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The effect of training doctors in communication skills on women's satisfaction with doctor-woman relationship during labour and delivery: a stepped wedge cluster randomised trial in Damascus.

ABSTRACT: To determine the effect of training residents in interpersonal and communication skills on women's satisfaction with doctor-woman relationship in labour and delivery rooms.A stepped wedge cluster randomised trial.4 tertiary care teaching maternity hospitals in Damascus, Syria.2000 women who gave birth to a living baby in the four study hospitals and consented to participate in the intervention took part in the study. Women with difficult labour and high-risk pregnancies were excluded. All were interviewed at home after discharge.A specially designed training package in communication skills was delivered to all resident doctors at the four hospitals.The main outcome measure was women's satisfaction with interpersonal relationships in labour and delivery rooms measured via a series of questions on a Likert scale modified from the Medical Interview Satisfaction Scale.At the individual level, the mean for the average satisfaction score was 3.23 (SD 0.72) of a possible score of 5 in the control group and 3.42 (SD 0.73) in the intervention group. Using generalised linear mixed models, we were unable to detect a difference between the mean for the average satisfaction score of women in the intervention arm and that of women in the control arm; the 95% CI associated with the effect of the intervention ranged from -0.08 to 0.15.Despite slight changes in the observed residents' communication skills, the training package in communication skills does not seem to be associated with higher satisfaction scores of women. This raises the question of whether training individuals without further structural changes in the delivery of care and without further reinforcement of the training can have an impact on improving the quality of doctor-patient communication.ISRCTN80243969.

SUBMITTER: Bashour HN

PROVIDER: S-EPMC3752047 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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The effect of training doctors in communication skills on women's satisfaction with doctor-woman relationship during labour and delivery: a stepped wedge cluster randomised trial in Damascus.

Bashour Hyam N HN Kanaan Mona M Kharouf Mayada H MH Abdulsalam Asmaa A AA Tabbaa Mohammed A MA Cheikha Salah A SA

BMJ open 20130814 8

<h4>Objectives</h4>To determine the effect of training residents in interpersonal and communication skills on women's satisfaction with doctor-woman relationship in labour and delivery rooms.<h4>Design</h4>A stepped wedge cluster randomised trial.<h4>Setting</h4>4 tertiary care teaching maternity hospitals in Damascus, Syria.<h4>Participants</h4>2000 women who gave birth to a living baby in the four study hospitals and consented to participate in the intervention took part in the study. Women wi ...[more]

PMID: 23945729

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Project description:OBJECTIVE:To estimate the pooled prevalence of women's satisfaction with existing labour and delivery services in Ethiopia. DESIGN:Systematic review and meta-analysis. METHODS:MEDLINE/PubMed, Scopus, Hinari, Google Scholar and web of science electronic databases were searched for the study. This meta-analysis included nineteen cross-sectional studies. Cochrane I2 statistics were used to check the heterogeneity of the studies. Subgroup and sensitivity analysis were conducted with the evidence of heterogeneity. Egger test with funnel plot were used to investigate publication bias. RESULT:Nineteen studies were included in the systematic review and meta-analysis. The overall prevalence of women's satisfaction with existing labour and delivery services in Ethiopia was 70.54% (95% CI 60.94 to 80.15). Having informal education of the women (adjusted OR (AOR)=2.19; 95%?CI 1.47 to 3.25), time to be seen by the healthcare providers within 20?min (AOR=2.97; 95%?CI 2.11 to 4.19), receiving free service (AOR=5.01; 95%?CI 2.87 to 8.75), keeping women privacy (AOR=2.84; 95%?CI 1.46 to 5.55), planned delivery in the health institution (AOR=2.85; 95%?CI 1.99 to 4.07), duration of labour within 12?hours (AOR=2.55; 95%?CI 1.70 to 3.81) and have not antenatal care follow-up (AOR=4.03; 95%?CI 2.21 to 7.35) were factors associated with women satisfaction with labour and delivery services in Ethiopia. CONCLUSION:The pooled prevalence of women's satisfaction with existing labour and delivery services was high. Informal education of the women, antenatal care follow-up, planned delivery in the health institution, keeping women privacy, getting free service, time to be seen by the healthcare providers and duration of labour were factors associated with women's satisfaction during labour and delivery services. This finding is important to design strategic policies and to prevent emergency neonatal and women complications during the childbirth and postpartum periods. PROSPERO REGISTRATION NUMBER:CRD42020149217.

