The Effect of Patient-Centered Communication Level on Frequency of Health Service Use and Trust in Physicians in Patients Receiving Primary Health Care Services

Öz

Patient-centered communication is a communication model based on mutual understanding and trust, where patients’ needs, expectations, and values are taken into account. When patients encounter a physician who understands them and is sensitive to their needs, they are less likely to neglect their health problems. Health service utilization frequency refers to how often patients seek healthcare services within a certain period. At the primary care level, this generally includes family physician visits, regular check-ups, prescription renewals, vaccinations, and routine screenings. Trust is one of the cornerstones of the patient-physician relationship. Trust in the physician encourages patients to comply with treatment recommendations, share health-related information, and develop a positive attitude toward healthcare services. A strong bond of trust enhances the effectiveness of treatment processes and improves health outcomes. Within this context, the aim of the study is to determine the effect of patient-centered communication on the frequency of health service utilization and trust in the physician among patients receiving primary healthcare services. The study population consisted of patients registered at a family health center in the city center of Erzincan. A sample size was calculated to obtain generalizable results, and it was determined that data needed to be collected from a minimum of 385 individuals. The data collection process was completed by administering a questionnaire to a total of 385 individuals who visited the family health center, using the face-to-face interview method. To determine whether levels of patient-centered communication and trust in the physician differed based on socio-demographic characteristics of the patients, t-tests and one-way analysis of variance (ANOVA) were used. Post hoc multiple comparison tests were employed to identify which groups showed differences. The analyses revealed that variables such as gender, age, marital status, income, number of children, employment status, and education level did not show a statistically significant difference in terms of patient-centered communication and trust in the physician. To test the research hypotheses and to examine the effect of patient-centered communication on trust in the physician and frequency of health service utilization, linear regression and multinomial logistic regression analyses were conducted. The regression analysis showed that patient-centered communication positively influenced both service utilization frequency and trust. As a result, it is considered that patient-centered communication increases patients’ trust in healthcare providers; and this trust, in turn, enhances treatment adherence and overall health outcomes. The findings of the study emphasize the importance of patient-centered communication strategies in enabling healthcare providers to establish more effective and higher quality communication with patients. Furthermore, patient-centered communication may increase patients' trust in service providers, thereby improving the quality of healthcare services and the treatment adherence process. In this context, while shaping health policies, it is necessary to take into account strategies that can enhance patient-centered communication and to identify and eliminate factors that may negatively affect communication between patients and physicians. Additionally, it is of great importance to equip physicians and other healthcare professionals with effective communication skills through in-service training programs.

Anahtar Kelimeler

• Patient-Centered Communication
• Trust in Physician
• Health Service
• Frequency of Service Use

Birinci Basamak Sağlık Hizmeti Alan Hastalarda Hasta Merkezli İletişim Düzeyinin Sağlık Hizmeti Kullanım Sıklığı ve Hekime Güven Üzerine Etkisi

Öz

Hasta merkezli iletişim; hastaların ihtiyaçlarının, beklentilerinin ve değerlerinin dikkate alındığı, karşılıklı anlayış ve güvene dayalı bir iletişim modelidir. Hastaların, kendilerini anlayan ve ihtiyaçlarına duyarlı olan bir hekimle karşılaştıklarında, sağlık sorunlarını ihmal etme olasılıkları azalır. Sağlık hizmeti kullanım sıklığı, hastaların belirli bir süre içinde sağlık hizmetlerine ne kadar sık başvurduğunu ifade eder. Bu, birinci basamak sağlık hizmetleri düzeyinde genellikle aile hekimi ziyaretleri, düzenli kontroller, reçete yenilemeleri, aşılar ve rutin taramalar gibi hizmetleri kapsar. Güven, hasta-hekim ilişkisinin temel taşlarından biridir. Hekime güven, hastaların tedavi önerilerine uymasını, sağlık bilgilerini paylaşmasını ve genel olarak sağlık hizmetlerine olumlu bir tutum geliştirmesini sağlar. Güçlü bir güven bağı, tedavi süreçlerinin etkinliğini artırır ve hastaların sağlık sonuçlarını iyileştirir. Bu kapsamda çalışmada, birinci basamak sağlık hizmeti alan hastalarda hasta merkezli iletişimin sağlık hizmeti kullanım sıklığı ve hekime güven üzerindeki etkisini belirlemek amaçlanmıştır. Çalışma evrenini Erzincan il merkezindeki bir aile sağlığı merkezine kayıtlı hastalar oluşturmuştur. Çalışmada örneklem büyüklüğü hesaplanarak evrene genellenebilir sonuç elde edebilmek için minimum 385 kişiden veri toplanması gerektiği belirlenmiş ve yüz yüze görüşme yöntemi ile aile sağlığı merkezine başvuran toplam 385 kişiye anket uygulanarak veri toplama süreci sonlandırılmıştır. Araştırmaya katılan hastaların hasta merkezli iletişim ve hekime güven düzeylerinin sosyo-demografik özelliklere göre farklılık gösterip göstermediğini belirlemek için t-testi ve tek yönlü varyans analizi kullanılmıştır. Farklılığın hangi gruplar arasında olduğunu belirlemek için Post Hoc çoklu karşılaştırma testlerinden faydalanılmıştır. Çalışma kapsamında yapılan analizler sonucunda cinsiyet, yaş, medeni durum, gelir, çocuk sayısı, çalışma durumu, eğitim gibi değişkenlerle hasta merkezli iletişim ve hekime güven arasında istatistiksel olarak anlamlı bir fark olmadığı tespit edilmiştir. Araştırma hipotezlerini test etmek için hasta merkezli iletişimin hekime güven ve hizmet kullanım sıklığı üzerindeki etkisini belirlemek amacıyla doğrusal regresyon ve multinomial lojistik regresyon analizleri kullanılmıştır. Regresyon analizi, hasta merkezli iletişimin hizmet kullanım sıklığını ve güveni olumlu yönde etkilediğini ortaya koymuştur. Sonuç olarak hasta merkezli iletişimin, hastaların sağlık hizmeti sağlayıcılarına olan güvenini artırdığı; bu güvenin de hastaların tedaviye uyumunu ve genel sağlık sonuçlarını iyileştirdiği düşünülmektedir. Çalışma kapsamında elde edilen bulgular sağlık hizmeti sunumunda hasta merkezli iletişim stratejileri ile sağlık hizmeti sağlayıcılarının, hastalarla daha etkili ve kaliteli iletişim kurmalarının önemini vurgulamaktadır. Diğer taraftan hasta merkezli iletişim, hastaların hizmet sunucularına olan güvenlerini artırarak genel sağlık hizmetlerinin kalitesini ve tedaviye uyum sürecini de artırabilmektedir. Bu kapsamda sağlık politikaları şekillendirilirken, hasta merkezli iletişimi artırabilecek olan stratejilerin de dikkate alınması ve hasta ile hekim arasındaki iletişimi etkileyebilecek olumsuz faktörlerin belirlenip ortadan kaldırılması gerekmektedir. Ayrıca hekimler ile diğer sağlık çalışanlarına hizmet içi eğitim programları gibi uygulamalarla etkili iletişim becerilerinin kazandırılması büyük önem arz etmektedir.

Anahtar Kelimeler

• Hasta Merkezli İletişim
• Hekime Güven
• Sağlık Hizmeti
• Hizmet Kullanım Sıklığı

Kaynakça

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