Experimental research and analysis of doctor-patient relationships

Размещено на http://www.allbest.ru/

Размещено на http://www.allbest.ru/

Azerbaijan University of Languages

Experimental research and analysis of doctor-patient relationships

Muradova Kh.R.

Doctoral Candidate at the Department of Psychology

The article elucidates the significance of communication within the professional domain, underscoring its role in the human experience. Interpersonal communication entails the utilization of communicative, interactive, and perceptual facets, with the pivotal element for successful communication residing in the cultivation of the empathetic sentiment. The article explicitly addresses the degree of empathy in the communication practices of physicians, delving into its role and import. It furnishes insights into the influence and consequences of communication in doctorpatient relationships, including an examination of character typologies. The article accentuates the relevance of communication in the professional lives of physicians, scrutinizing the articulateness of shared communicative values, the proficiency in communicative techniques contingent on self-regard, and the assimilation of communicative components into their medical practice. Moreover, the research investigates the degree to which communicative content is infused into the professional medical undertakings of a cohort of 100 physicians, establishing metrics predicated on professional communicative acumen and developmental benchmarks aligned with self-esteem. The research scrutinizes the level of empathy competencies among physicians, exploring their correlation with work experience. Additionally, the article categorizes and characterizes physicians based on personality types, analyzing their distribution relative to gender and professional tenure. A statistical analysis is conducted to ascertain the statistical linkage among medical experience, personality types, and empathy levels. The article concludes by contemplating the determinants influencing patients' selection of physicians and the dynamics of the patient-physician relationship as delineated by survey outcomes.

Key words: communication proficiency, social psychology, interpersonal communication, doctor-patient relationships.

Експериментальне дослідження та аналіз відносин лікар - пацієнт

У статті з'ясовується значення спілкування в професійній сфері, підкреслюється його роль у людському досвіді. Міжособистісне спілкування передбачає використання комунікативних, інтерактивних і перцептивних аспектів, причому основним елементом успішного спілкування є культивування емпатичного почуття. У статті чітко розглядається ступінь емпатії в практиках спілкування лікарів із заглибленням у її роль і значення. Це дає уявлення про вплив і наслідки спілкування у стосунках між лікарем і пацієнтом, включно з вивченням типології характеру. У статті наголошується на актуальності спілкування в професійному житті лікарів, досліджується сформульованість спільних комунікативних цінностей, володіння комунікативними техніками, що залежать від самооцінки, і засвоєння комунікативних компонентів у їхній медичній практиці. Крім того, дослідження вивчає ступінь, до якого комунікативний зміст проникає в професійні медичні заходи когорти зі 100 лікарів, встановлюючи показники, засновані на професійній комунікативній кмітливості й орієнтирах розвитку, узгоджених із самооцінкою. Дослідження ретельно вивчає рівень емпатійних компетенцій серед лікарів, досліджуючи їх кореляцію з досвідом роботи. Крім того, у статті класифіковано й охарактеризовано лікарів на основі типів особистості, здійснено аналіз їх розподілу відносно статі та професійної зайнятості. Проводиться статистичний аналіз, щоб з'ясувати статистичний зв'язок між медичним досвідом, типами особистості та рівнями емпатії. Стаття завершується розглядом детермінант, що впливають на вибір лікарів пацієнтами, і динаміки відносин між пацієнтом і лікарем, визначених результатами опитування.

Ключові слова: комунікативні навички, соціальна психологія, міжособистісна комунікація, стосунки лікар - пацієнт.

Introduction

In the realm of human health, cognitive, affective, and behavioral dimensions assume paramount significance, exerting a profound impact on physiological functions. The unequivocal interconnection between psychology and health, alongside the repercussions of socio- psychological determinants on an individual's health and convalescence, constitutes an established verity. In doctor-patient interactions, the inquiry should transcend mere biological etiologies of ailments, encompassing the patient's disposition, their attitude toward the malady, the ambient milieu, and interpersonally-oriented affiliations. Therefore, the assimilation of socio- psychological erudition and the scrutiny of this domain by psychologists are imperative.

Social psychology scrutinizes interpersonal relationships across various categories, with communication standing as a pivotal category. Given that communication is an inseparable facet of an individual's social existence and societal requisites, investigating its significance in doctorpatient relationships emerges as a contemporary and pivotal pursuit.

