Determinants of patient-centered communication based on the views of physicians, students and patients: a qualitative study

Despite benefits of Patient -Centered Communication (PCC), there are problems in its implementation. Problems are related to characteristics of patients or health system; patterns of patient-physician interaction; or perspectives in defining PCC.  This study reports determinants of PCC from the viewpoint of faculty members, medical residents and interns; and patients and recommends tips for improving Patient-Physician Relationship (PPR).

In this qualitative content analysis study in 2018, in Tabriz University of Medical Sciences, data were gathered using focus groups (62 participants), semi-structured interviews (31 participants) and participatory observations, based on purposive until the saturation was achieved. Content was analyzed through a thematic, manifest summative analysis. Standards for methodological rigor were enhanced through different strategies.

The findings were classified at four categories matched with four core concepts of PCC: 1- Respect and dignity, 2- Information sharing, 3- Participation and 4- Collaboration. Sub-categories included: recognition of patients’ individuality; attention to patients’ needs; physicians’ personal characteristics; physicians’ communication competencies; patient-focused care; patients’ trust-supported attitude; physicians’ motivation; physicians’ working context; socio-cultural induction; organizational policies; and physicians’ professional responsibility.

Based on the findings of this qualitative study,  patient-centered communication can be characterized  by: honoring patients’ individuality ; paying attention to patients’ needs; focusing on physicians’ proper personal characteristics in continuing medical education; enhancing physicians’ communication competencies; institutionalization of patient-focused care; creating trust-supported attitude among patients ;  increasing physicians’ motivation;  regulating physicians’ working context; serious attention to social and cultural inductions; making supportive organizational policies; and evaluating physicians’ professional responsibilities.