Adapting Behavioral Theories in Doctor- Patient Communication
Effective patient education is vital in healthcare for promoting better health behaviors and outcomes. "Teaching Patients with Low Literacy Skills" by Doak, Doak, & Root, 1996, stands as a valuable resource, offering guidance on communicating complex health information to patients with limited literacy skills. However, while the book outlines behavior change theories in chapter 2 that can be incredibly insightful, it's crucial to acknowledge the limitations in implementing these theories in the patient-doctor communication dynamic. This blog post delves into these theories and explores how doctors can practically apply them within the constraints of a clinical setting.
The book, authored by Doak, Doak, & Root, offers a wealth of knowledge for healthcare providers aiming to bridge the gap between health information and patient comprehension. However, the practical challenges doctors face in a typical clinical setting cannot be understated. Time constraints often limit the depth of discussions that doctors can have with patients about their beliefs and health behaviors. Transforming patient behavior can be a lengthy process, potentially requiring months of therapy or counseling – a luxury that isn't feasible in a clinical setting. Therefore, it becomes imperative to find ways to effectively apply these behavior change theories within the limited time available.
Behavior Change Theories in Patient Education
Before we delve into practical applications, let's briefly outline the behavior change theories mentioned in the book:
Health Belief Model: Focuses on patients' beliefs about health risks and the benefits of treatment.
Self-Efficacy Theory: Addresses the patient's belief in their ability to perform health-related actions.
Locus of Control Theory: Relates to whether patients feel in control of their health outcomes.
Cognitive Dissonance Theory: Involves the discomfort felt when behaviors contradict beliefs, which can motivate change.
Diffusion Theory: Concerns how health behaviors are adopted within a community or population.
Stages of Readiness Theory: Focuses on the patient's readiness to change health behaviors.
Adult Education: Emphasizes the characteristics of adult learners, particularly relevant for patients with low literacy skills.
Practical Application in a Clinical Setting
As previously mentioned, applying behavior change theories in a clinical setting would present a tremendous time burden on the clinician. However, there are some different communication techniques a clinician can use which are rooted in one of the behavioral theories above. According to Doak, Doak, & Root, these techniques could be used to enhance the communication between the patient and the doctor.
Setting Realistic Objectives:
Limit objectives to one or two for most patient instructions.
Ensure objectives reflect desired actions or behaviors from the intervention.
Focus on Behaviors and Skills:
Emphasize behaviors in content, rather than overwhelming patients with facts or principles.
Avoid complex physiological explanations for better patient understanding.
Presenting Context First (before giving new information):
State the purpose of new content information before presenting it.
Relate new information to the context of patients' lives.
Partitioning Complex Instructions:
Break down instructions into small, logical pieces.
Provide opportunities for small successes.
Making Instructions Interactive:
Encourage patient interaction with the instruction material.
Interaction enhances interest, recall, and long-term retention
"Teaching Patients with Low Literacy Skills" provides invaluable insights into behavior change theories that have been shown to improve patient education. Adapting these theories to the realities of a clinical setting requires creativity and resourcefulness. Doctors must strike a balance between the theoretical ideals outlined in the book and the constraints of their daily practice. Even though the book was written in 1996, the methods outlined still have not been widely accepted in the clinical environment due to these time constraints. Regardless of how the doctor communicates with the patient during the visit, most patients will forget almost everything (40-80% info forgotten immediately) that was mentioned during the visit. Doak, Doak, & Root mentions how the use of tape-recorders could be a solution to fill this gap in communication, however, the equipment and time it would take to set up these tapes posed another time constraint. Recent advancements in mobile technology could significantly reduce these time constraints.
By embracing these challenges and continuously seeking ways to improve patient-doctor communication, the digital age may offer new solutions for improving this communication gap. At Preventi, we are dedicated to leverage modern technology to bridge the patient-doctor communication gap. With our medical consultation recording tool, doctors can use behavior change theories to make strides in helping patients initiate and maintain healthy behaviors. Through systematic reminders, we emphasize the importance of continued education post-visit, fostering a greater understanding and adherence to health guidelines outlined by the doctor. In addition to providing the patient with their recorded medical consultation, we provide summaries, websites, and videos to further the their educational support.