Communication, construed as a process that contributes to the establishment and evolution of relationships among individuals, holds sway over facets such as information exchange, reciprocal influence, and mutual comprehension and perception within social psychology. Inadequate information about a patient's ailment frequently begets emotional turmoil, anxiety, and perturbation. Consequently, patients frequently turn to virtual social networks, acquaintances, kindred, and diverse online platforms. Patients seek information regarding the medications prescribed by doctors and their corresponding directives on online platforms. The lack of faith in a doctor, ineffectual communication, and the failure to forge apt relationships and communication channels contribute to a schism between doctors and patients.

A doctor's communicative adeptness constitutes a segment of their psychological preparedness, functioning as a subsystem that contributes to the self-regulation of discrete constituents within a comprehensive system [6]. Communicative adeptness entails the amalgamation of knowledge, skills, and attitudes, fostering the formation of the subject's self [4, p. 173]. The initiation of communication plays an indispensable role in shaping an individual's relationship with themselves. Interpersonal relationships germinate primarily within the family unit, subsequently transposing to other societal cohorts. Via communication and engagement within these cohorts, an individual develops their relationship with themselves. Hence, communicative adeptness is an indispensable determinant in a doctor's professional undertakings, fostering the amalgamation of knowledge, skills, and attitudes and the formation of the doctor's relationship with themselves.

Degree of problem elaboration - While ideas about doctor-patient relationships are extensively explored in Azerbaijan, there has not been an independent study on the social- psychological analysis of communication skills in medical practice in the country. Researchers such as Swastika Chandra [9], Masoud Mohammadnezhad [9], Paul Ward [9], Oliver Ommen [7], Qing Wu [8], A.S. Bayramov [1], A.A. Alizadeh [1], N.V. Ismayilov [3], and F.N. Ismayilov [3] have touched upon this topic in their works but have not conducted an in-depth investigation on the specific characteristics of communicative competence in this professional context in Azerbaijan.

The article explores the historical manifestations of the formation of physicianpatient relationships, the personal qualities of physicians, communication psychology, social- psychological approaches, and the social- psychological analysis of the physician's approach to patients in Azerbaijan and several European countries. Taking all this into consideration, the independent investigation of the topics mentioned above under specific headings is of great importance.

Purpose and Objectives: The primary purpose of the research is to analyze the impact of communication on the medical process between physicians and patients. Additionally, it aims to determine the extent to which physicians utilize communicative competence and empathy in their professional activities and identify the reasons behind it. Considering the uniqueness of the topic, the objectives include identifying various factors influencing physician-patient relationships, using specific terms related to the subject, explaining the role of the physician's personal qualities, and exploring the role of Azerbaijan and the world in the history of physician-patient relationships.

Methods: Comparative analysis methodology and, generally, analytical research methods were employed during the research. Depending on the set objectives, survey questionnaires among physicians and patients, the "Diagnostic of Empathy Skills" test [5], the "Communicative Competence in Medical Practice" methodology, and C. Jung's "Character Types" [6] methodology were utilized. The results were correlated, and statistical analysis was conducted using the SPSS program.

Main section

Professionalism and Ethical-Moral Qualities in the Medical Profession

The medical profession has always been a field of constant relevance and importance, consistently remaining at the center of attention. Renowned physician and scholar Zarifa Aliyeva remarked on the medical profession: “A physician should not distance themselves from people; they should not be indifferent or self-centered [4, p. 1]”. The personal qualities of a physician have always been at the forefront of professional activity. In the modern era, with patients having the ability to choose their physicians and a wide range of choices, the personal qualities of physicians become even more crucial. As people increasingly opt for healthcare services in other cities or countries and utilize virtual healthcare, artificial intelligence, and social networks, the number of physicians they come into contact with has also increased. Naturally, maintaining professionalism in medical practice has remained a fundamental factor in every era, but the number of professional physicians is also significant. Therefore, alongside professional expertise, developing communicative skills and being active on social networks have become essential requirements of the present and future.

Oliver Ommen [7] and his colleagues, using logistic regression models in their research, identified correlations between emotional support, information support, sharing decisionmaking, age, and socio-economic status. The lack of communicative competence in physicians can have a negative impact on their relationship with patients. Therefore, medical support should not only be biomedically oriented but also socio- psychological.

