The Effect of Video Tape on Presentations Made to Physicians: A Pilot Study in Patient Education Sandra S. Smith, MSW, and William L . Roberts, MSW T u c s o n , A r i z o n a This paper examines the use of brief patient education in en couraging patients to present stress conditions as problems to physicians. Participants were patients at the Family Practice Office, University of Arizona Health Sciences Center. All 40 selected patients were visiting the Family Practice Office for the first time. The two groups of 20 patients were similar in age and sex. An audio recording was made of the patient-physician en counter of all participants. The control group of 20 patients received no education prior to meeting the physician. The 20 patients in the experimental group observed a video tape prior to meeting the physician. The video tape, specially prepared for this project, described the relationship between stress conditions and illness. It further emphasized the physician’s need to know about these stress conditions and the patient’s responsibility for presenting them to the physician. The results of the chi-square test of association applied to the number of stress conditions presented demonstrated a highly significant difference between the two groups. The probability level was .01. This study produced strong evidence to support the hy pothesis that brief patient education does affect the presenta tion of stress conditions to physicians. This paper examines the use of patient educa Office of the Department of Family and Commu tion in encouraging patients to present stress con nity Medicine, University of Arizona Flealth Sci ditions to their physicians. It developed from the ences Center. A philosophy of encouraging pa recognition of a need to legitimize stress condi tients to assume increasing responsibility in the tions as appropriate problems for patients to pre care of their health, and an interest in the social sent to physicians. and emotional aspects as well as in the medical The study was conducted at the Family Practice aspects of health, made the Family Practice Office an ideal setting for this study. Patients come to the Family Practice Office Fr o m t h e D e p a r t m e n t o f F a m i l y a n d C o m m u n i t y M e d i c i n e , with a variety of problems. Those problems most C o l l e g e o f M e d i c i n e , T h e U n i v e r s i t y o f A r i z o n a , T u c s o n , A r i z o n a . R e q u e s t s f o r r e p r i n t s s h o u l d b e a d d r e s s e d t o M s. frequently presented are not necessarily the pri S a n d r a S . S m i t h , F a m i l y P r a c t i c e O f f i c e , 1 4 5 0 N o r t h C h e r r y mary problem the patient carries to the physician.1 A v e n u e , T u c s o n , A Z 8 5 7 1 9 . 9 3 T H E JO U R N A L O F F A M I L Y P R A C T I C E , V O L . 6 , N O . 1 , 1 9 7 8
VIDE OTAPE AND PRESENTATIONS TO PHYSICIANS Table 1. Results of Chi-square Test of Association Applied to Three Categories of Patient's Statements Statements Made by Patients Chi-Square Value Probability Level S t r e s s c o n d i t i o n s 6 .5 3 .0 1 V o l u n t e e r e d li f e c h a n g e s 0 .4 0 .5 2 L i f e c h a n g e r e s p o n s e s 0 .1 0 .7 4 Methods Often the presenting problem serves as a patient’s ticket of admission to the physician’s office: The study employed a selected sample of pa Zborowski describes social training that does not tients who were to see a physician at the Family necessarily discourage use of the physician, but Practice Office for the first time. To be selected, does imply that such use will be based on physical the patient needed to meet certain criteria. He/she needs rather than on emotional concerns.2 (1) had to be new to the Family Practice Office, (2) Today, patients, as consumers of services, are had to be regarded as adult, which was designated seeking more from physicians than the treatment by the Family Practice Office as 17 years or older, of diseases. Cobb suggested that patients seek not (3) could not be accompanied by another person only adequate medical care, but also sympathetic during the time spent with the physician, and (4) emotional support from the physician.3 Mechanic had to indicate consent to participate in the study. found that persons who change physicians be A total of 20 patients was selected for the con cause of dissatisfaction appear to complain more trol group, and 20 patients for the experimental about the physician’s lack of interest, caring, and group. The ages of the control group ranged from motivation than about his/her medical qualifica 19 to 80 years with a mean age of 39 years. The tions.4 ages of the experimental group ranged from 17 to Because the physician’s role involves commu 76 years with the mean age of 44.05 years. nication, interaction, and nurturance, Mechanic There were 6 males and 14 females in the con suggests that it also meets the interpersonal needs trol group. Likewise, there were 6 males and 14 of patients. This is not to say that physicians are in females in the experimental group. universal agreement over this holistic approach. The video tape, which was produced as the tool Black argues that “ the doctor’s focus should be on of brief patient education for the purpose of this the disease and not on the whole life of his patient study, was 6 minutes and 12 seconds long and had or on some general ideal of humanness.” 5 three thrusts to its content. The brief introduction Increasingly, however, physicians are accept emphasized that changes occurring in the life ex ing stress as significant in the etiology of disease. perience require the body to make some adapta Selye’s physiologic concept of stress has been ex tion or adjustment. This need for adjustment was panded to include environmental and social stres identified as stress, and stress was recognized as a ses, thus legitimizing the presentation of emotional significant factor in the etiology of disease. needs and changes in life situations to the physi The body of the script referred to several pos cian.6 sible changes or life events which the patient might While the relationship between stress and ill have experienced. Finally, the message was di ness is gaining wider acceptance among physi rected toward placing responsibility on the patient cians, patient education is necessary to help pa for bringing these events to the attention of the tients identify and accept emotional needs as physician. legitimate and appropriate for presentation to In order to measure the effectiveness of the physicians. This study examines the effect that selected tool of patient education it was necessary brief patient education has on the presentation of to confine the patients in the control group to the stress conditions to physicians. regular office procedure. Only those patients in 9 4 T H E JO U R N A L O F F A M I L Y P R A C T I C E , V O L . 6 , N O . 1 , 1 9 7 8
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