Determinants of Patient-centered Communication Based on the Views of Physicians, Students, and Patients: A Qualitative Study

Aims: Despite the benefits of Patient-Centered Communication (PCC), there are problems with its implementation. Problems are related to characteristics of patients or health systems, patterns of patient-physician interaction, or perspectives in defining PCC. This study aimed to examine determinants of PCC from the viewpoint of faculty members, medical residents and interns, and patients and recommends tips for improving Patient-Physician Relationships (PPR). Participants Methods: In this qualitative content analysis study in 2018 at Tabriz University of Medical Sciences, data were gathered using focus groups (62 participants), semi-structured interviews (31 participants), and participatory observations based on purposive until the saturation was achieved. The content was analyzed through a thematic, manifest summative analysis. Standards for methodological rigor were enhanced through different strategies. Findings: The findings were classified into four categories matched with four core concepts of PCC: 1) Respect and dignity, 2) Information sharing, 3) Participation, and 4) Collaboration. Sub-categories included recognition of patients’ individuality, attention to patients’ needs, physicians’ personal characteristics, physicians’ communication competencies, patient-focused care, patients’ trust-supported attitude, physicians’ motivation, physicians’ working context, socio-cultural inductions, organizational policies, and physicians’ professional responsibility. Conclusion: Patient-centered communication can be characterized by honoring patients’ individuality, paying attention to patients’ needs, focusing on physicians’ proper personal characteristics in continuing medical education, enhancing physicians’ communication competencies, institutionalization of patient-focused care, creating trust-supported attitudes among patients, increasing physicians’ motivation, regulating physicians’ working context, serious attention to social and cultural inductions, making supportive organizational policies, and evaluating physicians’ professional responsibilities.