***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A group of 200 patients who presented in general practice with symptoms but no abnormal physical signs and in whom no definite diagnosis was made were r and omly selected for one of four consultations : a consultation conducted in a " positive manner , " with and without treatment , and a consultation conducted in a " non-positive manner , " called a negative consultation , with and without treatment . Two weeks after consultation there was a significant difference in patient satisfaction between the positive and negative groups but not between the treated and untreated groups . Similarly , 64 % of those receiving a positive consultation  got better , compared with 39 % of those who received a negative consultation ( p = 0.001 ) and 53 % of those treated got better compared with 50 % of those not treated ( p = 0.5 ) BACKGROUND There is general support for general practitioners ( GPs ) using patient-centred styles . However , there is limited British evidence of beneficial outcomes for patients from such styles . AIM To explore whether , for patients presenting for new episodes of care , the GP 's consulting style , specifically the patient-centredness of the consultation , is related to five generic outcomes . METHOD General practitioners in South Wales were recruited , and one surgery consulting session was audiotape recorded for each participating clinician . Question naires were given to consenting patients before their consultations , immediately afterwards , and , by post , at two weeks to measure the following outcomes : doctor-patient agreement ( on the nature of the problem and management ) , patient satisfaction , resolution of symptoms , resolution of concerns , and functional health status . From the patients consulting for a new episode of care and completing all three question naires , one patient was selected at r and om for each GP and the audiotape of their consultation rated for patient-centredness . Statistical analysis employed correlation coefficients and t-tests , followed by multiple regression and logistic regression to control for potential confounders . RESULTS In total , 143 patients consulting 143 GPs were studied . The patient-centred score was positively and statistically significantly associated with patient satisfaction ( Pearson correlation = 0.28 ; P = 0.002 ) . No other associations were found with the other outcomes measured . CONCLUSION The study presents evidence that patient-centred styles of consulting produce benefits in terms of increased patient satisfaction for patients consulting for new episodes of care in Britain BACKGROUND No study has yet assessed the impact of physicians ' skills acquisition after a communication skills training programme on the evolution of patients ' anxiety following a medical consultation . This study aim ed to compare the impact , on patients ' anxiety , of a basic communication skills training programme ( BT ) and the same programme consoli date d by consolidation workshops ( CW ) , and to investigate physicians ' communication variables associated with patients ' anxiety . PATIENTS AND METHODS Physicians , after attending the BT , were r and omly assigned to CW or to a waiting list . The control group was not a non-intervention group . Consultations with a cancer patient were recorded . Patients ' anxiety was assessed with the State Trait Anxiety Inventory before and after a consultation . Communication skills were analysed according to the Cancer Research Campaign Workshop Evaluation Manual . RESULTS No statistically significant change over time and between groups was observed . Mixed-effects modelling showed that a decrease in patients ' anxiety was linked with screening questions ( P = 0.045 ) , physicians ' satisfaction about support given ( P = 0.004 ) and with patients ' distress ( P < 0.001 ) . An increase in anxiety was linked with breaking bad news ( P = 0.050 ) and with supportive skills ( P = 0.013 ) . No impact of the training programme was observed . CONCLUSIONS This study shows the influence of some communication skills on the evolution of patients ' anxiety . Physicians should be aware of these influences From previous studies there is a lot of evidence that in primary care setting s , many patients tend to express their mental problems in terms of physical symptoms . Therefore , the general practitioner ( GP ) needs to recognize mental problems at an early stage . Early recognition allows for adequate treatment that might speed up recovery . The present article reports on a study exploring the GP 's ability to recognize mental illness , the communication style that is supposed to support this ability , the subsequent treatment of mental problems , and the patient 's recovery . Two data bases were used . First , an observation study , involving 351 videotaped consultations held by 15 GPs  , yielded information on communication style and recognition abilities . Patients in this study were selected r and omly . The second data base obtained treatment data and measures of patient recovery from a 1-year follow-up study dealing with the treatment and course of mental illness . Patients in this study were selected because their GPs considered their problems " mainly psychosocial by nature " . Half of them were categorized within psychological and social diagnostic categories of the International Classification for Primary Care ( ICPC ) , the other half were categorized within physical disease categories , with an assessment by the GP that the complaints were mainly psychosocial . Results showed no significant relationships between the recognition of mental illness and nine communication features