Verbal and non-verbal behavior of doctors and patients in primary care consultations – How this relates to patient enablement
Pawlikowska, T., Zhang, Wenjuan, Griffiths, Frances, Dalen, Jan van and Vleuten, C. van der (Cees). (2011) Verbal and non-verbal behavior of doctors and patients in primary care consultations – How this relates to patient enablement. Patient Education and Counseling . ISSN 07383991Full text not available from this repository.
Official URL: http://dx.doi.org/10.1016/j.pec.2011.04.019
Objective: To assess the relationship between observable patient and doctor verbal and non-verbal behaviors and the degree of enablement in consultations according to the Patient Enablement Instrument (PEI) (a patient-reported consultation outcome measure).
Methods: We analyzed 88 recorded routine primary care consultations. Verbal and non-verbal communications were analyzed using the Roter Interaction Analysis System (RIAS) and the Medical Interaction Process System, respectively. Consultations were categorized as patient- or doctor-centered and by whether the patient or doctor was verbally dominant using the RIAS categorizations.
Consultations that were regarded as patient-centered or verbally dominated by the patient on RIAS coding were considered enabling. Socio-emotional interchange (agreements, approvals, laughter, legitimization) was associated with enablement. These features, together with task-related behavior explain up to 33% of the variance of enablement, leaving 67% unexplained. Thus, enablement appears to include aspects beyond those expressed as observable behavior.
Conclusion: For enablement consultations should be patient-centered and doctors should facilitate socio-emotional interchange. Observable behavior included in communication skills training probably contributes to only about a third of the factors that engender enablement in consultations.
To support patient enablement in consultations, clinicians should focus on agreements, approvals and legitimization whilst attending to patient agendas.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
|Divisions:||Faculty of Medicine > Warwick Medical School
Faculty of Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
|Library of Congress Subject Headings (LCSH):||Physician and patient, Nonverbal communication, Medical consultation|
|Journal or Publication Title:||Patient Education and Counseling|
|Publisher:||Elsevier Science BV|
|Access rights to Published version:||Restricted or Subscription Access|
|Funder:||Warwick Medical School Research Development Grant|
|Grant number:||MD001 (WMS)|
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