![]() Time distribution during the consultation It has also been possible to produce a residual confounding bias as not having measured other variables probably related, among them, the reason for consultation.įinally, this type of design of research studies does not allow establishing causal relationships between variables. Regarding scale of measurement, there are many questionnaires to measure patient-physician communication, but only two that have been validated in Spain, one is the CICAA scale, which has certainly demonstrated its validity for this purpose. 20 In our work, recording a minimum of 1 h is recommended, selecting multiple consultations of each professional and eliminating the first. Although this is the method most frequently used in video-recorded studies 20 is not exempt from possible selection bias, and may represent a subpopulation of more motivated professionals with a better communication profile.Īnother difficulty would be behaviour change whilst being recorded however it has been shown that this did not occur. The interobserver agreement of both was 0.94 (95% CI 0.89–0.96).īefore analysing the results, we must discuss possible limitations including voluntary sample selection. The intraobserver agreement by the intraclass correlation coefficient was 0.89 (95% CI 0.79–0.94) for the first observer and 0.91 (95% CI 0.84–0.95) for the second. The main researcher then selected 4 video recordings of each professional (excluding their first consultation and bureaucratic or internal consultations) at random, which were subsequently analysed by two people alien to the research and trained in the use and management of video recordings using the CICAA survey. They were videotaped during regular working hours. ![]() Andalusian physicians of family medicine participated, accredited as tutors and residents in their last year of training. This is a cross-sectional, multicentre study carried out in health centres in four Spanish provinces. This study is part of a larger project funded by the Andalusian Council and analyses the communicational profile of medical tutors and senior resident physicians of family and community medicine in four Andalusian cities. In particular we aim to understand whether better communication and a more patient-centred, participatory style consultation requires more time. In this study, we plan to discover how consultation length is distributed, as well as the factors associated with longer or shorter medical consultations in primary care. ![]() In Spain, a country where the increase in consultation time is a continuous demand, the relationship between consultation time and communication with patient has hardly been addressed. 6, 7 The importance of this finding would lie in the proven link between adequate communication and improvement of health. 5, 12, 13, 14Lastly, some authors find to communicate better with patients, a longer consultation is required. ![]() The gender of the professional also seems to have an influence women generally carry out longer consultations, which seems related to a more patient-centred experience, encouraging them to express themselves more. For some authors this does not increase consultation length, 9, 10 while for others it does. Other factors such as if the patient is accompanied, are not so clear. Several factors have been associated with longer consultations older professionals, female patients, increased patient participation, a greater number of reasons for consultations or type of problem (psychological or social). 1, 2 By contrast, a consultation lasting less than 10 min, in addition to increasing dissatisfaction, could cause malpractice and higher costs. 1, 4 A longer duration would allow a more comprehensive approach, exploring risk factors, prevention, and improving lifestyle. The Spanish Public Health System allocates 6 min on average to consultations, much less than the 10–15 min allocated in other European countries and the 20 min in North America and Canada. 1 In Spain there are precise limits (10 min minimum on average), that under no circumstances should be exceeded. 1, 2 The appropriate length of a consultation is a controversial issue. There are many different factors that influence interaction between patient and physician in medical practice, including the duration of the consultation.
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