Six male GPs from Manchester (UK) and six from Verona (Italy) each contributed five consultations, which were coded using the VR-MICS. Intra-rater and inter-rater reliability were assessed both for the division of interviews into speech units and the speech unit coding. Interaction and main effects of GHQ-12 status and nationality on patient and GP expressions were assessed by two-way ANOVA. Results: Agreement indices for the division of speech units varied between 88–96 and 87–93% for GP and patient speech, respectively; those for coding categories between 88–91 and 82–86%, with Cohen’s Kappa values between 0.86–0.91 and 0.80–0.85 for GP and patient speech, respectively. Cross-cultural comparisons of patient and GP speech showed no interaction effects between GHQ-12 status and nationality. The Italian GPs were more ‘doctor-centred’, while the UK GPs tended to use a more ‘sharing’ consulting style. Independent of nationality, distressed patients talked more, gave more psychosocial cues and increased amounts of positive talk compared to non-distressed patients. GPs in both settings, when interviewing distressed patients, reduced social conversation and increased psychosocial information-giving, checking questions and reassurance.
Valutazione dello stile comunicativo dei medici di Medicina Generale. Confronto cross-nazionale mediante un nuovo strumento, il VR-MICS
ZIMMERMANN, Christa;DEL PICCOLO, Lidia
2002-01-01
Abstract
Six male GPs from Manchester (UK) and six from Verona (Italy) each contributed five consultations, which were coded using the VR-MICS. Intra-rater and inter-rater reliability were assessed both for the division of interviews into speech units and the speech unit coding. Interaction and main effects of GHQ-12 status and nationality on patient and GP expressions were assessed by two-way ANOVA. Results: Agreement indices for the division of speech units varied between 88–96 and 87–93% for GP and patient speech, respectively; those for coding categories between 88–91 and 82–86%, with Cohen’s Kappa values between 0.86–0.91 and 0.80–0.85 for GP and patient speech, respectively. Cross-cultural comparisons of patient and GP speech showed no interaction effects between GHQ-12 status and nationality. The Italian GPs were more ‘doctor-centred’, while the UK GPs tended to use a more ‘sharing’ consulting style. Independent of nationality, distressed patients talked more, gave more psychosocial cues and increased amounts of positive talk compared to non-distressed patients. GPs in both settings, when interviewing distressed patients, reduced social conversation and increased psychosocial information-giving, checking questions and reassurance.
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