Analyzing communication in medical consultations. Do behavioral measures correspond to patients' perceptions?
ABSTRACT When analyzing relationships between physician-patient communication and medical outcomes, researchers typically rely on quantitative measures of behavior (e.g., frequencies or ratios) derived from observer-coding of transcripts, audiotapes, or videotapes. Interestingly, rarely have researchers assessed whether quantitative measures of communication (e.g., the physician's information giving) correspond to patients' perceptions of physicians' communication (e.g., informative). This investigation of 115 pediatric consultations examined this issue and yielded several notable findings. First, less satisfied parents received more directives and proportionally less patient-centered utterances from physicians than did more satisfied parents. Second, findings were mixed regarding the degree to which behavioral measures related to analogue measures of parents' perceptions. For example, the doctors' use of patient-centered statements was predictive of parents' perceptions of physicians' interpersonal sensitivity and partnership building, but the amount of information physicians provided parents was unrelated to judgments of the doctors' informativeness. Third, with some important exceptions, relationships between behavioral measures and parents' evaluations did not vary for parents differing in education and anxiety about the child's health. Finally, behavioral measures in the form of frequencies tended to be better predictors of parents' perceptions than were measures in the form of proportions. Implications are discussed.
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ABSTRACT: Objective. Little is known about the features and role of exercise discussions between rheumatologists and patients. The goals of this study were to: 1) describe rheumatologists' and patients' attitudes and beliefs regarding exercise and physical therapy for rheumatoid arthritis (RA); 2) describe frequency and length of exercise discussions; 3) determine the accuracy of recall for exercise discussions; and 4) assess the influence of attitudes regarding exercise on communication about exercise. Methods. Goals 1–3 were addressed with analysis of baseline questionnaires and audiotaped encoun-ters. The influence of attitudes and beliefs regarding exercise on the frequency and length of exercise discussions was assessed prospectively. Patients and rheumatologists were enrolled from a large tertiary care institution. Clinical encounters were audio-taped, transcribed, coded, and analyzed to identify specific characteristics of the exercise discussions. Results. One hundred thirty-two patients and 25 rheumatologists participated in the study. Rheuma-tologists and patients discussed exercise in 53% of the encounters. Rheumatologists' beliefs regarding the usefulness of exercise for RA varied, with the least positive beliefs being reported for aerobic exer-cise. Exercise discussions were more likely to occur if the patient was currently exercising, odds ratio (OR) 5 2.4; 95% confidence interval (CI) (1.2– 4.9), and when the rheumatologist believed aerobic exercises were useful in managing RA, OR 5 1.4; 95% CI (1.1–1.9). Current exercise behavior was associated with patients' positive attitude toward exercise (x
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ABSTRACT: In the context of breast-cancer care, there is extremely little research on the association between observed (i.e., taped and coded) communication behaviors and patients' health outcomes, especially those other than satisfaction. In the context of presurgical consultations between female breast cancer patients and a surgeon, the aim of this exploratory study was to test the association between communication-based participation behaviors and pre-post consultation changes in aspects of patients' mental adjustment to cancer (i.e., coping). Participants included 51 women newly diagnosed with breast cancer and a surgical oncologist from a National Cancer Institute (NCI)-designated cancer center in the northeastern United States. Outcomes were changes in patients' fighting spirit, helplessness/hopelessness, anxious preoccupation, cognitive avoidance, and fatalism (measured immediately before and after consultations via survey), and the main predictors were three communication-based participation behaviors coded from videotapes of consultations: patient question asking, patient assertion of treatment preferences, and surgeon solicitation of patient question/concern/opinion. Patients who more frequently asserted their treatment preferences experienced increases in their fighting spirit (p = .01) and decreases in their anxious preoccupation (p = .02). When companions (e.g., sister, spouse) asked more questions, patients experienced decreases in their anxious preoccupation (p = .05). These findings suggest that, in the present context, there may be specific, trainable communication behaviors, such as patients asserting their treatment preferences and companions asking questions, that may improve patients' psychosocial health outcomes.Health Communication 08/2014; · 0.97 Impact Factor
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ABSTRACT: The Cognitive-Emotional Theory of Esteem Support Messages posits that messages intended to enhance recipients' state self-esteem focus on cognitions and/or behaviors. In the current studies, problem-focused message content (i.e., content focused on enacting behavior to alleviate the esteem threat) was of particular interest. College students (Study 1, n= 227) applying for postgraduation jobs and unemployed, underemployed, and/or displaced workers recruited from a government one-stop career center (Study 2, n = 292) rated esteem support messages varying in degree of focus on behaviors vs. cognitions relevant to the job search process. Messages focused on behavior were rated as less effective than those focusing on cognitions relevant to the esteem threat, although support for this result was stronger in Study 2.Human Communication Research 01/2014; 40:161-187. · 1.84 Impact Factor