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How doctors make themselves understood in primary care consultations: A mixed methods analysis of video data applying health literacy universal precautions

Byrne, JV; Whitaker, KL; Black, GB; (2021) How doctors make themselves understood in primary care consultations: A mixed methods analysis of video data applying health literacy universal precautions. PLoS One , 16 (9) , Article e0257312. 10.1371/journal.pone.0257312. Green open access

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Abstract

PURPOSE: To mitigate the health risks that result from low health literacy and difficulty identifying patients with insufficient health literacy, health organizations recommend physicians apply health literacy universal precaution communication skills when communicating with all patients. Our aim was to assess how health literacy universal precautions are delivered in routine GP consultations, and explore whether there were differences in how GPs used universal precaution approaches according to areas of deprivation in England. METHODS: This was a mixed methods study using video and interview data. Ten physicians conducted 217 consultations in primary care settings with adults over 50 years old between July 2017 and March 2018 in England. Eighty consultations (N = 80) met the inclusion criteria of new or persisting problems. Descriptive quantitative analysis of video-recorded consultations using an observation tool and qualitative thematic analysis of transcribed scripts. Meta-themes explored differences in physicians' communication by areas of deprivation. RESULTS: Descriptive statistics showed physicians used a caring tone of voice and attitude (n = 73, 91.3%) and displayed comfortable body language (n = 69, 86.3%) but infrequently demonstrated profession-specific health literacy universal precaution communication skills, such as the teach-back technique (n = 3, 3.8%). Inferences about physicians' communication from qualitative analysis converged with the quantitative findings. Differences in physicians' communication varied according to areas of deprivation. CONCLUSIONS: Physicians need health literacy universal precautions communication skills to improve population health.

Type: Article
Title: How doctors make themselves understood in primary care consultations: A mixed methods analysis of video data applying health literacy universal precautions
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0257312
Publisher version: https://doi.org/10.1371/journal.pone.0257312
Language: English
Additional information: © 2021 Byrne et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
URI: https://discovery.ucl.ac.uk/id/eprint/10135704
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