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Prof. Dr. E. Farin-Glattacker

Universitätsklinikum Freiburg

Abt. Qualitätsmanagement und Sozialmedizin

Engelbergerstr. 21

79106 Freiburg

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Communication competencies of the chronically ill with regard to the interaction with treatment providers (KoKoPa project)

Running time June 2011 – May 2014

Objective
The KoKoPa project continues the project "The patient- provider communication in the chronically ill..." (PaBeKo). The intervention conceived in the PaBeKo project is oriented towards treatment providers. In the context of the patient empowerment paradigm, however, this approach requires an additional intervention alignment that starts with the patients themselves and enables them to exert control over the patient-treatment-provider communication themselves to a reasonable degree. This approach is supported by empirical findings, which show that with communication training on the part of the patient, which is comparatively simple to conduct, the patient participation can be improved, while on the other hand, in the area of treatment-provider training, a great effort has to be made for small and not universally discernible effects.
 
Following patient interviews regarding competent communication behaviour in chronically ill patients (qualitative study 1), which serves to determine  the attitudes and subjective concepts that need to be considered for the further implementation of the study, by means of interaction and sequential analytical methods, a qualitative analysis of the effects of the patients' behavioural patterns shown in the patient-physician interaction will be conducted (qualitative study 2). With this sub-study, in terms of short-term endpoints, effective behavioural patterns should be identified and at the same time (together with literature findings), content-based foundations for the development of two questionnaires for self-assessment and assessment by others of the communication-based competences (KoKo questionnaire) should be created. The subsequent qualitative study 2 contains a cognitive pretest for the developed patient questionnaires. Quantitative study 1 serves to psychometrically test the questionnaire, before finally, in quantitative study 2 (=main study), the central research questions of the project are examined: Are the previously established hypotheses regarding effective (and in this respect to be described as "competent") patient behavioural patterns confirmed? How competently do patients with chronic diseases behave? What influence does the gender of patient and treatment provider have in this respect? The project concludes with the conception of patient training modules on communicative competencies.
 
Project Plan and Design
Qualitative study 1: Group interviews will be conducted with six patient focus groups and three treatment provider focus groups from rehabilitation centers.

Qualitative study 2: In the participating rehabilitation centers, a total of 36 admission dialogues between patients and physicians will be audio-taped. The evaluation of dialogues will ensue with the RIAS system and contains both an interaction analysis and a sequential analysis.

Qualitative study 3: The draft of the patient version of the KoKo questionnaires will be presented to 10 patients in the framework of a cognitive pretest in individual interviews.

Quantitative study 1: Relating to their respective physician admission dialogue, N=250 patients fill in the KoKo questionnaire (self-rating version). 

Quantitative study 2 (main study): Three measurement time points (beginning of rehab t0, end of rehab t1, 6 months after end of rehab t2) are realised; the sample size strived for at the first measurement time point amounts to N=720. As statistical procedures, structural equation models and regression analyses are implemented. In view of the multi-level structure of the data (patients are grouped according to rehabilitation centers), moreover, hierarchical linear models are to be applied.

Included in the study are patients with chronic back pain, chronic-ischemic heart disease or breast cancer. A total of approx. 25 rehabilitation centers are taking part in the project (see www.aqms.de, from 1.6.2011).

 

Conference/Congress contributions




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