. 2019 Aug 28;19:603. doi: 10.1186/s12913-019-4410-9

Table 3.

Communication elements within PA-patient encounters associated with core functions of medical encounter communication

Core functions of medical encounter communication (de Haes & Bensing, 2009) [27]	Fostering the relationship(s)	Gathering information	Decision making	Responding to emotions
	PA conveying expertise: “It was her demeanour. It was the way she explained things … She was very calm.” (Participant 3) “A good, professional manner... the way she was presented.” (Participant 6) PA giving direct answer to questions: “She was efficient and she knew, she wasn’t sort of telling you bull. She didn’t have to think before she gave an answer.” (Participant 10) Personable approach of PA: “She was friendly. It didn’t feel too official, which frightens mums a bit.” (Participant 1) “So we spoke a bit ‘Oh where did you go on holiday?’ a bit personal-like, it was just nice.” (Participant 2) PA conveying respect: “Treating patients like people...You can be efficient and still be pleasant and approachable.” (Participant 11)	PA encouraging information sharing: “She was finding out more about what’s wrong with him and help us understand what’s wrong with him.” (Participant 9) “She was very nice so I was happy to talk to her. She was very easy to talk to.” (Participant 2) Participants feeling informed: “She shared everything with us...I mean the problem.” (Participant 7) “She said ‘I found those kind of things and I’m going to go and see the senior doctor to talk about what we’re going to do’.” (Participant 8) “I was informed a bit more as well of what was happening. Just trying to get me a bed and trying to get the reduction in the blood pressure reading.” (Participant 4) Participants understanding information provided: “The person that we saw today, she was really nice and friendly and she even made it easier for us to understand what’s wrong with him.” (Participant 9)	Participants understanding possible options: “The score says what the risk factor is for me to have a heart problem … she went through that process and explained what my score is and what could be the next actions.” (Participant 12) “She looked through all my medical records, my previous records, and she tried to suggest the future course of action.” (Participant 14) Shared discussion of management/ treatment options: “I think she pulled out what was the important way ahead. Because patients have the choice and I think she helped me make the right choice.” (Participant 3) “We’ve decided not to look too deeply into whether there’s anything... that would cause mum distress to have a procedure done. And we’d just maintain her bloods and iron.” (Participant 1)	PA communication of emotional support: “It makes you feel more relaxed … it’s nice to have someone more informal.” (Participant 6) PA demonstrating care: “The way she approached us was kind, loving, and the way she treated my son, she was like someone that cared.” (Participant 8) “She is so lovely, she is so caring, she told me which will help me … Because she talks so politely, she make me understand everything.” (Participant 13) PA enabling question asking: “If someone is smiling at you and is very open to you, you can communicate.” (Participant 4) PA listening skills “She showed an interest in her patient, she listened, she was a listener.” (Participant 3)

Core functions of medical encounter communication (de Haes & Bensing, 2009) [27]

Fostering the relationship(s)

Gathering information

Decision making

Responding to emotions

Providing information

Enabling disease & treatment related behaviour

Study themes

Feeling trust and confidence in the relationship

Sharing relevant and meaningful information

Sharing discussion on illness management & treatment

Experiencing emotional care and support

PA conveying expertise:

“It was her demeanour. It was the way she explained things … She was very calm.” (Participant 3)

“A good, professional manner... the way she was presented.” (Participant 6)

PA giving direct answer to questions:

“She was efficient and she knew, she wasn’t sort of telling you bull. She didn’t have to think before she gave an answer.” (Participant 10)

Personable approach of PA:

“She was friendly. It didn’t feel too official, which frightens mums a bit.” (Participant 1)

“So we spoke a bit ‘Oh where did you go on holiday?’ a bit personal-like, it was just nice.” (Participant 2)

PA conveying respect:

“Treating patients like people...You can be efficient and still be pleasant and approachable.” (Participant 11)

PA encouraging information sharing:

“She was finding out more about what’s wrong with him and help us understand what’s wrong with him.” (Participant 9)

“She was very nice so I was happy to talk to her. She was very easy to talk to.” (Participant 2)

Participants feeling informed:

“She shared everything with us...I mean the problem.” (Participant 7)

“She said ‘I found those kind of things and I’m going to go and see the senior doctor to talk about what we’re going to do’.” (Participant 8)

“I was informed a bit more as well of what was happening. Just trying to get me a bed and trying to get the reduction in the blood pressure reading.” (Participant 4)

Participants understanding information provided:

“The person that we saw today, she was really nice and friendly and she even made it easier for us to understand what’s wrong with him.” (Participant 9)

Participants understanding possible options:

“The score says what the risk factor is for me to have a heart problem … she went through that process and explained what my score is and what could be the next actions.” (Participant 12)

“She looked through all my medical records, my previous records, and she tried to suggest the future course of action.” (Participant 14)

Shared discussion of management/ treatment options:

“I think she pulled out what was the important way ahead. Because patients have the choice and I think she helped me make the right choice.” (Participant 3)

“We’ve decided not to look too deeply into whether there’s anything... that would cause mum distress to have a procedure done. And we’d just maintain her bloods and iron.” (Participant 1)

PA communication of emotional support:

“It makes you feel more relaxed … it’s nice to have someone more informal.” (Participant 6)

PA demonstrating care:

“The way she approached us was kind, loving, and the way she treated my son, she was like someone that cared.” (Participant 8)

“She is so lovely, she is so caring, she told me which will help me … Because she talks so politely, she make me understand everything.” (Participant 13)

PA enabling question asking:

“If someone is smiling at you and is very open to you, you can communicate.” (Participant 4)

PA listening skills

“She showed an interest in her patient, she listened, she was a listener.” (Participant 3)