Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data

Abstract

Objective-To describe the frequency, roles, and utility of family companion involvement in the care of patients with Heart Failure (HF) care and to examine the association between audiotaped patient, companion, and provider communication behaviors.Methods-We collected survey data and audiotaped a single medical visit for 93 HF patients (36 brought a companion into the examination room) and their cardiology provider. Communication data was analyzed using the Roter Interaction Analysis System.Results-There were 32% more positive rapport-building statements (p<.01) and almost three times as many social rapport-building statements (p<0.01) from patients and companions in accompanied visits versus unaccompanied patient visits. There were less psychosocial information giving statements in accompanied visits compared to unaccompanied patient visits (p<0.01.) Providers made 25% more biomedical information giving statements (p=0.04) and almost three times more social rapport-building statements (p<0.01) in accompanied visits. Providers asked fewer biomedical and psychosocial questions in accompanied versus unaccompanied visits. Providers made 16% fewer partnership-building statements in accompanied versus unaccompanied visits (p=0.01).Conclusions-Our findings are mixed regarding the benefits of accompaniment for facilitating patient-provider communication based on survey and audiotaped data.Practice Implications-Strategies to enhance engagement during visits, such as pre-visit question prompt lists, may be beneficial.

Relationship between Provider Communication Behaviors and the Quality of Life for Patients with Advanced Cancer in Saudi Arabia

“…Moreover, health-care providers may ask fewer biomedical and psychosocial questions, particularly when a family member is present, resulting in concerns about the length of the visit. Health-care providers may focus on building rapport with a patient and the family during their communication in an accompanied visit, which could lead to insufficient evaluation of patient concerns about biomedical issues [18]. Thus, a provider's communication behaviors were irrelevant to the patient's needs and concerns Another possible explanation is that the patient-provider gender concordance may influence patients' perception of providers' communication behavior.…”

Patient, caregiving partner, and clinician recommendations for improving heart failure care in the Veterans Health Administration

“…While clinicians in this study were asked about their concerns to family involvement, couples were not explicitly asked to comment on this issue. Recent work has identified some potential downsides to family involvement, 55 including what information may be shared with providers during a visit 55 and disagreements on the shared responsibility of HF self-care. 56 Other work has also looked at the type of relationship persons with HF and their caregiver may have that determine if they are managing HF as a dyad.…”

Impact of Patients' Companions on Clinical Encounters Between Black Patients and Their Non-Black Oncologists

“…22 Overall, however, research supports the idea that bringing a companion to clinical encounters is beneficial to patients. 14,23 For example, when a patient is accompanied, the provider tends to be more satisfied with the encounter, 24 provide more information, 5,25 and better understand the patient's concerns 26 ; accompanied patients report better understanding of the information they are given, 26 and the encounter is longer. 25 Even fewer studies have specifically focused on the impact of companions on oncology encounters.…”