Certainly, a physician must rely on the knowledge, skills, and competencies relevant to their profession and undergo advanced medical education. Moreover, combining the positive moral qualities of a physician with their knowledge, skills, and competencies is crucial for implementing them in professional activities. When establishing communication with a patient, the physician must earn the trust of the other party to obtain necessary information. Qing Wu [8] noted in their research that a physician's sense of empathy directly and indirectly affects relationships with patients, and the physician's kindness and benevolence contribute to the development of mutual relationships.

In addition, a physician's communicative competence should address not only the cognitive level but also emotional and behavioral levels. Alongside providing information about the patient's illness, establishing empathy with them is crucial. It is essential to anticipate the patient's emotions and reactions to such information in advance and develop corresponding behavioral strategies. For instance, a physician should guide a patient facing stressful situations related to their illness on how to cope with stress. Acquiring the necessary knowledge, skills, and competencies is crucial for a physician to establish proper communication with patients, maintain and develop that communication.

Communicative Competence in Professional Activities Among Physicians

For this purpose, a survey questionnaire was utilized in the research related to the topic, assessing the empathy skills of physicians and patients, measuring the communicative competence among physicians in professional activities, and evaluating character types through testing. The obtained results were subjected to correlation analysis, and the findings were processed using the SPSS program.

The article measured the overall expressiveness of communicative values, the level of possessing communicative techniques based on self-assessment, and the degree to which communicative content is integrated into professional medical activities. Additionally, although physicians were separately analyzed as therapists and pediatricians, no significant correlation was found in the levels of empathy between them. At times, pediatricians may choose pediatrics because they have not yet met the required scores for admission to the treatment and prevention specialty when entering university. However, the correlation has taken a different direction in this context. The main issue is not the direction the physician chooses but rather considering the human factor.

Character Types (according to Jung)

The test determining Jung's character types identified extravert, introvert, and ambivert types among physicians. Extravert types make crucial decisions and behaviors based not on subjective perspectives but on objective conditions. If this inclination is repeated and persistent, it indicates an extravert orientation. If an individual thinks, feels, and behaves in accordance with the demands and conditions of the surrounding environment, they are extraverted. Although they have their own subjective opinions, the influence of the surroundings exerts a stronger influence [9, p. 181]. Jung later explained the facets of the extravert type at the levels of consciousness and unconsciousness, analyzing the specific features of basic psychological functions.

Introvert types, on the other hand, are oriented towards the subjective realm rather than the objective. Their subjective thoughts form the basis for the behavior between them and the object, hindering objective conduct. In other words, even if they look at the same object, introverts prioritize thinking under the influence of personal feelings. Jung also distinguished conscious and unconscious orientations in introverted personality types.

Ambivert personality types, on the other hand, stand in between introversion and extraversion, behaving either internally or externally depending on the situation.

According to Jung's typology presented in the research, all three personality types participated in the survey among physicians, and their correlation with the sense of empathy was investigated.

The results of the survey and tests

In the research, 100 physicians were recruited. All 100 respondents participating in the survey are professional physicians with work experience. As shown in Fig. 1., 36 of them (36%) have up to 10 years of experience, 42 individuals (42%) have between 10 and 20 years of experience, and 22 individuals (22%) have over 20 years of work experience.

In terms of gender composition, out of the 100 respondents in the study, 88% were female, and 22% were male. The average age for female respondents was 44.45, while for male respondents, it was 43.33 years.

Among the 88 female participants, 18.2% are unmarried, and 81.8% are married. Among the 12 male participants, 16.7% are unmarried, and 83.3% are married.

The methodology of communicative competence in the medical profession [5] was employed in the research. The results of the applied test indicate that there are no robust values for the initial 3 blocks related to communicative effectiveness, possession of communicative techniques based on self-esteem, and the level of integration of communicative structure into professional medical activity. Primarily, the indicators for all 3 blocks are either not expressed or moderately expressed.

In the I block indicating orientation towards social relationships, the demand for communication is moderately expressed in 66 out of 100 respondents. The remaining 34 respondents did not articulate this indicator, signifying it is equal to 0.

