Verbal and non-verbal behavior of doctors and patients in primary care consultations - how this relates to patient enablement.
Publication year
2012Source
Patient Education and Counseling, 86, 1, (2012), pp. 70-76ISSN
Annotation
1 januari 2012
Publication type
Article / Letter to editor

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Organization
Primary and Community Care
Journal title
Patient Education and Counseling
Volume
vol. 86
Issue
iss. 1
Page start
p. 70
Page end
p. 76
Subject
NCEBP 7: Effective primary care and public healthAbstract
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. RESULTS: 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. PRACTICE IMPLICATIONS: To support patient enablement in consultations, clinicians should focus on agreements, approvals and legitimization whilst attending to patient agendas.
This item appears in the following Collection(s)
- Academic publications [204996]
- Faculty of Medical Sciences [81051]
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