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An evaluation of the impact of training Honduran health care providers in interpersonal communication

LORI DIPRETE BROWN, BÉRENGÈRE DE NEGRI, ORLANDO HERNANDEZ, LILIAN DOMINGUEZ, JULIE H SANCHACK, DEBRA ROTER
DOI: http://dx.doi.org/10.1093/intqhc/12.6.495 495-501 First published online: 1 December 2000

Abstract

Objective. To evaluate the impact of interpersonal communication (IPC) training on practice and patient satisfaction and to determine the acceptability of this training to providers in a developing country. Design. The study used a pre–post design with treatment and control groups. Data collection methods included interaction analysis of audio-taped clinical encounters, patient exit interviews, and a self-administered questionnaire for health providers. Study participants. Interaction analysis was based on an experimental group of 24 doctors and a control group of eight (with multiple observations for each provider). Exit interviews were carried out with 220 pre-test patients and 218 post-test patients. All 87 health providers who received training responded to the self-administered questionnaire. Intervention. A brief in-service training programme on interpersonal communications was presented in three half-day sessions; these focused on overall socio-emotional communication, problem solving skills and counselling. Main outcome measures and results. The IPC intervention was associated with more communication by trained providers (mean scores of 136.6 versus 94.4; P=0.0001), more positive talk (15.93 versus 7.99; P=0.001), less negative talk (0.11 versus 0.59; P=0.018), more emotional talk (15.7 versus 5.5; P=0.021), and more medical counselling (17.3 versus 11.3; P=0.026). Patients responded by communicating more (mean scores of 113.8 versus 79.6; P=0.011) and disclosing more medical information (54.7 versus 41.7; P=0.002). Patient satisfaction ratings were higher for providers who had received the training and providers reported training to be relevant and useful. Conclusions. Further validation of IPC skills and simplification of assessment methods are needed if IPC is to be an area for routine monitoring and quality improvement.