Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.
Background: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this work was contribute to knowledge of the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomism.
Methods: A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyse paternalism and associated factors.
Results: A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomism were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomism (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomism was observed.
Conclusions: Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomism. Strengthening the competencies of health professionals and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.
On 20 Nov, 2020
On 15 Nov, 2020
On 24 Oct, 2020
Received 21 Oct, 2020
Invitations sent on 05 Oct, 2020
On 05 Oct, 2020
On 29 Sep, 2020
On 28 Sep, 2020
On 28 Sep, 2020
Posted 10 Jul, 2020
On 17 Sep, 2020
Received 04 Sep, 2020
On 14 Aug, 2020
Invitations sent on 13 Aug, 2020
On 08 Jul, 2020
On 07 Jul, 2020
On 07 Jul, 2020
On 24 Apr, 2020
Received 23 Apr, 2020
Received 19 Apr, 2020
On 29 Mar, 2020
On 27 Mar, 2020
Invitations sent on 23 Mar, 2020
On 17 Mar, 2020
On 16 Mar, 2020
On 16 Mar, 2020
On 12 Mar, 2020
Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.
On 20 Nov, 2020
On 15 Nov, 2020
On 24 Oct, 2020
Received 21 Oct, 2020
Invitations sent on 05 Oct, 2020
On 05 Oct, 2020
On 29 Sep, 2020
On 28 Sep, 2020
On 28 Sep, 2020
Posted 10 Jul, 2020
On 17 Sep, 2020
Received 04 Sep, 2020
On 14 Aug, 2020
Invitations sent on 13 Aug, 2020
On 08 Jul, 2020
On 07 Jul, 2020
On 07 Jul, 2020
On 24 Apr, 2020
Received 23 Apr, 2020
Received 19 Apr, 2020
On 29 Mar, 2020
On 27 Mar, 2020
Invitations sent on 23 Mar, 2020
On 17 Mar, 2020
On 16 Mar, 2020
On 16 Mar, 2020
On 12 Mar, 2020
Background: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this work was contribute to knowledge of the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomism.
Methods: A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyse paternalism and associated factors.
Results: A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomism were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomism (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomism was observed.
Conclusions: Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomism. Strengthening the competencies of health professionals and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.