A single-blinded assessment of the effect of communication on psychological burden among oral cancer and oral potentially malignant disorder patients.

Objective: Lack of communication begets distress in patients and often hampers patient care. This study aims to assess the effect of communication on psychological distress among patients with Oral Cancer (OC) and Oral Potentially Malignant Disorder (OPMD). Methods: This is a prospective single-arm study wherein the psychological burden in terms of depression, anxiety, and stress was evaluated in 120 patients through Beck's anxiety inventory, Beck's depression inventory, and perceived stress scale respectively when they were diagnosed with OPMD or OC. All patients were then communicated and informed about their disease through an audiovisual mode and their queries were resolved. Their psychological status was re-evaluated 15 min after this communication. Results: Wilcoxon signed ranks test revealed a statistically significant decline in the scores of each domain for both OC and OPMD post communication. When OC and OPMD were compared, a statistically significant difference was observed for only depression and anxiety domains. Conclusion: Audiovisual communication by healthcare professionals reduces the psychological burden of patients and is immensely useful in providing tailored information to the patients and their families. It is recommended to initiate such communication set ups at the waiting area of all outpatient departments as a good practice, where detailed tailored information can be provided to the patients. Practice implications: The intervention used in this study was not time-consuming and expensive, and can be used by the clinicians or health professional in their clinical practice to improve upon their treatment outcome. However, it should not be considered as a substitute to treatment.

Outpatient clinic waiting time, provider communication styles and satisfaction with healthcare in India.

Purpose - The purpose of this paper is to evaluate the impact of extended waiting time on patients' perceptions of provider communication skills and in-clinic satisfaction, in three major cities in India. Design/methodology/approach - In total, 625 patients were interviewed. The multivariate general linear model was used to determine the causality and relationship between the independent and the dependent variable. A moderation analysis was also conducted to assess waiting time role as a potential moderator in doctor-patient communication. Findings - Results show that patients with higher waiting time were less satisfied with health care quality. Male patients and patients of male providers were more affected by extended waiting time than female patients and patients of female providers. The advanced regression analysis, however, suggests weak support for waiting time and its effect on overall satisfaction with clinic quality. Waiting time did not moderate the relationship between satisfaction with dominant communication style, and overall satisfaction at the outpatient clinic. Research limitations/implications - A cross-sectional study does not easily lend itself to explaining causality with certainty. Thus, sophisticated techniques, such as structural equation modelling may also be utilized to assess the influence of extended waiting time on satisfaction with healthcare at outpatient clinics. Practical implications - Findings are relevant for providers as the onus is on them to ensure patient satisfaction. They should initiate a workable waiting time assessment model at the operational level. Originality/value - There has been a relatively lesser focus on patient waiting time in patient-provider satisfaction studies. In India, this aspect is still vastly unexplored especially in the context of outpatient clinics. Gender wise pattern of patient satisfaction and waiting time is also missing in most studies.

Thyroid cytopathology reporting by the bethesda system: a two-year prospective study in an academic institution.

Background. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears. Aims. The objective of this study was to analyze the thyroid cytology smears by TBSRTC, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features, and to correlate the cytopathology with histopathology, wherever surgery was done. Materials and Methods. This was a prospective study of 225 fine needle aspirations (FNA) of thyroid nodules. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into nondiagnostic/unsatisfactory (ND/UNS), benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm/suspicious of a follicular neoplasm (FN/SFN), suspicious for malignancy (SFM), and malignant. Cytohistological correlation was done, when surgical material was available. Results. The distribution of various categories from 225 evaluated thyroid nodules was as follows: 7.2% ND/UNS, 80.0% benign, 4.9% AUS/FLUS, 2.2% FN, 3.5% SFM, and 2.2% malignant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Conclusions. TBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow-up FNA or surgery and also the extent of surgery.