Trial document




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  DRKS00000762

Trial Description

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Title

Patient–provider communication for chronically ill patients: gender- and age-specific preferences of patients

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Trial Acronym

PaBeKo

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URL of the Trial

[---]*

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Brief Summary in Lay Language

The subject of this study is the communication between the chronically ill patients and the provider (Doctor, Nurse, Therapist) during rehabilitation. The diseases under investigation are chronic backpains and chronic ischaemic heart disease.

The primary aim of this project is the development of a measuring instrument (questionnaire) that measures preferences of chronically ill patients’ when communicating with their providers. Furthermore, the aim of this project is the development of a questionnaire that is supposed to capture the providers’ attitude concerning the communication with patients. During the course of this project different preferences of a various groups of patients (male/female, age groups, stationary/ambulant) will be analysed based on these instruments. Additionally, it will be investigated what influence congruency between patient’s and provider’s attitudes has on the success of the treatment. Furthermore, it is intended to develop a training program for providers based on these results. The training program is supposed to teach the consideration of individual patient’s communication preferences which lead to better patient-provider communication.

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Brief Summary in Scientific Language

This study investigates patient-provider communication concerning chronically ill patients. Patients with chronic backpains and chronic ischemic heart disease are subject of this study.

Communication is the central element of patient-provider interaction. Communication preferences might differ between patients and might also vary within patients depending on context and time. Providers taking part in this study are not only doctors but also nurses and therapists. Successful communication is thoroughly characterized by congruency between wishes and expectations of the patients and the attitudes of the provider. It is expected that intact patient-provider communication has a positive influence on adherence and treatment success. Hence, providers should be fexible in framing patient-communication according patients’ individual needs.

A central aim of this research project is the development and the methodological examination of an instrument that measures preferences of chronically ill patients in relation to patient-provider communication (Questionnaire for patients’ communication preferences [the KOPRA questionnaire]). The questionnaire should be in accordance with the test theoretical requirement of Rasch’s Model. Simulatenously it is anticipated to develop of a comparable instrument for providers (Questionnaire for providers’ atttitudes towards communication [the KOMBEIN questionnaire]).
On the one hand, the developenment of the questionnaires is based on qualitative data, which is collected during a preliminary study employing focus-groups made up of patients and providers. During this investigation patients and providers should be incorporated in the decision making process of the content of each measuring method. This is done by asking open-ended questions about patient-provider communication that are not structured according to a theoretical background (e.g. What do you wish for during a consultation with your physician? What is important for you?). Item generation should, next to empirical input, also be achieved by considering models and concepts that postulate relevant aspects of patient-provider communication (Makoul, 2001; Arora, 2003; Krupat et al., 2000a; McKinstry, 2000). The drafted questionnaires will be tested for clarity and acceptance in a second preliminary study using single patient interviews.
During further course of this study quantitative data collection will be exercised. It will based on the newly developed measuring instruments. Data collection is supposed to identify possible influencing factors on patients’ peferences. This is done by analysing different preference of
a) female and male patients.
b) patients in different age groups.
c) patients with different types of diagnosis.
d) stationary/ambulant patients
Furthermore, it is anticipated to analyse the influence of congruency between patients’ and providers’ attitudes on the outcome of the treatment. Also, based on the collected results, an intervention should be developed to consider patients’ individual communication preferences, which aids the improvement of patient-provider communication. This should enable providers to consider patients’ individual communication preferences and to make the patient-provider communication more flexible and conscious.

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Organizational Data

  •   DRKS00000762
  •   2011/07/29
  •   2008/03/25
  •   yes
  •   Approved
  •   62/08, Ethik-Kommission der Albert-Ludwigs-Universität Freiburg
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Secondary IDs

  •   U1111-1120-2636 
  •   UKF001534  (Register klinischer Studien des Universitätsklinikums Freiburg)
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Health Condition or Problem studied

  •   Chronic back pain
  •   Chronic ischemic heart disease
  •   M47.1 -  Other spondylosis with myelopathy
  •   M47.2 -  Other spondylosis with radiculopathy
  •   M47.8 -  Other spondylosis
  •   M47.9 -  Spondylosis, unspecified
  •   M48.1 -  Ankylosing hyperostosis [Forestier]
  •   M48.2 -  Kissing spine
  •   M48.8 -  Other specified spondylopathies
  •   M48.9 -  Spondylopathy, unspecified
  •   M51.0 -  Lumbar and other intervertebral disc disorders with myelopathy
  •   M51.1 -  Lumbar and other intervertebral disc disorders with radiculopathy
  •   M51.2 -  Other specified intervertebral disc displacement
  •   M51.3 -  Other specified intervertebral disc degeneration
  •   M51.4 -  Schmorl's nodes
  •   M51.8 -  Other specified intervertebral disc disorders
  •   M51.9 -  Intervertebral disc disorder, unspecified
  •   M53.8 -  Other specified dorsopathies
  •   M53.9 -  Dorsopathy, unspecified
  •   M54.1 -  Radiculopathy
  •   M54.3 -  Sciatica
  •   M54.4 -  Lumbago with sciatica
  •   M54.5 -  Low back pain
  •   M54.8 -  Other dorsalgia
  •   M54.9 -  Dorsalgia, unspecified
  •   F45.4 -  Persistent somatoform pain disorder
  •   I25 -  Chronic ischaemic heart disease
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Interventions/Observational Groups

