TY - JOUR
T1 - Patient contribution to the medical dialogue and perceived patient-centeredness
T2 - An observational study in Japanese geriatric consultations
AU - Ishikawa, Hirono
AU - Hashimoto, Hideki
AU - Roter, Debra L.
AU - Yamazaki, Yoshihiko
AU - Takayama, Tomoko
AU - Yano, Eiji
N1 - Funding Information:
This research was supported by a grant from the Pfizer health research foundation. We sincerely thank all physicians, patients, and accompanying persons who participated in this study at the University of Tokyo Hospital, Department of Geriatric Medicine. I express deep gratitude to Drs. Masao Yos-hizumi, Koichi Kozaki, Takahide Nagase, and Yasuyoshi Ouchi, who backed up my entry into the field and provided valuable practical advice in conducting the survey.
PY - 2005/10
Y1 - 2005/10
N2 - BACKGROUND: Relatively few studies have directly addressed the interaction dynamics and consequences of a companion's presence in the medical visit, and their findings have been contradictory. OBJECTIVES: To examine how patient's contribution to the medical dialogue, with or without the presence of a visit companion, is related to the perception of the medical visit as patient-centered. DESIGN: Observational study using pre- and postvisit questionnaires and audiotape recording of medical visits. PARTICIPANTS: One hundred and fifty-five patients aged 65 or over; 63 in medical visits that included the presence of a companion and 82 in visits that did not include a companion. MAIN OUTCOME MEASURE: Patient ratings of visit patient-centeredness. RESULTS: Long visits (greater than 10 minutes long) and visits in which patients were verbally active were rated as more patient-centered by patients than other visits. Since patients were generally less verbally active in visits that included a companion, accompanied visits, especially if they were less than 10 minutes long, received lower patient-centered ratings than others. The presence of a companion was not related to length of the visit, suggesting that the verbal activity of the companion was off-set by decreased verbal activity of the patient. CONCLUSIONS: Our results have suggested that patients are more likely to perceive their physician and visit as patient-centered when they have an opportunity to engage directly in the medical dialogue. A minimal amount of "talk-time" for patients themselves should be safe-guarded even in a short visit, when a companion is present.
AB - BACKGROUND: Relatively few studies have directly addressed the interaction dynamics and consequences of a companion's presence in the medical visit, and their findings have been contradictory. OBJECTIVES: To examine how patient's contribution to the medical dialogue, with or without the presence of a visit companion, is related to the perception of the medical visit as patient-centered. DESIGN: Observational study using pre- and postvisit questionnaires and audiotape recording of medical visits. PARTICIPANTS: One hundred and fifty-five patients aged 65 or over; 63 in medical visits that included the presence of a companion and 82 in visits that did not include a companion. MAIN OUTCOME MEASURE: Patient ratings of visit patient-centeredness. RESULTS: Long visits (greater than 10 minutes long) and visits in which patients were verbally active were rated as more patient-centered by patients than other visits. Since patients were generally less verbally active in visits that included a companion, accompanied visits, especially if they were less than 10 minutes long, received lower patient-centered ratings than others. The presence of a companion was not related to length of the visit, suggesting that the verbal activity of the companion was off-set by decreased verbal activity of the patient. CONCLUSIONS: Our results have suggested that patients are more likely to perceive their physician and visit as patient-centered when they have an opportunity to engage directly in the medical dialogue. A minimal amount of "talk-time" for patients themselves should be safe-guarded even in a short visit, when a companion is present.
KW - Companion
KW - Elderly
KW - Patient participation
KW - Patient-centeredness
KW - Patient-physician communication
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U2 - 10.1111/j.1525-1497.2005.0200.x
DO - 10.1111/j.1525-1497.2005.0200.x
M3 - Article
C2 - 16191136
AN - SCOPUS:28444484313
VL - 20
SP - 906
EP - 910
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 10
ER -