Project description:BackgroundStepped wedge randomised trial designs involve sequential roll-out of an intervention to participants (individuals or clusters) over a number of time periods. By the end of the study, all participants will have received the intervention, although the order in which participants receive the intervention is determined at random. The design is particularly relevant where it is predicted that the intervention will do more good than harm (making a parallel design, in which certain participants do not receive the intervention unethical) and/or where, for logistical, practical or financial reasons, it is impossible to deliver the intervention simultaneously to all participants. Stepped wedge designs offer a number of opportunities for data analysis, particularly for modelling the effect of time on the effectiveness of an intervention. This paper presents a review of 12 studies (or protocols) that use (or plan to use) a stepped wedge design. One aim of the review is to highlight the potential for the stepped wedge design, given its infrequent use to date.MethodsComprehensive literature review of studies or protocols using a stepped wedge design. Data were extracted from the studies in three categories for subsequent consideration: study information (epidemiology, intervention, number of participants), reasons for using a stepped wedge design and methods of data analysis.ResultsThe 12 studies included in this review describe evaluations of a wide range of interventions, across different diseases in different settings. However the stepped wedge design appears to have found a niche for evaluating interventions in developing countries, specifically those concerned with HIV. There were few consistent motivations for employing a stepped wedge design or methods of data analysis across studies. The methodological descriptions of stepped wedge studies, including methods of randomisation, sample size calculations and methods of analysis, are not always complete.ConclusionWhile the stepped wedge design offers a number of opportunities for use in future evaluations, a more consistent approach to reporting and data analysis is required.

Project description:BackgroundFor cancer patients to effectively engage in decision making, they require comprehensive and understandable information regarding treatment options and their associated outcomes. We developed an online prediction tool and supporting communication skills training to assist healthcare providers (HCPs) in this complex task. This study aims to assess the impact of this combined intervention (prediction tool and training) on the communication practices of HCPs when discussing treatment options.MethodsWe conducted a multicenter intervention trial using a pragmatic stepped wedge design (NCT04232735). Standardized Patient Assessments (simulated consultations) using cases of esophageal and gastric cancer patients, were performed before and after the combined intervention (March 2020 to July 2022). Audio recordings were analyzed using an observational coding scale, rating all utterances of treatment outcome information on the primary outcome-precision of provided outcome information-and on secondary outcomes-such as: personalization, tailoring and use of visualizations. Pre vs. post measurements were compared in order to assess the effect of the intervention.Findings31 HCPs of 11 different centers in the Netherlands participated. The tool and training significantly affected the precision of the overall communicated treatment outcome information (p = 0.001, median difference 6.93, IQR (-0.32 to 12.44)). In the curative setting, survival information was significantly more precise after the intervention (p = 0.029). In the palliative setting, information about side effects was more precise (p < 0.001).InterpretationA prediction tool and communication skills training for HCPs improves the precision of treatment information on outcomes in simulated consultations. The next step is to examine the effect of such interventions on communication in clinical practice and on patient-reported outcomes.FundingFinancial support for this study was provided entirely by a grant from the Dutch Cancer Society (UVA 2014-7000).

Dataset Information

The effect of training doctors in communication skills on women's satisfaction with doctor-woman relationship during labour and delivery: a stepped wedge cluster randomised trial in Damascus.

Publications

The effect of training doctors in communication skills on women's satisfaction with doctor-woman relationship during labour and delivery: a stepped wedge cluster randomised trial in Damascus.

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