Assertiveness, Clarity, Positivity Model
Vaz de Almeida, C., & Belim, C. (2020). Health Professionals' Communication Competences as a Light on the Patient Pathway: The Assertiveness, Clarity, and Positivity (ACP) Model. International Journal of Applied Research on Public Health Management (IJARPHM), 6(1), 1-16. DOI: 10.4018/IJARPHM.2021010102 Retrieved from: https://www.igi-global.com/article/health-professionals-communication-c…
Almeida, C. V. (2019). Modelo de comunicação em saúde ACP: As competências de comunicação no cerne de uma literacia em saúde transversal, holística e prática. In C. Lopes & C. V. Almeida (Coords.), Literacia em saúde na prática (pp. 43-52). Lisboa: Edições ISPA [ebook] Retrieved from: http://loja.ispa.pt/produto/literacia-em-saude-na-pratica
2016The questionnaire survey in the present investigation is mainly used to explore how physicians and nurses understand, in the therapeutic relationship, their contribution in relation to assertiveness, clear language and positivity for the improvement of health literacy, in their dimensions of access, understanding and use of the message (therapeutic adherence), of the patient. The validity of the results was verified in the intention of the questionnaire reflecting the concepts (Bryman, 2012, p. 47), in this case the communication skills, the intrinsic s to the ACP model and the dimensions of health literacy. It is intended that the Q-COM-LIT (Appendix 4) will act as a practical contribution in the assessment of the self-perceptions of the communication skills of the health professional and to serve as a future model in this evaluation of health professionals.
We started from a research of instruments already applied and validated with reference to the theme of communication (e.g. Cegala, 2003; Ferreira, Raposo & Pisco, 2017; Finset & Mjaaland, 2009; Makoul, 2001; Neumann et others, 2010; McGee & McNeilis, 1996; Silverman and others, 2013; Schriver and others, 2010) and health literacy (Sørensen and others; Saboga-Nunes, 2014).
https://docs.google.com/forms/d/1gcLppFhGbiwenPZ7Fh12P3ckABJhjDVT-bAOSc…
The Q-COM-LIT consists of 50 questions: sociodemographic characterization (n=7), scripts (n=3); assertiveness (n=13); clarity (n=13); positivity (n=13); open final question (n=1). The ACP group of questions comprises those numbered from 9 to 11, totaling 39 items. A Likert scale (1. It's terrible; 2. Bad; 3. Sufficient; 4. Good; 5. Excellent) for individual evaluation of the professional, based on Bryman (2012, p. 166).
To improve the enunciation and order of the questions, a pre-test was made, which gathered, between September 22 and November 10, 2019, 21 participants.
Due to the prestige of EUROPEP (1996, 2017), a user satisfaction questionnaire in Portugal (Annex 1), and because they were the researchers responsible for its translation, dissemination and evaluation, it was considered useful to submit the Q-COM-LIT to the appreciation of Professors Pedro Ferreira and Victor Raposo, who evaluated it very positively.
The age group from 35 to 44 years represents 35.7% of respondents, followed by the 45 to 54 years age group with 23.9%, 25 to 34 years with 22.9% of respondents, 3.9% of professionals aged 18 to 24 years and only 1.5% over 65 years. A total of 59.1% are married or living in a marital life, while 27% of respondents are single and 13% divorced or widowed. It is in the municipality of Lisbon that the majority resides (31.9%). Also 60.7% work in chulc, reflecting the result of dissemination in this hospital center, after the authorization of the EC (process 704/2019).
The INE (2017; 2018) indicates, for the metropolitan area of Lisbon, the total of 12 913 nurses in the hospital context and that of 1,836 FGM physicians in office. Therefore, a total of 14 749 health professionals. In an attempt to optimize the quality of the sample as much as possible, the calculation was applied to finite populations and, through quotas, proportions of reality were inserted. The total sample to be computed, applying the calculation for finite populations – <100,000 elements – (Pocinho, 2009, pp. 18-19) and considering a confidence level of 95% and a sampling error of 5%, is: 389.
The socio-demographic characterization of these respondents also seeks an approximation to the Portuguese reality. In order for the sample to be proportional to the total number of physicians and nurses, the simple three rule was applied. Intending a sampling by proportional quotas of profession and gender, the sample for the survey consisted of 341 nurses (87.7% of the total) and 48 FGM physicians (12.3%). Given the feminization rate (SNS, 2016) of medical staff – 59.1% – and that of nursing staff of 83.4% (SNS, 2016, p. 149), 21 males and 27 females and, in nursing, 283 women and 58 men ( table 2 ) are considered among physicians.
The request for the application of the survey was made to the Ethical Committees of the Regional Health Administration of Lisbon and Tagus Valley (ARSLVT), and to the EC of the University Hospital Center of Central Lisbon (CHULC). Within the CHULC, authorization was obtained by the Ethical Comission, through its Board of Directors, for the application of the online questionnaire.
Considering the reliability indexes, which are between 0.75 and 1 and, given the result for Cronbach's alpha of the Q-COM-LIT of 0.788 (for the 50 items), the values confirm the reliability of the instrument.
Based on similar studies of assessment of competencies of health professionals who used the Likert scale, such as Cegala and others (1998), Knapp, Raynor, Thistlethwaite and Jones (2009), Sperati and others (2019). As in HLS-EU (2012), there is no neutral category, and tasks/situations have been integrated. Marôco and Garcia-Marques (2006) also confirm that, in the social sciences, multi-item scales are generally used to assess different capacities, personality characteristics, or other psychological dimensions (p. 69).
Considering the reliability indexes, which are between 0.75 and 1 and, given the result for Cronbach's alpha of the Q-COM-LIT of 0.788 (for the 50 items), the values confirm the reliability of the instrument.
Although the sociodemographic questions of the survey were not in the values that could be considered low (Marôco & Garcia-Marques, 2006), excluding them the result rose to a reliability index of 0.959 .
The results of the Q-COM-LIT reinforce those of the FG, through the evaluation attributed by health professionals to their communicative competencies, combined with the ACP model – in the variables Assertiveness, Clarity and Positivity.
By evaluating the measures of central trend, such as the Median, Moda and Quartiles, it is possible to obtain a confirmation of its appreciation of health communication skills.