Raising awareness on physician-patient communication in IPF: an Italian multicenter study exploring the pulmonologist's perspective

Sara Tomassetti; Alfredo Sebastiani; Antonella Caminati; Tiberio Oggionni; Michele Davì; Alessandra Ghirardini; Monica M Martinoli

doi:10.36141/svdld.v38i3.11400

Raising awareness on physician-patient communication in IPF: an Italian multicenter study exploring the pulmonologist's perspective

Sarcoidosis Vasc Diffuse Lung Dis. 2021;38(3):e2021042. doi: 10.36141/svdld.v38i3.11400. Epub 2021 Sep 30.

Authors

Sara Tomassetti^{1

2}, Alfredo Sebastiani³, Antonella Caminati⁴, Tiberio Oggionni⁵, Michele Davì⁶, Alessandra Ghirardini⁶, Monica M Martinoli⁷

Affiliations

¹ Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy.
² Present address: Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy.
³ Day Hospital and ILD Unit, San Camillo-Forlanini Hospital, Rome, Italy.
⁴ Semi-Intensive Care Unit, Department of Pneumology, Department of Respiratory Physiopathology and Pulmonary Hemodynamics, San Giuseppe Hospital - MultiMedica IRCCS, Milan, Italy.
⁵ Pulmonology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
⁶ Roche SpA, Monza, Italy.
⁷ Freelancer; Adjunct Professor, University of the Studies of Milan, Milan, Italy.

Abstract

Background: Idiopathic pulmonary fibrosis (IPF) remains a debilitating, poor prognosis disease requiring a patient-centered approach.

Objectives: To explore the pulmonologist's perspective on physician-patient communication.

Methods: A faculty of psychologists and pulmonologists organized a training course consisting of two workshops 12 months apart. Self-assessment questionnaires (pre- and post-course), role play (RP) simulations (during both workshops) and clinical consultation observations followed by semi-structured interviews (during the 12 months) were employed to evaluate the pulmonologists' knowledge of patient-centered medicine and communication/relational skills (questionnaires), their communication style (RP) and possible communication/relational difficulties (semi-structured interviews).

Results: Twenty-three pulmonologists attended the first workshop and 14 the second one; 10 attended both. The questionnaires revealed the interest in patient-centered medicine and communication but also the need for deeper knowledge and improved skills. From the RP sessions performed during the first workshop, a disease-oriented approach emerged; notably, after the training, some improvements suggested a more patient-centered approach, e.g., a more frequent exploration of the patient agenda. Finally, the semi-structured interviews allowed to identify the low patients' cultural level and the poor general knowledge of IPF among the barriers hampering an effective communication with the clinician, who, however, is responsible for overcoming these obstacles.

Conclusions: Despite the overall disease-prone approach to IPF patients, there was room for improvement through adequate training, which, in practice, may ameliorate communication and drive towards patient-centeredness. Exploring the pulmonologists' needs may help tailoring training interventions. Raising awareness on these topics is crucial to ensure IPF patients optimal care.

Keywords: Communication; Idiopathic pulmonary fibrosis; Patient-centeredness; Questionnaire; Role play; Semi-structured interviews; Training.