title: Quality of doctor-patient communication through the eyes of the patient: variation according to the patient's educational level.
abstract: Good doctor-patient communication may lead to better compliance, higher patient satisfaction, and finally, better health. Although the social variance in how physicians and patients communicate is clearly demonstrated, little is known about what patients with different educational attainments actually prefer in doctor-patient communication. In this study we describe patients' perspective in doctor-patient communication according to their educational level, and to what extent these perspectives lean towards the expert opinion on doctor-patient communication. In a multi-center study (Belgium, The Netherlands, UK and Italy), focus group discussions were organised using videotaped medical consultations. A mixed methods approach was used to analyse the data. Firstly, a difference in perspective in communication style was found between the lower educated participants versus the middle and higher educated participants. Secondly, lower educated participants referred positively most to aspects related to the affective/emotional area of the medical consultation, followed by the task-oriented/problem-focused area. Middle and higher educated participants positively referred most to the task-oriented/problem-focused area. The competency of the physician was an important category of communication for all participants, independent of social background. The results indicate that the preferences of lower educated participants lean more towards the expert opinion in doctor-patient communication than the middle and higher educated participants. Patients' educational level seems to influence their perspective on communication style and should be taken into account by physicians. Further quantitative research is needed to confirm these results.
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Family Medicine and Primary Health Care, Ghent University Hospital - 6K3, De Pintelaan 185, 9000, Ghent, Belgium. karolien.aelbrecht@ugent.be.
authors.forename: Karolien
authors.initials: K
authors.lastname: Aelbrecht
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Rimondini
authors.affiliation: Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands.|Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Jozien
authors.initials: J
authors.lastname: Bensing
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Moretti
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Family Medicine and Primary Health Care, Ghent University Hospital - 6K3, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Sara
authors.initials: S
authors.lastname: Willems
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Mazzi
authors.affiliation: Health Sciences Research, Lancaster University, Lancaster, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Fletcher
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Family Medicine and Primary Health Care, Ghent University Hospital - 6K3, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Myriam
authors.initials: M
authors.lastname: Deveugele
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D004522:Educational Status; D005060:Europe; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014741:Video Recording
keywords: Communication; Doctor–patient communication; Educational level; Patients’ perspective; Quality