Doctor and patient perceptions of the level of doctor explanation and quality of patient-doctor communication.

BACKGROUND: Several measures, such as the frequency, duration and ratio of quantitative communication behaviours, have been used to evaluate patient-doctor communication; however, these measures have several major problems. Therefore, we examined whether doctors' and patients' perceptions of the level of doctors' explanations provide a better measure for evaluating the quality of patient-doctor communication. METHODS: The subjects were 630 doctor-patient pairs in Japan. One-way anova and multiple logistic regression analysis were used for the data analysis. RESULTS: Of 190 doctors and 950 patients selected randomly, 126 doctors and 630 patients returned questionnaires (response rates, both 66.3%). We found the following. (i) With respect to the sufficiency of the doctor explanation, the 'patient-better' situation (i.e. when patients' evaluations were better than doctors' evaluations) had a more positive influence on patients' outcome measures than did other situations. (ii) The 'doctor better' situation (i.e. when doctors' evaluations were better than patients' evaluations) had the most negative influence on patient outcome measures compared with the other situations. (iii) The length of clinical experience, patient gender and guidance concerning a change in lifestyle were predictors of the doctor-better condition in the two types of doctor explanations. CONCLUSIONS: A measure that classifies patient-doctor pairs into doctor-better and the other situations might be effective for evaluating the quality of patient-doctor communication. As this is a new approach to evaluating patient-doctor communication, more studies are necessary to verify these findings.