Thomas C. Froehle

Clinician communication associated with diabetic patients' comprehension of their therapeutic regimen

The purpose of this study was to identify the types of statements used by medical and nursing clinicians in encounters with diabetic outpatients that are associated with accurate comprehension of their therapeutic regimen. Encounters between 19 clinicians and 29 patients followed in an urban diabetes clinic were examined. Statements made by clinicians were classified by trained observers according to an 11-category observation scheme. Immediately after the encounters, each patient was interviewed and asked to recall his or her regimen as just discussed. Recall was verified by review of a videotape of the encounter. By use of multiple discriminant analysis, a combination of three types of statements by clinicians was found to predict high (better than 80%) comprehension by patients: demonstrating respect, sharing current clinical data, and acknowledging patient statements (inversely). Insofar as patient comprehension of the diabetic regimen is a prerequisite for compliance with that regimen, this study suggests that the chances for therapeutic success are increased when the interaction of clinician and patient takes a certain tone. Most importantly, the clinician should be informative. Current laboratory and physical findings should be shared with the patient in order to make more obvious the successes and failures of recent attempts at compliance. As suggested in previous research, this information should have its strongest effect when conveyed in a nonthreatening manner.

Construct Validity of the FIRO-B Questionnaire: A Failure to Replicate?

Summary The purpose of this investigation was to partially replicate and elaborate upon a validation study of the FIRO-B Questionnaire reported by Kramer. (1967a) The 25 Ss employed in this study were administered the FIRO-B Questionnaire, given a brief lecture on the theory behind the instrument and then directed to estimate their scores on the three FIRO-B dimensions. Rank order correlations were calculated between the measured and estimated scores. Contrary to Kramers findings only one of the six resulting coefficients attained significance at or beyond the .05 level of confidence. A recent finding in the estimated and measured test score approach to test validation studies, namely scale relevance to individual Ss, was proposed as a possible explanation for the inconsistent results. A partial replication of the Kramer (1967a) test validation study of the FIRO-B Questionnaire yielded a significant relationship between estimated and measured scores on one of the six scales of the instrument, namely, exp...