovisual Aids; D003142:Communication; D003695:Delivery of Health Care / Q000458:organization & administration; D004644:Emotions; D005260:Female; D015438:Health Behavior; D006694:Holistic Health; D006801:Humans; D007398:Interpersonal Relations; D008019:Life Style; D010358:Patient Participation / Q000379:methods*; D010817:Physician-Patient Relations; D055815:Young Adult