supposed to induce these abilities . There was a tendency however , for a positive association between recommended communicative behaviour of the GP and his or her tendency to give frequently psychosocial evaluations of the patient 's complaints . Also , there was a negative tendency between this recommended behaviour and the degree of agreement between the GP 's evaluation and the score on a psychiatric screening question naire . This agreement is called " accuracy " . Frequent psychosocial evaluations were related to exploring behaviour and mental health referral in case of psychosocial complaints . Further , relationships between the GPs ' recognition ability and various measures of patients ' recovery did not prove univocal . Both positive , negative and absent relationships were found OBJECTIVE Patients ' affect and expectancies can set off placebo effects and thus impact patients ' health . We assessed the relative effects of physicians ' affect-oriented communication style and raising expectations on patients ' affective state and outcome expectancies . METHOD Thirty healthy women presented severe menstrual pain in a scripted consultation with a general practitioner ( GP ) . In a 2x2 r and omized controlled trial , the GP communicated in a warm , empathic or cold , formal way and raised positive or uncertain expectations . Effects on subjects ' state anxiety , affective state and outcome expectancies were assessed . RESULTS Only warm , empathic communication combined with positive expectations led to a significant and relevant decrease in state anxiety . Subjects ' positive and negative affects were influenced by GPs affect-oriented communication style . Negative affect and outcome expectancies are influenced by GP suggestions about outcomes . CONCLUSION Manipulations in physicians ' affect-oriented and expectancy-related communication can have a large impact on patients ' affective state and outcome expectations . A combination of a warm , empathic communication style and raising positive expectations result ed in optimal subject outcomes . PRACTICE IMPLICATION S Physicians should take into account that communicating in warm , empathic way combined with raising positive expectations seems to lead to the most favorable effects on patients ' state anxiety and outcome expectancies This study extends the literature on personality and job performance through the use of r and om coefficient modeling to test the validity of the Big Five personality traits in predicting overall sales performance and sales performance trajectories -- or systematic patterns of performance growth -- in 2 sample s of pharmaceutical sales representatives at maintenance and transitional job stages ( K. R. Murphy , 1989 ) . In the maintenance sample , conscientiousness and extraversion were positively associated with between-person differences in total sales , whereas only conscientiousness predicted performance growth . In the transitional sample , agreeableness and openness to experience predicted overall performance differences and performance trends . All effects remained significant with job tenure statistically controlled . Possible explanations for these findings are offered , and theoretical and practical implication s of findings are discussed OBJECTIVE To ascertain whether the quality of physician-patient communication makes a significant difference to patient health outcomes . DATA SOURCES The MEDLINE data base was search ed for articles published from 1983 to 1993 using " physician-patient relations " as the primary medical subject heading . Several bibliographies and conference proceedings were also review ed . STUDY SELECTION R and omized controlled trials ( RCTs ) and analytic studies of physician-patient communication in which patient health was an outcome variable . DATA EXTRACTION The following information was recorded about each study : sample size , patient characteristics , clinical setting , elements of communication assessed , patient outcomes measured , and direction and significance of any association found between aspects of communication and patient outcomes . DATA SYNTHESIS Of the 21 studies that met the final criteria for review , 16 reported positive results , 4 reported negative ( i.e. , nonsignificant ) results , and 1 was inconclusive . The quality of communication both in the history-taking segment of the visit and during discussion of the management plan was found to influence patient health outcomes . The outcomes affected were , in descending order of frequency , emotional health , symptom resolution , function , physiologic measures ( i.e. , blood pressure and blood sugar level ) and pain control . CONCLUSIONS Most of the studies review ed demonstrated a correlation between effective physician-patient communication and improved patient health outcomes . The components of effective communication identified by these studies can be used as the basis both for curriculum development in medical education and for patient education programs . Future research should focus on evaluating such educational programs BACKGROUND No study has yet assessed the impact of physicians ' skills acquisition after a communication skills training program on changes in patients ' and relatives ' anxiety following a three-person medical consultation . This study aim ed at comparing , in a r and omized study , the impact , on patients ' and relatives ' anxiety , of a basic communication skills training program and the same program consoli date d by consolidation workshops and at investigating physicians ' communication variables associated with patients ' and relatives ' anxiety . METHODS Consultations with a cancer patient and a relative were recorded