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Dyachenko E.V., Samoylenko N.V. (2020). Patient image semantics and its change in training skills in quasi professional medical activity. National Psychological Journal, [Natsional’nyy psikhologicheskiy zhurnal], (13)1, 115–125

Abstract

Background. The increase of public satisfaction with the quality of medical care is one of the Russian healthcare issues. A method for increasing public satisfaction lies in modernizing the model of medical care, i.e. a shift from the paternalistic approach to the patient-oriented one in medical counseling. For its successful implementation, the image of the patient in the attending physician is of great importance.

Objective. We hypothesized that targeted doctor training in professional communication skills will cause a qualitatively-quantitative change in the semantic content of the patient’s image. Therefore, the objective is studying changes of the patient’s image in medical students in the course of their participation in quasi-professional activities.

Design. In order to test the hypothesis, we conducted an experimental study that included 250 (78.2% females, 21.8% males) first-year students of the Faculty of Medicine and Prevention, the Ural State Medical University. The average age of the participants is 18.8 years. To eliminate distortions in the responses of the participants, the patient’s image was studied from the perspective of a psychosemantic research approach. An important criterion in choosing an approach and a research method was the desire to identify implicit and in most cases indirect characteristics of the patient’s image. To study the subjective semantic spaces representing a set of subjective systems of meanings in relation to a patient, the method of bipolar and unipolar personality semantic differential was used

Results. The results of factorial and comparative analysis (T-Student) by the methodology “Bipolar and unipolar personality semantic differential” showed that the content of the patient’s image as a semantic space of the world’s image of doctors with targeted training in professional communication skills tends to change when performing educational and professional tasks of clinical practice.

Conclusion. The contents of the semantic category “patient image” is significantly expanding filled with various semantic meanings. Accordingly, various changes in the behaviour of future doctors turn to be possible. The results of the study can serve as the basis for integrating a targeted training of professional communication skills into the medical educational programs, which will increase the quality of doctors’ preparedness for practical activities and help increase public satisfaction with the quality of medical care.

Received: 09/18/2019
Accepted: 02/12/2020
Pages: 115-125
DOI: 10.11621/npj.2020.0111

By: Dyachenko E.V.; Samoylenko N.V.;

Sections: Psychology and Medicine;

PDF: /pdf/npj-no37-2020/npj_no37_2020_115-125.pdf

Keywords: semantic contents of the image; patient’s image; students of a medical university; quasi-professional activity; skills of professional communication with patients;

Available Online 31.03.2020

Table 1. Patient’s image in the medical students of the 1st year before undergoing training in professional communication skills

Features of the “Patient” Image

Factor loads (loads with a weight coefficient ≥0, 50)

Factor 1

Factor 2

Factor 3

Charming / Unattractive

-0.26

0.65

0.14

Weak/ Strong

0.56

-0.20

-0.20

Jovial/ Taciturn

-0.03

0.34

-0.25

Irresponsible / Conscientious

0.78

-0.25

-0.20

Stubborn / Agreeable

0.49

0.14

-0.54

Closed / Open

0.77

-0.05

0.002

Kind / Selfish

-0.22

0.58

0.25

Dependent / Independent

0.41

-0.11

-0.21

Active / Passive

-0.20

0.71

0.06

Callous / Responsive

0.85

-0.12

-0.03

Decisive / Indecisive

-0.18

0.60

0.23

Lethargic / Energetic

0.69

-0.41

0.004

Fair / unfair

-0.18

0.64

0.12

Relaxed / Stressful

0.20

0.38

0.72

Fussy / Calm

0.42

-0.23

-0.71

Hostile / Friendly

0.81

-0.03

-0.05

Confident / Unsure

-0.14

0.50

0.30

Unoccupied / Sociable

0.69

-0.04

0.09

Honest / Insincere

-0.32

0.49

-0.23

Non-Independent / Independent

0.70

-0.10

-0.15

Annoying / Imperturbable

0.53

-0.26

-0.55

Hard / soft

0.44

-0.02

-0.06

Rough / Gentle

0.70

-0.17

-0.26

Excitable / Calm

0.61

-0.22

-0.38

Stressful / Relaxed

0.41

-0.18

-0.59

Rational / Irrational

-0.15

0.68

0.20

Logical / Intuitive

0.03

0.64

0.19

Unique / Typical

0.22

0.44

0.01

Normal / Unusual

0.31

0.09

-0.19

Sociable / Reserved

-0.16

0.48

0.15

Friendly / Lonely

-0.31

0.59

0.27

Proud / Humble

0.55

0.19

-0.23

Difficult / Naive

0.15

0.17

-0.02

Predictable / Unpredictable

0.09

0.05

0.54

Defined / Amorphous

-0.52

0.31

0.12

Explained Variation

22%

15.1%

9.3%

NB: selection of factors rotation method: Varimax with Kaiser normalization.

