Provider and patient perspectives regarding health care for war-related health concerns. 2007

Jamie D Davis, and Charles C Engel, and Matthew Mishkind, and Ambereen Jaffer, and Terry Sjoberg, and Tim Tinker, and Martin McGough, and Stacia Tipton, and David Armstrong, and Timothy O'Leary
Deployment Health Clinical Center, Walter Reed Army Medical Center, Washington, DC, USA.

OBJECTIVE To gain insight about Department of Defense providers' and health care beneficiaries' opinions regarding provider-patient communication of health care for post-deployment health concerns. METHODS Thirty-five Department of Defense primary care providers and 14 military beneficiaries participated in focus groups at five military medical treatment facilities. We audiotaped, transcribed, and qualitatively analyzed semi-structured focus group interviews to determine attitudes and beliefs about war-related health concerns, symptoms, and health care quality. RESULTS Focus groups revealed important insights about provider and patient perspectives of communication and care in four general areas: physician-patient trust, validity of symptoms and concerns, exchange of health information, and barriers to care. CONCLUSIONS Provider-patient communication contributes to patient satisfaction with medical care; poor communication may contribute to decreased patient satisfaction and provider effectiveness. The military health care system poses several challenges to provider-patient communication: the dual nature of the provider's role, the occupational relationship between illness and health care, pre- and post-deployment issues, and continuity of care impact patient and provider perspectives. The prevalence of various beneficiary and provider concerns regarding health care communication requires further study, particularly for the severely wounded. CONCLUSIONS The quality of information exchanged and of the interpersonal relationship impact medical decision making, particularly in occupational health settings such as the military. Attention to these issues may improve patient outcomes including satisfaction, adherence, trust, health status, and quality of life.

UI MeSH Term Description Entries
D007722 Health Knowledge, Attitudes, Practice Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL). Knowledge, Attitudes, Practice
D008297 Male Males
D008887 Military Medicine The practice of medicine as applied to special circumstances associated with military operations. Medicine, Military
D008889 Military Personnel Persons including soldiers involved with the armed forces. Air Force Personnel,Armed Forces Personnel,Army Personnel,Coast Guard,Marines,Navy Personnel,Sailors,Soldiers,Submariners,Military,Force Personnel, Air,Personnel, Air Force,Personnel, Armed Forces,Personnel, Army,Personnel, Military,Personnel, Navy,Sailor,Soldier,Submariner
D010353 Patient Education as Topic The teaching or training of patients concerning their own health needs. Education of Patients,Education, Patient,Patient Education
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D010819 Physician's Role The expected function of a member of the medical profession. Physicians' Role,Physician Role,Physician's Roles,Physicians Role,Physicians' Roles,Role, Physician's,Role, Physicians',Roles, Physician's,Roles, Physicians'
D010821 Physicians, Family Those physicians who have completed the education requirements specified by the American Academy of Family Physicians. Family Physician,Family Physicians,Physician, Family
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response

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