and analyzed by the Cancer Research Campaign Workshop Evaluation Manual . Patients ' and relatives ' anxiety were assessed with the State-Trait Anxiety Inventory-State . RESULTS No statistically significant change over time and between groups was observed . Mixed-effects modeling of changes in patients ' and relatives ' anxiety showed that decreases in both patients ' and relatives ' anxiety were linked with patients ' and relatives ' self-reported distress ( p = 0.031 and 0.005 ) , and that increases in both patients ' and relatives ' anxiety were linked with physicians ' breaking bad news ( p = 0.028 and 0.005 ) . CONCLUSION No impact of the training program was observed . Results indicate the need to further study communication skills which may help reduce patients ' and relatives ' anxiety especially when breaking bad news OBJECTIVE Effective doctor-patient communication , including a shared underst and ing , is associated with treatment adherence across medicine . However , communication is affected by a diagnosis of schizophrenia and reaching a shared underst and ing can be challenging . During conversation , people detect and deal with possible misunderst and ing using a conversational process called repair . This study tested the hypothesis that more frequent repair in psychiatrist-patient communication is associated with better treatment adherence in schizophrenia . METHODS Routine psychiatric consultations involving patients with ( DSM-IV ) schizophrenia or schizoaffective disorder were audio-visually recorded . Consultations were coded for repair and patients ' symptoms and insight assessed . Adherence was assessed six months later . A principal components analysis reduced the repair data for further analysis . R and om effects models examined the association between repair and adherence , adjusting for symptoms , consultation length and the amount patients spoke . RESULTS 138 consultations were recorded , 118 were followed up . Patients requesting clarification of the psychiatrist 's talk and the clarification provided by the psychiatrist was associated with adherence six months later ( OR 5.82 , 95 % CI 1.31 - 25.82 , p=0.02 ) . CONCLUSION The quality of doctor-patient communication also appears to influence adherence in schizophrenia . PRACTICE IMPLICATION S Future research should investigate how patient clarification can be encouraged among patients and facilitated by psychiatrists ' communication Context In primary , acute-care visits , patients frequently present with more than 1 concern . Various visit factors prevent additional concerns from being articulated and addressed . Objective To test an intervention to reduce patients ’ unmet concerns . Design Cross-sectional comparison of 2 experimental questions , with videotaping of office visits and pre and postvisit surveys . Setting Twenty outpatient offices of community-based physicians equally divided between Los Angeles County and a midsized town in Pennsylvania . Participants A volunteer sample of 20 family physicians ( participation rate = 80 % ) and 224 patients approached consecutively within physicians ( participation rate = 73 % ; approximately 11 participating for each enrolled physician ) seeking care for an acute condition . InterventionAfter seeing 4 nonintervention patients , physicians were r and omly assigned to solicit additional concerns by asking 1 of the following 2 questions after patients presented their chief concern : “ Is there anything else you want to address in the visit today ? ” ( ANY condition ) and “ Is there something else you want to address in the visit today ? ” ( SOME condition).Main Outcome Measures Patients ’ unmet concerns : concerns listed on previsit surveys but not addressed during visits , visit time , unanticipated concerns : concerns that were addressed during the visit but not listed on previsit surveys . Results Relative to nonintervention cases , the implemented SOME intervention eliminated 78 % of unmet concerns ( odds ratio ( OR ) = .154 , p = .001 ) . The ANY intervention could not be significantly distinguished from the control condition ( p = .122 ) . Neither intervention affected visit length , or patients ’ ; expression of unanticipated concerns not listed in previsit surveys . Conclusions Patients ’ unmet concerns can be dramatically reduced by a simple inquiry framed in the SOME form . Both the learning and implementation of the intervention require very little time PURPOSE This study explores how weight-related topics are discussed between physicians and their overweight and obese female patients . METHODS We surveyed and audio-recorded preventive health and chronic care visits with 25 overweight and obese female patients . We coded both for quantity ( content and time ) of weight-related discussion s and quality ( adherence to Motivational Interviewing [ MI ] techniques ) . We then tested correlations of these measures with 
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Results The findings showed that physician work engagement was associated with fewer reported medical errors and that job satisfaction was associated with better communication and patient satisfaction .
Autonomy and learning opportunities were positively associated with physician work engagement .
Work engagement was positively associated with teaching performance .
In addition , physician work engagement was most likely supported by personality trait conscientiousness ( e. g. responsibility ) .
Conclusion Given the reported associations of physician work engagement with aspects of their professional performance , hospitals could support  physician work engagement in service of optimal performance in residency training and patient care .