Table 2. Patient’s image in the medical students of the 1st year after undergoing training in professional communication skills

Features of the “Patient” Image

Factor loads (loads with a weight coefficient ≥0. 50)

Factor 1

Factor 2

Factor 3

Charming / Unattractive

-0.75

0.26

-0.12

Weak/ Strong

0.69

-0.16

0.08

Jovial/ Taciturn

-.470

0.18

0.33

Irresponsible / Conscientious

0.82

0.02

-0.10

Stubborn / Agreeable

0.35

0.51

0.05

Closed / Open

0.73

-0.12

-0.33

Kind / Selfish

-0.68

-0.05

-0.07

Dependent / Independent

0.38

-0.17

0.36

Active / Passive

-0.71

0.18

0.18

Callous / Responsive

0.76

0.11

0.07

Decisive / Indecisive

-0.75

0.20

0.19

Lethargic / Energetic

0.73

-0.19

0.04

Fair / unfair

-0.77

0.06

0.005

Relaxed / Stressful

-0.67

-0.21

0.05

Fussy / Calm

0.73

0.18

0.35

Hostile / Friendly

0.78

0.07

0.21

Confident / Unsure

-0.76

0.12

-0.02

Unoccupied / Sociable

0.72

-0.01

-0.13

Honest / Insincere

-0.76

0.10

0.22

Non-Independent / Independent

0.68

-0.02

0.27

Annoying / Imperturbable

0.71

0.23

0.31

Hard / soft

0.12

0.64

0.14

Rough / Gentle

0.62

0.25

0.19

Excitable / Calm

0.71

0.43

0.11

Stressful / Relaxed

0.69

0.41

0.18

Rational / Irrational

-0.74

0.01

0.30

Logical / Intuitive

-0.58

0.01

0.09

Unique / Typical

-0.29

0.67

-0.19

Normal / Unusual

-0.004

-0.53

0.49

Sociable / Reserved

-0.74

0.16

0.28

Friendly / Lonely

-0.77

0.01

0.26

Proud / Humble

0.45

0.48

0.22

Difficult / Naive

-0.17

0.53

-0.25

Predictable / Unpredictable

-0.02

-0.36

0.56

Defined / Amorphous

-0.63

0.16

0.08

Explained Variation

41%

9%

5.40%

NB: selection of factors rotation method: Varimax with Kaiser normalization.

Table 3. Comparative analysis using t-Student

Category

t-empirical (with t-critical 1.99) p=0.05

Category

t-empirical (with t-critical 1.99) p=0.05

Category

t-empirical (with t-critical 1.99) p=0.05

Mean

Mean

Mean

before

after

before

after

before

after

Stubborn / Agreeable

t-empirical 1.51

Organised

t-эмпирич. 0.33

Prudent

t-эмпирич. 1.70

-1.1

0.24

-0.75

0.52

-1.20

-0.51

Dependent / Independent

t-empirical 1.18

Selfish

t-empirical 0.96

Disorganised

t-empirical 0.46

1.12

0.25

-0.45

-0.92

0.86

-1.62

Annoying / Imperturbable

t-empirical 1.74

Self-critical

t-empirical 0.48

Optimistic

t-empirical 0.51

-0.18

0.16

0.37

-0.39

-0.51

0.78

Stressful / Relaxed

t-empirical 1.37

Hardworking

t-empirical 0.28

Thin

t-empirical 1.09

-0.45

-0.09

-0.35

0.42

-0.77

-0.58

Proud / humble

t-empirical 0.24

Experienced

t-empirical 0.69

Cold

t-empirical 1.78

0.42

0.17

-0.62

-0.13

0.05

-0.97

Kind

t-empirical 0.12

Vile

t-empirical 1.58

Inexperienced

t-empirical 1.98

0.73

0.54

-0.21

-2.23

1.31

-0.42

Sociable

t-empirical 1.04

Tough

t-empirical 0.16

Natural

t-empirical 0.12

-0.75

0.73

-0.88

-0.27

0.30

0.98

Honest

t-empirical 0.50

Charming

t-empirical 1.43

Mobile

t-empirical 1.27

-0.43

0.89

-0.62

-0.18

0.24

0.29

Active

t-empirical 0.53

Benevolent

t-empirical 0.96

Witty

t-empirical 0.17

0.07

0.50

-0.18

0.87

0.38

-0.04

Clever

t-empirical 0.63

Flexible

t-empirical 0.21

Erudite

t-empirical 0.55

-1.39

0.17

-0.02

0.08

-1.38

0.41

Open

t-empirical 0.06

Poetic

t-empirical 0.92

Unfriendly

t-empirical 1.97

-1.43

0.82

-1.86

-0.79

-0.71

-1.58

Stupid

t-empirical 0.67

Saboteur

t-empirical 1.77

Nonchallant

t-empirical 0.27

-0.01

-0.54

-1.86

-2.21

-0.98

-1.08

Strong

t-empirical 0.24

Pretty

t-empirical 0.49

Изворотливый

t-empirical 0.20

0.70

-0.04

0.18

-0.37

-0.06

-1.05

Simple

t-empirical 0.47

Connoisseur

t-empirical 0.44

Meticulous

t-empirical 1.91

0.63

0.59

-0.57

0.10

-0.33

-1.57

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For citing this article:

Dyachenko E.V., Samoylenko N.V. (2020). Patient image semantics and its change in training skills in quasi professional medical activity. National Psychological Journal, [Natsional’nyy psikhologicheskiy zhurnal], (13)1, 115–125

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