A web-based program to empower patients who have schizophrenia to discuss quality of care with mental health providers

Donald M. Steinwachs, Debra L. Roter, Elizabeth A. Skinner, Anthony F. Lehman, Maureen Fahey, Bernadette Cullen, Anita Smith Everett, Gerard Gallucci

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study evaluated a Web-based tool to help patients with schizophrenia communicate with clinicians about evidence-based treatments. Methods: Fifty patients used an interactive Web-based intervention featuring actors simulating a patient discussing treatment concerns (intervention group; N=24) or were shown an educational video about schizophrenia treatment before an appointment for routine follow-up care (control group; N=26). The visits were recorded and analyzed by using the Roter Interaction Analysis System. Results: Visits by patients in the intervention group were longer (24 versus 19 minutes, p<.05) and had a proportionately greater patient contribution to the dialogue (288 versus 229 statements, p<.05) and a smaller ratio of clinician to patient talk (1.1 versus 1.4, p<.05) compared with visits by the control group. Patients in the intervention group asked more questions about treatment (2 versus .9, p<.05), disclosed more lifestyle information (76 versus 53 statements, p<.005), and more often checked that they understood information (3.6 versus 2.1 checks, p<.05). Clinicians asked more questions about treatment (7.5 versus 5.1, p<.05) and the medical condition (7.8 versus 4.7, p<.05) to control group patients but made more statements of empathy (1.3 versus .4, p<.03) and cues of interest (48 versus 22, p<.05) with the intervention group. The patient-centeredness ratio was greater for visits by patients in the intervention group than by the control group (8.5 versus 3.2, p<.05). Patients' tone was more dominant and respectful (p<.05) and clinicians' tone was more sympathetic (p<.05) during visits by patients in the intervention. Conclusions: The Web-based tool empowered persons with schizophrenia to engage more fully in a patient-centered dialogue about their treatment.

Original languageEnglish (US)
Pages (from-to)1296-1302
Number of pages7
JournalPsychiatric Services
Volume62
Issue number11
DOIs
StatePublished - Nov 1 2011

ASJC Scopus subject areas

  • Psychiatry and Mental health

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