Patient-clinician communication and needs identification for outpatients with schizophrenia in Hong Kong: Role of the 2-COM instrument

Abstract

Objectives: To assess perceived needs of schizophrenic outpatients in Hong Kong, and the effectiveness of clinicians in identifying those needs; and to explore the use of a self-rated instrument to enhance needs identification. Participants and Methods: The two-way communication checklist was completed by 70 outpatients before consultation. Their clinicians were either given the checklist during the consultation (2-COM group, n = 36), or were unaware of the patients' answers and independently completed the checklist (needs awareness group, n = 34). A standard care group (n = 35) was included for comparison. Consultation time and patient satisfaction were also recorded. Results: The major concern of patients was information about their illness and treatment (59%). In the needs awareness group, under-recognition of patients' needs by clinicians was observed in various domains. Consultation time (mean, 5.6 minutes) correlated with the number of needs identified by clinicians. The 2-COM group showed a trend towards higher satisfaction compared to the standard care group, although this did not reach statistical significance. Conclusions: Clinicians may under-identify problems perceived by patients due to time constraints and other factors. The use of a structured questionnaire may facilitate effective needs identification in a busy outpatient clinic. © 2008 Hong Kong College of Psychiatrists.