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: Research in primary care medicine demonstrates that health care providers' communication varies depending on their sex, and that these sex differences in communication can influence patients' health outcomes. The present study aimed to examine the extent to which sex differences in primary care providers' communication extend to the sensitive context of gynecological care for genital herpes and whether these potential sex differences in communication influence patients' herpes transmission prevention behaviors and herpes-related quality of life. Women (N = 123) from the United States recently diagnosed with genital herpes anonymously completed established measures in which they rated (a) their health care providers' communication, (b) their herpes transmission prevention behaviors, and (c) their herpes-related quality of life. The authors found significant sex differences in health care providers' communication; this finding supports that sex differences in primary care providers' communication extend to gynecological care for herpes. Specifically, patients with female health care providers indicated that their providers engaged in more patient-centered communication and were more satisfied with their providers' communication. However, health care providers' sex did not predict women's quality of life, a finding that suggests that health care providers' sex alone is of little importance in patients' health outcomes. Patient-centered communication was significantly associated with greater quality-of-life scores and may provide a promising avenue for intervention.Journal of Health Communication 09/2013; 18(12). DOI:10.1080/10810730.2013.798377 · 1.61 Impact Factor
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ABSTRACT: Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and barriers, with an emphasis on differences across providers' disciplines. A representative panel of chronic patients (n = 1314) filled out the short Perceived Efficacy in Patient-Provider Interaction scale and were questioned about barriers to participation and interest in communication support. Potential correlates included socio-demographic (age, sex, education, living situation), clinical (discipline care provider, type of illness, comorbidity, illness duration, functional disabilities, health consultations in last year) and personal characteristics (information preference, health literacy, level of general patient activation). Most patients felt efficacious in consultations, although 46% reported barriers to participation and 39% had an interest in support. Barriers most frequently recognized were 'not wanting to be bothersome', 'perception there is too little time' and 'remembering subjects only afterwards'. Patients most frequently endorsed relatively simple support. Patients perceived the least barriers and were least likely to endorse support when seeing a nurse. In multivariate models, consistent risk factors for low efficacy and perceived barriers were low health literacy and a low general patient activation. Many chronically ill patients feel confident in medical interactions. Still, a significant number might benefit from support. Often this concerned more generally vulnerable patients, that is, the low literate and generally less activated. Relatively simple supportive interventions are likely to be endorsed and might overcome frequent barriers.Health expectations: an international journal of public participation in health care and health policy 05/2014; DOI:10.1111/hex.12206 · 2.85 Impact Factor
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ABSTRACT: Assessing the quantity and quality of pharmacist-patient communication is important to create strategies for improving communication. Findings from studies on pharmacist-patient communication differ on the extent of communication by pharmacists. This disagreement could be because of different methods of data collection, samples, and concepts used to measure communication. This research compared findings from 2 widely used methods of data collection (survey and observation) to identify: (1) the extent to which pharmacists ask questions to patients and provide information on directions, side effects, and adverse effect, (2) agreement between observation and patient report data on pharmacist information giving and question asking, and (3) how patient perceptions of question asking vary according to the structure of the question asked. A cross-sectional fieldwork design was used to collect data from a stratified random sample of 30 community pharmacies in Southeast and South-central Wisconsin. At each pharmacy, the dispensing pharmacist and 12 patients filling prescriptions were recruited. Each patient was observed for their interaction with the pharmacist and completed a survey while exiting the pharmacy. Both the survey and the observation tool consisted of items pertaining to recording of pharmacist information provision related to direction, side effects, and interactions, and pharmacist's question-asking behaviors. Descriptive analyses and correlations are reported. There was good agreement between the 2 methods regarding pharmacist information provision behaviors (r=0.091, P<.001), this was less true of question asking (r=0.28, P=.034). Certain types of questions showed greater concordance with the observed pharmacist questions. Patients were less likely to report having been asked a question when it took the form of a nonspecific closed-ended questions, that is, "Do you have any questions?" One of the most frequent questions pharmacists ask patients may not be either remembered or perceived by patients as a serious question, let alone an invitation to raise a concern. Secondly, during the selection of a specific method of data collection, researchers need to weigh strengths and weaknesses of various methods. Multimethod studies are encouraged.Research in Social and Administrative Pharmacy 03/2011; 7(3):272-80. DOI:10.1016/j.sapharm.2010.07.001 · 2.35 Impact Factor