Figure 1.1. Work Experience of Respondents

communion doctor patient

Among the 66 respondents with moderately expressed indicators for communication demand, 54 are female, and 12 are male. Regarding the 11 block, indicating "technical success" in personal communication, only 18 out of 100 respondents have a moderately expressed level of possession of communicative techniques based on selfesteem. The remaining 82 respondents did not articulate this indicator, signifying it is equal to 0.

Among the 18 respondents with moderately expressed indicators for possession of communicative techniques based on self-esteem, 12 are female, and 6 are male. In the III block indicating the importance of communicative components in the professional self-concept, the degree of integration of communicative structure into professional medical activity is moderately expressed in 88 out of 100 respondents. The remaining 12 respondents did not express this indicator, signifying it is equal to 0.

Among the 88 respondents with moderately expressed indicators for the integration of communicative structure into professional medical activity, 76 are female, and 12 are male. Unlike other indicators, in the IV block indicating the development level of professional communicative skills and virtues in self-esteem, the indicators are strongly expressed in 2 out of 100 respondents and moderately expressed in 84 out of 100 respondents. The remaining 14 respondents did not express this indicator, signifying it is equal to 0.

Among the 2 respondents with strongly expressed indicators for the development level of professional communicative skills and virtues based on self-esteem, both are female. Among the 84 respondents with moderately expressed indicators, 72 are female, and 12 are male.

From these results, it can be concluded that according to the test results of the Blocks of the "Communicative Competence in the Medical Profession" methodology, communicative skills of the participating physicians have not developed sufficiently, or physicians do not attach sufficient importance to communicative competence.

Regarding the investigation of physicians' empathy, based on the results of the "Diagnostic of Empathy Skills" test [5], 28% of the respondents have a moderate level of empathy, 66% have a low level, and 6% have a very low level of empathy. No one from the respondents has shown a very high level of empathy.

Although a very low level of empathy is observed among physicians with 0-10 and 10-20 years of work experience, it is not observed among physicians with 20 or more years of work experience.

Based on the empathy level, among respondents with 0-10 years of work experience, 4 individuals (11.1%) obtained very low, 16 individuals (44.4%) low, and 16 individuals (44.4%) moderate scores.

Concerning the empathy level, among respondents with 10-20 years of work experience, 2 individuals (4.8%) obtained very low, 32 individuals (76.2%) low, and 8 individuals (19.0%) moderate scores. Regarding the empathy level, among respondents with 20 or more years of work experience, 18 individuals (81.8%) obtained low, and 4 individuals (18.2%) obtained moderate scores.

Fig. 2. Distribution of Empathy Levels Based on Work Experience

Additionally, Fig.3. shows that the indicators of empathy levels are differently distributed among female and male respondents. The histogram reveals that lower empathy levels are more prevalent among both female and male individuals compared to moderate-level indicators.

From female respondents, 6 individuals (6.8%) obtained a very low empathy level, 56 individuals (63.6%) obtained a low level, and 26 individuals (29.5%) obtained a moderate indicator. Among male respondents, 10 individuals (83.3%) achieved a low level, and 2 individuals (16.7%) obtained a moderate indicator.

Fig. 3. Distribution of Empathy Level Indicators by Gender

Although comparing the results of female and male respondents may not be statistically accurate due to the imbalance in their numbers, the overall analysis has been considered.

In general, we can conclude that an increase in work experience does not affect empathy level indicators. The fact that empathy levels do not develop later in physicians suggests that there may not be a crucial need for the development of this skill.

According to C. Jung's [6] results from the test determining character types (among physicians), as shown in Table 1.4., 24 individuals (24%) were introverted, 72 individuals (72%) were ambivert, and 4 individuals (4%) were extravert.

We can observe the distribution of character types by gender in Fig. 4.

Among female respondents, 20 individuals (22.7%) were introverted, 64 individuals (72.7%) were ambivert, and 4 individuals (4.5%) were extravert based on their character type.

Among male respondents, 4 individuals (33.3%) were introverted, and 8 individuals (66.7%) were ambivert based on their character type.

Based on character type, among respondents with 0-10 years of work experience, 8 individuals (22.2%) were introverted, 26 individuals (72.2%) were ambivert, and 2 individuals (5.6%) were extravert.

