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Doctors' responses to patients' concerns: testing the use of sequential analysis

Published online by Cambridge University Press:  11 October 2011

Atie Van Den Brink-Muinen  and
Wilma Caris-Verhallen
Atie Van Den Brink-Muinen*
Affiliation:
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
Wilma Caris-Verhallen
Affiliation:
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
*
Address for correspondence: Dr. A. van den Brink-Muinen, NIVEL, PO Box 1568, 3500 BN Utrecht (The Netherlands). Fax: +31-30-2729729 E-mail: a.vandenbrink@nivel.nl
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Summary

Aims – The aim of this small scale study was to explore interaction sequences during the medical consultation. Specific attention was paid to how doctors responded to patient's concerns and worries. Empathic behaviours ( e.g. concern, partnership, legitimising) and facilitating behaviours (e.g. paraphrasing, agreement) were considered as an adequate response to a patient's concern. Methods – Nine consultations of nine different GPs were randomly selected from a sample of 1600 videotaped doctor-patient consultations, that were all rated with the Roter Interaction Analysis System. Each consultation contained at least 9 utterances of patient's concern. It was investigated how doctors respond within five lags of utterances after a patient's concern. Results – The results showed that doctors more often responded to a patient's concern in a facilitative way than in an empathic way. When an empathic response was given, it appeared mostly during the first utterance after the patient expressed a concern. Conclusions – The findings indicate that sequential analysis is appropriate to investigate a health care provider's specific style of responding. Based on the problems emerged during the sequential analysis, further exploration of the method is recommended.

Declaration of Interest: none.

Keywords

general practicedoctor-patient communicationsequential analysiscommunication style
Type
Sequence Analysis of Patient-Provider Interaction
Information
Epidemiology and Psychiatric Sciences , Volume 12 , Special Issue 2: Sequence Analysis of Patient-Provider Interaction , June 2003 , pp. 92 - 97
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

Bensing, J.M. 1991. Doctor-Patient Communication and tlie Quality of Care. NIVEL: Utrecht.Google Scholar
Butow, P.N., Kazemi, J.N., Beeney, L.J., Griffin, A.M., Dunn, S.M. & Tattersall, M.H. 1996. When the diagnosis is cancer: patient communication experiences and preferences. Cancer 77, 2630–2637.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Butow, P.N., Brown, R.F., Cogar, S., Tattersall, M.H. & Dunn, S.M. 2002. Oncologists' reactions to cancer patients' verbal cues. Psychooncology 11, 47–58.CrossRefGoogle Scholar
Caris-Verhallen, W.M.C. M. 1999. Nurse-Patient Communication in Elderly Care. NIVEL: Utrecht.Google Scholar
Del Piccolo, L., Saltini, A., Zimmermann, C. & Dunn, G. 2000. Differences in verbal behaviours of patients with and without emotional distress during primary care consultations. Psyclwlogical Medicine 30, 629–643.CrossRefGoogle ScholarPubMed
Gilotti, C., Thompson, T. & McNeilis, K.S. 2002. Communicative competence in the delivery of bad news. Social Science and Medicine 54, 1011–1023.CrossRefGoogle Scholar
Goldberg, D.P., Jenkins, L., Millar, T. & Faragher, E.B. 1993. The ability of trainee general practitioners to identify psychological distress among their patients. Psychological Medicine 23, 185–193.CrossRefGoogle ScholarPubMed
Heaven, C.M. 2001. Measurement of Skills. (Unpub PhD thesis) Psychological Medicine Group, Stanley House, Christie Hospital: Manchester.Google Scholar
Kelley, J.E., Lumley, M.A. & Leisen, J.C.C. 1997. Health effects of emotional disclosure in rheumatoid arthritis patients. Health Psychology 16, 331–340.CrossRefGoogle ScholarPubMed
Maguire, P., Faulkner, A., Booth, K., Elliott, C. & Hillier, V.F. 1996. Helping cancer patients disclose their concerns. European Journal of Cancer 32, 78–81.CrossRefGoogle Scholar
Ong, L.M.L., Visser, M.R.M., Kruijver, I.P.M., Bensing, J.M., van den Brink-Muinen, A., Stouthard, J.M.L., Lammes, F.B. & de Haes, J.C.J.M. 1998.The Roter Interaction Analysis System (RIAS) in oncological consultations: psychometric properties. Psycho-Oncology 7, 387–401.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Ram, P., Grol, R., Rethans, J.J. & van der Vleuten, C. 1999. Videotoetsing van consulten van huisartsen in de eigen praktijk [Assessment of communicative and medical performance of general practitioners in daily practice. Validity, reliability and feasibility of video observation]. Huisarts & Wetenscliap 42, 439–445.Google Scholar
Roter, D.L. 2001. The Roter Method of Interaction Process Analysis. Johns Hopkins University: Baltimore.Google Scholar
Schellevis, F.G., Westert, G.P., de Bakker, D.H., Groenewegen, P.P., van der Zee, J. & Bensing, J.M. 2003. De tweede Nationale Studie naar ziekten en verrichtingen in de huisartsenpraktijk: aanleiding en methoden. [Second Dutch National Survey of Morbidity and Interventions in General Practice] Huisarts & Wetenscliap 46(1 ),7–12.Google Scholar
Spiegel, D. & Stephton, S.E. 2001. Psychoneuroimmune and endocrine pathways in cancer: effects of stress and support. Seminars in Clinical Neuropsychiatry 6, 252–265.CrossRefGoogle ScholarPubMed
Thorne, S.E. 1999. Communication in cancer care: what science can and cannot teach us. Cancer Nursing 22, 370–378.CrossRefGoogle ScholarPubMed
Van den Brink-Muinen, A., Van Dulmen, A.M., Messerli-Rohrbach, V. & Bensing, J.M. 2002. Do gender-dyads have different communi- cation patterns? A comparative study in Western-European general practices. Patient Education and Counseling 48, 253–264.CrossRefGoogle Scholar
Van Dulmen, A.M. 1996. Exploring Cognitions in Irritable Bowel Syndrome: Implications for the Role of the Doctor. KUN: Nijmegen.Google Scholar