Communication Beyond the Clinical Interaction: Delivering Comprehensive Healthcare to Patients with Intellectual Disabilities
Date
2017
Authors
MacArthur, Brenda
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Abstract
This dissertation develops, delivers, and evaluates an evidence-based communication skills training curriculum for healthcare providers (HCPs) servicing patients with intellectual disabilities (PWID). This dissertation also tests a theoretical model combining elements of interpersonal communication (Anxiety/Uncertainty Management Theory; Communication Accommodation Theory) and behavior change (Theory of Planned Behavior) theories to examine predictors of HCPs’ patient-centered communication with PWID. Specifically, this dissertation examines HCPs’ attitudes, perceived behavioral control, uncertainty, and anxiety in predicting intention to engage in patient-centered communication. HCPs representing a variety of subspecialties participated in a two-hour face-to-face training intervention that included lecture, discussion, role-play, and case study analysis. Participants completed pre- and post-test questionnaires prior to and immediately following the completion of the training intervention, which contained items that represented each variable in the study. Paired-samples t-tests indicate that after exposure to the training intervention, HCPs reported increased intentions to engage in patient-centered communication, improved attitudes toward doing so, and decreased uncertainty about such interactions. HCPs reported no significant change in perceived behavioral control or anxiety levels following exposure to the intervention. With regard to the predictive power of variables in the theoretical model, multiple regressions determined perceived behavioral control to be the strongest predictor of intention. Uncertainty and anxiety were not significant predictors of intention when perceived behavioral control was included in the model. HCPs’ attitudes were significantly associated with uncertainty and anxiety, but did not predict intention. This dissertation provides support for the integration of interpersonal and behavior change theories when developing health communication interventions, to directly target factors that are likely to influence a particular communication interaction. This dissertation also holds implications for the Theory of Planned Behavior and highlights the unique role that perceived behavioral control plays in predicting HCPs’ intentions for patient-centered communication with PWID.
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Keywords
Communication, Communication skills training, Evidence-based intervention, Intellectual disability, Patient-centered, Provider-patient interaction