For those with 10-20 years of work experience, 12 individuals (28.6%) were introverted, 28 individuals (66.7%) were ambivert, and 2 individuals (4.8%) were extravert based on their character type.

For those with 20 or more years of work experience, 4 individuals (18.2%) were introverted, and 18 individuals (81.8%) were ambivert based on their character type.

To determine whether there is a statistical relationship between work experience and empathy level, correlation analysis was employed. Given that correlation analysis relies on the Spearman correlation coefficient and considering the ordinal scale of the variables, an association was considered when the p-value was less than 0.05.

Conclusions

According to the correlation employed in the investigation, there exists no statistically significant association between medical tenure and the degree of empathy. Correspondingly, there is no statistically noteworthy linkage between character archetypes and medical experience.

The study reveals that solely a statistically meaningful unilateral and feeble correlation (p < 0.05; 0.166*) is discerned between empathy level indicators and character archetypes. Considering the enduring nature of character types and their infrequent alterations, it may be inferred that the constancy in empathy is attributed to the stability of a physician's character archetype. If one's attitude toward others persists, it is likely that empathy, being an integral component of this demeanor, will remain unaltered over time, notwithstanding an augmentation in professional experience.

Fig. 4. Distribution of Character Types by Gender

Hence, notwithstanding the accrual of professional experience in the medical vocation, no substantial transformation is observed in empathy sentiments and character traits. The slight correlation between empathy and character suggests that this sentiment is inherent in one's character and does not necessarily undergo development with professional maturation. The absence of a specific curriculum for physicians to acquire communicative skills and the likelihood that they do not autonomously cultivate these skills underscores the lack of demand for such competencies. Other indices, including extensive professional experience, specialized expertise, robust promotional efforts, and recognition, overshadow communicative skills and empathy.

In the 18th query of the patient survey, "What factors do you prioritize when selecting a healthcare provider?" - 75% of respondents indicated "reliance on the recommendations of acquaintances". Consequently, the communicative prowess or empathic disposition of physicians is not accorded paramount importance. In a cultural context, preference is given to the endorsements of family and acquaintances when opting for a healthcare provider. In the absence of a demand for the advancement of communicative skills, there is no impetus encouraging progress in this domain. Despite respondents demonstrating a proclivity to heed the advice of others when seeking a physician, the paradoxical situation persists, with survey participants displaying low levels of trust in people.

Notwithstanding, considering the expeditious advancement of the global landscape in scientific and technological spheres, it is advisable that physicians engage in training sessions and workshops facilitated by psychologists to establish effective communication, thereby contributing to the augmentation of empathic capacities and fostering the further evolution of emotional intelligence and enhancement in communicative aptitudes.

Bibliography

1. Bayramov Q.S., Qlizada Q.Q. Sosial psixologiya. Baki: “Qapp-Poliqraf” korporasiyasi, 2003. 356 s.

2. Cahangirov A. Tahsilimiz: dunandan sabaha. Optimistin baxi§lari. Baki: “§arq-Qarb”, 2020. 384 s.

3. ismayilov N., ismayilov F. Tibbi psixologiya va psixoterapiya. Baki: 2008. 416 s.

4. Nurlu omrun salnamasi. Zarifa Qliyeva-95. M.F.Axundov ad. Azarbaycan Milli Kitabxanasi; tart. ed. S.Quliyeva; elmi red. K.Tahirov; red. L.Qhmadova. Baki: 2018. 33 s.

5. Psixodiaqnostika: metodikalar va testlar / tarc.Q.Y.Abbasova, B.Y.Cafarova / Baki: 2014. 280 s.

6. Jung C.G. Psychological Types. URL: https://archive.org/details/Vol06.

7. Oliver O. and others. The relationship between social support, shared decision-making and patient's trust in doctors: a cross-sectional survey in of 2,197 inpatients using the Cologne Patient Questionnaire. URL: https://link.springer.com/article/.

8. Qing Wu PhD, Zheyu Jin, Pei Wang PhD. The relationship between the Physician-Patient relationship, Physician empathy, and Patient Trust. URL: https://link.springer.com/article.

9. Swastika Chandra, Masoud Mohammadnezhad, Paul Ward. Trust_and_Communication_in_a_Doctor_ Patient_Relationship. URL: https://www.researchgate. net/profile.

Размещено на Allbest.ru