Qualitative and quantitative analysis of doctor–patient interactions during andrological consultations

Abstract

Introduction: Although a trustworthy connection between doctor and patient is crucial in clinical practice, it could be hindered by different cultural and linguistic backgrounds. Moreover, an effective doctor–patient interaction could be even more challenging in andrological fields, in which psychological and social components are predominant. Aim: To analyse the doctor–patient relationship in the andrological field, applying both qualitative and quantitative analyses. Methods: monocentric, cross-sectional, observational study was performed between May and December 2018. During the study, all patients aged >18 years attending the Modena Andrology Unit for couple infertility or erectile dysfunction were enrolled and the doctor–patients interaction recorded. Patients were divided into two groups depending on their medical seeking and were further divided between native and non-native speakers of Italian. All patients underwent a routine andrological examination. Every first medical consultation was audio-recorded and transcribed using “ELAN” software for socio-linguistic analysis. Transcriptions underwent qualitative analysis through conversation analysis. Then, quantitative analyses were performed, and interaction parameters underwent correlation analyses. Results: Twenty-five patients were enrolled. The analysis of the andrological interview allowed to recognise five consecutive phases, following a semi-standardized pattern. Patients without linguistic barriers and with infertility problems showed more autonomous contribution during the consultation. No difference arose in the sexual dysfunctions group. Doctor's explanations were frequent, but when linguistic barrier was present or Italian patients seemed less talkative, explanations were shorter, and doctors tried to use other conversational mechanisms to promote understanding. Patient's variables were significantly lower compared to the doctor, considering the number of turns (p = 0.025) and their minimum (p = 0.032), maximum (p < 0.001), and average durations (p < 0.001). Only patient's latency was significantly higher than the doctor's (p = 0.001). Conclusion: This is the first attempt to analyse the doctor–patient relationship in andrology using authentic audio-recorded consultations. The results confirmed that a patient-centred communication must be applied also in andrological consultations. However, the topics discussed may require more “medical formulation” to be acceptable to the participants in this context.