Patient-physician communication in the emergency department in Taiwan: physicians' perspectives.

BACKGROUND: Effective patient-physician communication promotes trust and understanding between physicians and patients and reduces medical disputes. In this study, the Roter Interaction Analysis System was used to explore physician-patient communication behaviors in the emergency departments of Taiwanese hospitals. METHOD: Data was collected from the dialogues between 8 emergency physicians and 54 patients through nonparticipant observation, and 675 pieces of data were quantitatively and qualitatively analyzed. RESULTS: The results showed that: 1. Emergency physicians' communication behaviors are task-focused. They usually ask closed-ended questions to collect data to identify the symptoms quickly and provide medical treatment. 2. Socioemotion-oriented physician-patient communication behaviors are less common in the emergency department and only serve as an aid for health education and follow-up. Due to time constraints, it is difficult to establish relationships with patients and evoke their positivity. CONCLUSIONS: It is suggested that future education programs on physician-patient communication in the emergency department should focus on strengthening physicians' ability to communicate with patients in a more open way. They should adopt socioemotional-oriented communication skills, expressing respect and kindness, and allowing patients to briefly describe their symptoms and participate in the treatment process to achieve physician-patient consensus.

Enhancing growth and proliferation of human gingival fibroblasts on chitosan grafted poly (epsilon-caprolactone) films is influenced by nano-roughness chitosan surfaces.

The bioactivity of poly (epsilon-caprolactone) (PCL) films is improved by grafting chitosan (CS) surfaces with various values of nano-roughness on PCL surfaces. To examine the effects of the design, growing human gingival fibroblasts (HGFs) on the films was conducted. Various values of nano-rough CS surfaces were cast using nano-rough PCL molds that had been fabricated using a solvent-etched technique. The features of nano-CS/PCL surfaces were characterized using an atomic force microscope (AFM) to observe the topography and to determine the value of centerline average roughness of a surface, R(a). The R(a) values of the nano-CS/PCL films were 36.8 +/- 1.6, 100.0 +/- 3.0, and 148 +/- 7.0 nm, while that of the smooth CS/PCL film was 12.5 +/- 1.6 nm. The growth and proliferation of HGFs on the films are elucidated by fluorescent staining and analyzed by MTT viability assay following three and 7 days of culture. The viability assay of the cells reveals that the growth rates of HGFs on both CS/PCL and nano-CS/PCL films significantly exceed (95% or more; P < 0.001) those of PCL on both days, demonstrating the improvement of the bioactivity of PCL films by grafting CS. Additionally, the growth rates and proliferations of HGFs on nano-CS/PCL films of roughness 100 and 148 nm markedly exceed (15% or more; P < 0.001) those on 36.8 nm nano-CS/PCL and CS/PCL films, after both periods of culturing, indicating that the high nano-roughness CS surfaces further enhance the growth rate of HGFs. In conclusion, markedly improving the bioactivity of PCL films by grafting CS is demonstrated. Moreover, high nano-roughness of nano-CS/PCL films can further accelerate the growth and proliferation of HGFs compared with those of CS/PCL films. This work presents a new concept for designing biomaterials in tissue engineering.