Journal of General Internal Medicine

, Volume 26, Issue 5, pp 518–523

A Video-Intervention to Improve Clinician Attitudes Toward Patients with Sickle Cell Disease: The Results of a Randomized Experiment

  • Carlton HaywoodJr.
  • Sophie Lanzkron
  • Mark T. Hughes
  • Rochelle Brown
  • Michele Massa
  • Neda Ratanawongsa
  • Mary Catherine Beach
Original Research

DOI: 10.1007/s11606-010-1605-5

Cite this article as:
Haywood, C., Lanzkron, S., Hughes, M.T. et al. J GEN INTERN MED (2011) 26: 518. doi:10.1007/s11606-010-1605-5

ABSTRACT

BACKGROUND

Clinician attitudes toward patients are associated with variability in the quality of health care. Attitudes are typically considered difficult to change, and few interventions have attempted to do so. Negative attitudes toward adults with sickle cell disease have been identified as an important barrier to the receipt of appropriate pain management for this patient population.

OBJECTIVE

To test the effect of a video-intervention designed to improve clinician attitudes toward adults with sickle cell disease.

INTERVENTIONS

An 8-minute video depicting a clinician expert and patients discussing challenges in seeking treatment for sickle cell pain.

DESIGN AND PARTICIPANTS

A randomized post-test only control group design was used to assess the impact of the intervention on the attitudes of 276 nurses and housestaff working at a large, urban, academic medical center.

MAIN MEASURES

Attitudes toward adult sickle cell patients assessed using 5- and 6-point Likert-scale items. Exploratory factor analysis was used to identify underlying attitudinal domains and develop scales. Examples of the negative and positive attitudes assessed include clinician estimates of the percentage of SCD patients that exaggerate pain (negative) or make clinicians glad they went into medicine (positive).

KEY RESULTS

Compared to the control group, the intervention group exhibited decreased negative attitudes (Difference in means = -8.9, 95%CI [-14.2, -3.6]; Cohen’s d = 0.41), decreased endorsement of certain patient behaviors as “concern-raising” (Difference in means = -7.8, 95%CI [-13.1, -2.5]; Cohen’s d = 0.36), and increased positive attitudes toward sickle cell patients (Difference in means = 6.6, 95% CI [0.6, 12.6]; Cohen’s d = 0.27).

CONCLUSIONS

Our results suggest that the attitudes of clinicians toward sickle cell patients may be improved through a short and relatively easy to implement intervention. Whether the attitudinal differences associated with our intervention are sustainable or are linked to clinical outcomes remains to be seen.

KEY WORDS

healthcare provider attitudes sickle cell disease randomized experiment video interventions 

Supplementary material

11606_2010_1605_MOESM1_ESM.doc (92 kb)
Online Appendix(DOC 93 kb)

Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Carlton HaywoodJr.
    • 1
  • Sophie Lanzkron
    • 2
  • Mark T. Hughes
    • 3
  • Rochelle Brown
    • 4
  • Michele Massa
    • 4
  • Neda Ratanawongsa
    • 5
  • Mary Catherine Beach
    • 3
  1. 1.Division of HematologyThe Johns Hopkins University School of Medicine, The Johns Hopkins Berman Institute of BioethicsBaltimoreUSA
  2. 2.Division of HematologyThe Johns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Division of General Internal MedicineThe Johns Hopkins University School of Medicine, The Johns Hopkins Berman Institute of BioethicsBaltimoreUSA
  4. 4.Division of General Internal MedicineThe Johns Hopkins University School of MedicineBaltimoreUSA
  5. 5.University of California, San Francisco, San Francisco General HospitalSan FranciscoUSA

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