  •   The PaBeKo-project consisted of four partial studies, two pre-studies and two main studies. We included one group of participants (chronically ill patientes = chronic back pain or chronic ischemic heart disease).
    The aim of pre-studies was to develop items for questionnaires (to measure communication preferences of patients and - attitudes and - behaivior of providers). These questionnaires were psychmetrically tested in main studie one and analysis of communication preferences and their impact on relevant outcome variables were surveyed in main study two.

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Characteristics

  •   Non-interventional
  •   Other
  •   Single arm study
  •   Open (masking not used)
  •   [---]*
  •   Uncontrolled/Single arm
  •   Basic research/physiological study
  •   Single (group)
  •   [---]*
  •   N/A
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Primary Outcome

The primary aim of this research project is the development and the methodological examination of an instrument that measures preferences of chronically ill patients in relation to patient-provider communication (Questionnaire for patients’ communication preferences [the KOPRA questionnaire]). The questionnaire should be in accordance with the test theoretical requirement of Rasch’s Model. Simulatenously it is anticipated to develop of a comparable instrument for providers (Questionnaire for providers’ atttitudes towards communication [the KOMBEIN questionnaire]) and a questionnaire for testing communicative behavior of providers (KOVA questionnaire).

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Secondary Outcome

During further course of this study quantitative data collection will be exercised. It will based on the newly developed measuring instruments. Data collection is supposed to identify possible influencing factors on patients’ peferences. This is done by analysing different preference of
a) female and male patients.
b) patients in different age groups.
c) patients with different types of diagnosis.
d) stationary/ambulant patients

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Countries of Recruitment

  •   Germany
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Locations of Recruitment

  • [---]*
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Recruitment

  •   Actual
  •   2008/03/09
  •   900
  •   Monocenter trial
  •   National
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Inclusion Criteria

  •   Both, male and female
  •   18   Years
  •   no maximum age
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Additional Inclusion Criteria

Diagnosis "Chronic back pain" or "Chronic ischemic heart disease"

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Exclusion Criteria

Language impairment; cognitive and/or physical impairment (patient is not able to fill out questionnaire)

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Addresses

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    • Uniklinikum Freiburg Abteilung Qualitätsmanagement und Sozialmedizin (AQMS)
    • Engelbergerstraße 21
    • 79106   Freiburg
    • Germany
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    •   0761-27074470
    •   0761-27073310
    •   [---]*
    •   http://www.aqms.de
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    • Universitätsklinikum Freiburg Abteilung für Qualitätsmanagement und Sozialmedizin (AQMS)
    • Mr.  Prof. Dr.  Erik  Farin-Glattacker 
    • Engelbergerstraße 21
    • 79106  Freiburg
    • Germany
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    • Universitätsklinikum Freiburg Abteilung für Qualitätsmanagement und Sozialmedizin (AQMS)
    • Mr.  Dipl.-Psych.  Lukas  Gramm 
    • Engelbergerstraße 21
    • 79106  Freiburg
    • Germany
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Sources of Monetary or Material Support

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    • Deutsches Zentrum für Luft- und Raumfahrt e.V. (DLR), Projektträger des BMBF, Gesundheitsforschung
    • Ms.  Dr.  Birgit  Kuna 
    • Heinrich-Kronen-Straße 1
    • 53227  Bonn
    • Germany
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Status

  •   Recruiting complete, follow-up complete
  •   2011/06/30
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Trial Publications, Results and other Documents

