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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Verbal and non-verbal behavior of doctors and patients in primary care consultations - How this relates to patient enablement
Patient Education and Counseling, Volume 86, No. 1, Year 2012
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Description
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. © 2011 Elsevier Ireland Ltd.
Authors & Co-Authors
Pawlikowska, Teresa R.B.
United Kingdom, Coventry
University of Warwick
Griffiths, Frances E.
United Kingdom, Coventry
University of Warwick
van Dalen, Jan
Netherlands, Maastricht
Universiteit Maastricht
Van Der Vleuten, Cees P.M.
Netherlands, Maastricht
Universiteit Maastricht
Statistics
Citations: 102
Authors: 4
Affiliations: 2
Identifiers
Doi:
10.1016/j.pec.2011.04.019
ISSN:
18735134
Research Areas
Health System And Policy