TY - JOUR
T1 - Physician-elderly patient-companion communication and roles of companions in Japanese geriatric encounters
AU - Ishikawa, Hirono
AU - Roter, Debra L.
AU - Yamazaki, Yoshihiko
AU - Takayama, Tomoko
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. Many thanks go to Drs. Koichi Kozaki, Takahide Nagase, Yasuyoshi Ouchi, and Masao Yoshizumi for their kind help in conducting the survey. Also, we are grateful to Dr. Hideki Hashimoto for his constructive comments and valuable suggestions at all stages of this study.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2005/5
Y1 - 2005/5
N2 - Although the triadic encounter of physician, patient, and an accompanying family member is a common phenomenon in geriatrics, previous research on the communication in medical encounters has primarily focused on dyadic interactions between physician and patient. This study aimed to explore the triadic communication and communication roles of patient companions in Japanese geriatric encounters. Among elderly patients aged 65 or over who were under continuous care of nine attending physicians at a university affiliated geriatric clinic in Tokyo, 63 accompanied patients and 82 unaccompanied patients were included for this study. The consultation was audiotape recorded and analyzed using the Roter Interaction Analysis System (RIAS) with additional categories developed to code aspects of companion communication. In dyadic encounters, the average proportions of physician's talk and patient's talk were 54% and 46%, respectively, while in triadic encounters the average talk proportions of physician, patient, and companion were 49%, 29%, and 22%. Companions made a significant contribution to the communication during the visit by providing information and asking the physician questions, as well as facilitating patient's talk. The companion's communication may influence not only the patient's but also the physician's communication. The patient's expectation of the companion's role during the visit and the companion's intention regarding their role were generally related to one another, and had positive associations with the companion's actual behavior during the visit. Nevertheless, companions often anticipated playing a more direct communication role during the visit, including the provision of information and asking of questions, than patients expected of them. Further investigation is needed to explore the communication dynamics in triads and dyads, and its relation to patient outcomes.
AB - Although the triadic encounter of physician, patient, and an accompanying family member is a common phenomenon in geriatrics, previous research on the communication in medical encounters has primarily focused on dyadic interactions between physician and patient. This study aimed to explore the triadic communication and communication roles of patient companions in Japanese geriatric encounters. Among elderly patients aged 65 or over who were under continuous care of nine attending physicians at a university affiliated geriatric clinic in Tokyo, 63 accompanied patients and 82 unaccompanied patients were included for this study. The consultation was audiotape recorded and analyzed using the Roter Interaction Analysis System (RIAS) with additional categories developed to code aspects of companion communication. In dyadic encounters, the average proportions of physician's talk and patient's talk were 54% and 46%, respectively, while in triadic encounters the average talk proportions of physician, patient, and companion were 49%, 29%, and 22%. Companions made a significant contribution to the communication during the visit by providing information and asking the physician questions, as well as facilitating patient's talk. The companion's communication may influence not only the patient's but also the physician's communication. The patient's expectation of the companion's role during the visit and the companion's intention regarding their role were generally related to one another, and had positive associations with the companion's actual behavior during the visit. Nevertheless, companions often anticipated playing a more direct communication role during the visit, including the provision of information and asking of questions, than patients expected of them. Further investigation is needed to explore the communication dynamics in triads and dyads, and its relation to patient outcomes.
KW - Companion
KW - Elderly
KW - Family
KW - Japan
KW - Physician-patient communication
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U2 - 10.1016/j.socscimed.2004.08.071
DO - 10.1016/j.socscimed.2004.08.071
M3 - Article
C2 - 15748678
AN - SCOPUS:14644426649
SN - 0277-9536
VL - 60
SP - 2307
EP - 2320
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 10
ER -