Communication and disease management: a qualitative study on coronary disease

This study investigated doctor–patient communication and its role in the management of coronary disease. The aim was to identify patients’ information needs and related issues and to compare these findings with doctors’ perceptions of patients’ needs and communication barriers. Two focus groups were conducted with eight patients who suffered from coronary disease and six cardiologists. Recorded sessions were coded thematically and analyzed with interpretative phenomenological analysis. The results showed a “frustration of understanding” in both groups. Patients reported difficulty in understanding experts’ language, and physicians found it difficult to translate the medical terminology into simple words. However, they accused each other of creating these difficulties. Patients described physicians as an “elite” group with excessive technical language, and physicians reported that patients’ age and education (respectively, high and low) are real obstacles to good communication. Patients evaluated an autonomous search for health information as a way to better manage fear and anxiety related to the illness, but physicians considered it as a lack of trust and, thus, judged it negatively. Patients reported multiple unfilled needs, which were mainly related to information about how other people experienced the same illness and to specific information for their relatives, especially their spouses. Physicians stressed the need to transmit information about drug therapy and the need for adherence to manage chronic conditions. The analysis of patients’ information preferences and the awareness of patients’ information needs might strongly improve the overall quality of chronic disease management by suggesting new communication strategies.