Quality assessment of health counseling: performance of health advisors in cardiovascular prevention.

Quality assessments of interventions are seen as essential in optimizing their implementation, interpreting their effectiveness, and illuminating their underlying processes. In Hartslag Limburg, a cardiovascular prevention project, the quality of a health counseling intervention was assessed as part of the process evaluation. Four health advisors each video-taped 16 counseling sessions, all of which were assessed by three independent observers. Health counseling was found to be a very difficult skill, but, all things considered, the overall quality was evaluated as rather encouraging. No indication was found of quality improvement over time. The interpretation of the findings was complicated by limited absolute interobserver agreement, but reliable relative distinctions could be made between the health advisors' performance and their application of various counseling skills. Future quality investigators are advised to carefully match study goals with study methods, and practitioners planning a health counseling project should take the complexity of the task into account.

[1]  J. Bensing,et al.  Doctor-patient communication in different European health care systems: relevance and performance from the patients' perspective. , 2000, Patient education and counseling.

[2]  J. de Haes,et al.  Doctor-patient communication: a review of the literature. , 1995, Social science & medicine.

[3]  Carlo C. DiClemente,et al.  The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy , 1994 .

[4]  Geoffrey R. Norman,et al.  Assessing "clinical competence". , 1968, British medical journal.

[5]  J. Bensing.  Doctor-patient communication and the quality of care. , 1991, Social science & medicine.

[6]  F. H. Kanfer,et al.  Guiding the process of therapeutic change , 1988 .

[7]  C. Rogers.  Client-Centered Therapy: Its Current Practice, Implications and Theory , 1951 .

[8]  P. Bower,et al.  Patient-centredness: a conceptual framework and review of the empirical literature. , 2000, Social science & medicine.

[9]  P Kinnersley,et al.  Measuring the involvement of patients in shared decision-making: a systematic review of instruments. , 2001, Patient education and counseling.

[10]  Jonathan Silverman,et al.  Skills for Communicating with Patients , 1998 .

[11]  H. T. Molen,et al.  Three methods for the assessment of communication skills , 1996 .

[12]  J. Rethans,et al.  Assessment of general practitioners by video observation of communicative and medical performance in daily practice: issues of validity, reliability and feasibility , 1999, Medical education.

[13]  F. Crawford,et al.  A pilot study to establish a randomized trial methodology to test the efficacy of a behavioural intervention. , 2000, Health education research.

[14]  T. Coleman.  Using video-recorded consultations for research in primary care: advantages and limitations. , 2000, Family practice.

[15]  F B Lammes,et al.  Doctor-patient communication and cancer patients' quality of life and satisfaction. , 2000, Patient education and counseling.

[16]  B. Tabachnick,et al.  Using Multivariate Statistics , 1983 .

[17]  C. Rogers,et al.  Client-Centered Therapy , 1951 .

[18]  S. Siegel,et al.  Nonparametric Statistics for the Behavioral Sciences , 2022, The SAGE Encyclopedia of Research Design.

[19]  David Gill,et al.  Predicting health behavior , 1997 .

[20]  D. Streiner,et al.  Health Measurement Scales: A practical guide to thier development and use , 1989 .

[21]  Verl T. Pope,et al.  The Personal Characteristics of Effective Counselors: What 10 Experts Think , 1999, Psychological reports.

[22]  T. Kettunen,et al.  Taciturn Patients in Health Counseling at a Hospital: Passive Recipients or Active Participators? , 2001, Qualitative health research.

[23]  J. Bensing,et al.  Evaluation of communication training programs in nursing care: a review of the literature. , 2000, Patient education and counseling.

[24]  W. Miller,et al.  Motivational Interviewing: Preparing People to Change Addictive Behavior , 1991 .

[25]  N. Weinstein.  The precaution adoption process. , 1988, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[26]  C. Charles,et al.  Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). , 1997, Social science & medicine.

[27]  Patricia Dolan Mullen,et al.  Measurement and Evaluation in Health Education and Health Promotion , 1986 .

[28]  T. Kettunen,et al.  Communicator styles of hospital patients during nurse-patient counseling. , 2000, Patient education and counseling.

[29]  Thomas B. Scott,et al.  Further Evidence for Unidimensionality of Measures of Counseling Performance , 1986, Psychological reports.

[30]  J. Yaphe,et al.  A comparison of videotape and audiotape assessment of patient-centredness in family physicians' consultations. , 2001, Patient education and counseling.

[31]  A. Avenell,et al.  Systematic review of randomised controlled trials , 2018 .

[32]  David Pendleton,et al.  Doctor-patient communication , 1983 .