  •   Farin, E., Gramm, L. & Kosiol, D. (2011): Development of a questionnaire to assess communicationion preferences of patients with chronic illness. Patient Education and Counseling, 82, 81–88.
  •   Farin, E. (2010) Die Patient-Behandler-Kommunikation bei chronischen Krankheiten: Überblick über den Forschungsstand in ausgewählten Themenbereichen. Die Rehabilitation, 49(5), 277-291.
  •   Gramm, L., Kosiol, D, Opitz, U. & Farin, E. (2011). Qualitative Erfassung von Patientenpräferenzen und Behandlereinstellungen zur Patient-Behandler-Kommunikation: eine Fokusgruppen-Studie. Zeitschrift für medizinische Psychologie, 20(2), 76-87.
  •   Farin, E., Gramm, L. & Schmidt, E. (2012). Taking into account patients’ communication preferences: Development of an instrument and descriptive results in patients with chronic back pain. Patient Education and Counse¬ling, 86, 41-48, http://dx.doi.org/10.1016/j.pec.2011.04.012
  •   Farin, E., Gramm, L. & Schmidt, E. (2011). The congruence of patients’ communication preferences and physicians’ communication behavior in cardiac patients. Journal of Cardio¬pulmonary Rehabilitation and Prevention, 31(6): 349-357.
  •   Schmidt, E., Gramm, L. & Farin, E. Kommunikationspräferenzen chronischer Rückenschmerzpatienten in der medizinischen Rehabilitation. Der Schmerz, 26, 69-76, http://dx.doi.org/10.1007/s00482-011-1105-5
  •   Farin, E., Gramm, L. & Kosiol, D. (2009). Die Entwicklung eines Fragebogens zu den Kommunikationspräferenzen von Patienten mit chronischen Krankheiten: der KOPRA-Bogen. 8. Deutschen Kongress für Versorgungsforschung im Oktober 2009 in Heidelberg (Vortrag).
  •   Farin, E., Gramm, L., Kosiol, D. (2010). Die Präferenzen chronisch Kranker im Hinblick auf die Kommunikation mit BehandlerInnen. 18. Jahrestagung der DGPM, 61. Arbeitstagung des DKPM/19.03.2010 in Berlin (Vortrag).
  •   Farin, E., Gramm, L. & Schmidt, E. (2011). Die kommunikationsbezogenen Einstellungen von BehandlerInnen in der medizinischen Rehabilitation. 20. Rehabilitationswissenschaftliches Kolloquium vom 14. bis 16. März 2011 in Bochum (Poster).
  •   Gramm, L., Kosiol, D. & Farin, E. (2009).Patient-professional communication: Congruence of patients’ preferences and professionals’ attitudes. 5th World Congress of the International Society of Physical and Rehabilitation Medicine (ISPRM) vom 13. bis 17. Juni 2009 in Istanbul (Poster).
  •   Gramm, L., Kosiol, D., & Farin, E. (2009). Die Patient-Behandler-Kommunikation: Kommunikationsbezogene Präferenzen chronisch kranker Patienten in der Rehabilitation. Das Gesundheitswesen, 71(08/09). Gemeinsame Tagung der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) und der Deutschen Gesellschaft für Medizinische Soziologie (DGMS) vom 23. bis 25. September 2009 in Hamburg (Vortrag).
  •   Gramm, L., Kosiol, D. & Farin, E. (2010). Evaluation der deutschen Version des Fragebogens „Perceived efficacy in patient-physician interactions“ (PEPPI). 19. Rehabilitationswissenschaftliches Kolloquium vom 10. bis 12. März 2010 in Leipzig (Vortrag).
  •   Gramm, L., Kosiol, D. & Farin, E. (2010). Kongruenz von patientenseitigen Kommunikationspräferenzen und arztseitigem Kommunikationsverhalten als Prädiktor des Behandlungserfolgs bei Patienten mit chronischem Rückenschmerz. 9. Deutscher Kongress für Versorgungsforschung vom 30.September bis 02.Oktober 2010 in Bonn (Vortrag).
  •   Gramm, L., Schmidt, E., Kosiol, D. & Farin, E. (2011). Prädiktoren der Kommunikationspräferenzen von Patienten mit chronischem Rückenschmerz. 20. Rehabilitationswissenschaftliches Kolloquium vom 14. bis 16. März 2011 in Bochum (Vortrag).
  •   Kosiol, D., Gramm, L. & Farin, E. (2009). Die Patient-Behandler-Kommunikaton: Kommunikationsbezogene Präferenzen von chronisch kranken Patienten in der Rehabilitation. 18. Rehabilitationswissenschaftliches Kolloquium vom 9. bis 11. März 2009 in Münster (Vortrag).
  •   Kosiol, D., Gramm, L. & Farin, E. (2010). Kommunikationspräferenzen chronisch kranker Patienten in der medizinischen Rehabilitation. 19. Rehabilitationswissenschaftliches Kolloquium vom 10. bis 12. März 2010 in Leipzig (Vortrag).
  •   Schmidt, E., Gramm, L. & Farin, E. (2011). Die Messung von Kommunikationspräferenzen chronischer Schmerzpatienten im Klinikalltag. 7. Workshopkongress der Fachgruppe Klinische Psychologie in Berlin vom 2. bis 4. Juni 2011 (Poster).
  •   Farin-Glattacker E, Gramm L, Schmidt E (2012). Der Einfluss der Patient-Arzt-Beziehung bei Rehabilitanden mit chronischen Rückenschmerzen auf die Effekte der Rehabilitation. Abstract. DRV-Schriften, 2012; 98: 133-134 (21. Rehabilitationswissenschaftliches Kolloquium/ 05.-07.3.2011 in Hamburg/ DRV Bund und DRV Nord), Deutsche Rentenversicherung Bund (Hrsg) [Vortrag]
  •   Gramm L, Schmidt E, Kosiol D, Farin-Glattacker E (2012). Behandlungseffekte in der medizinischen Rehabilitation von Patienten mit chronischem Rückenschmerz. Abstract. DRV-Schriften, 2012; 98: 358-370 (21. Rehabilitationswissenschaftliches Kolloquium/ 05.-07.3.2011 in Hamburg/ DRV Bund und DRV Nord), Deutsche Rentenversicherung Bund (Hrsg) [Vortrag]
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