The consequences of task delegation for the process of care: Female patients seem to benefit more.
The shift of tasks from primary care physicians to practice nurses and the continuing incease in the numbers of women involved in medical care may have consequences for the provision of health care and communication. The aim of the present study was to examine potential differences in female practice nurses' application of communication skills, practice guidelines, and motivational interviewing skills during consultations with female and male patients. Nineteen female practice nurses and their patients (n = 181) agreed to have their consultations videotaped (during 2010-2011). The videotaped consultations were rated using two validated instruments: the Maas-Global (to assess generic communication skills and practice guidelines) and the Behaviour Change Counselling Index (to assess motivational interviewing skills). Multilevel linear and logistic regression analyses were performed. Female practice nurses provided significantly more comprehensive information during consultations with female patients (p = .03) and talked more about management with male patients (p = .04). Furthermore, nurses applied motivational interviewing skills more clearly during consultations with female than with male patients (p < .01). The shift in tasks from primary care physicians toward practice nurses may have implications for clinical and patient outcomes as patients will no longer be counseled by male professionals. Conceivably, female patients are motivated more by nurses to change their behavior, while male patients receive more concrete management information or advice.
a Netherlands Institute for Health Services Research (NIVEL) , Utrecht , The Netherlands.
Janneke
J
Noordman
a Netherlands Institute for Health Services Research (NIVEL) , Utrecht , The Netherlands.|b Department of Primary and Community Care , Radboud University Medical Centre , Nijmegen , The Netherlands.|c Department of Health Science , Buskerud University College , Drammen , Norway.
Sandra
S
van Dulmen
D000328:Adult; D002983:Clinical Competence; D003142:Communication; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods*; D009722:Nurse Practitioners; D009723:Nurse-Patient Relations; D032024:Personnel Delegation / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses'; D011320:Primary Health Care; D012017:Referral and Consultation; D014741:Video Recording; D000078329:Workforce
Behavior; gender differences; knowledge