The Effects of the Presence of a Third Person on the Physician‐Older Patient Medical Interview

Greene, Michele G.; Majerovitz, S. Deborah; Adelman, Ronald D.; Rizzo, Connie

doi:10.1111/j.1532-5415.1994.tb07490.x

Cited by 121 publications

(88 citation statements)

References 13 publications

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“…The scarce research on multi-party medical interactions within the setting of pediatrics [34][35][36], geriatrics [37], dietary counseling [38] and the general practitioner's surgery [39,40] showed that the mere presence of a third person changes the dynamics of the medical interaction, no matter how small the third person's conversational contribution to the actual visit. After all, in attending a health care provider, patients have their agenda (needs and expectations) but so have the persons accompanying the patient.…”

Section: Beyond the Dialoguementioning

confidence: 99%

Communication in context: new directions in communication research

Bensing

Dulmen

Tates

2003

Patient Education and Counseling

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By focusing attention almost exclusively on a single encounter, researchers have adopted a rather restricted view on studying communication in health care. After all, communication does not take place in a vacuum but is influenced by the context in which it takes place. We would therefore strongly recommend to broaden the perspective of communication research. In this respect, four lines of investigation are proposed, each guided by different theories. In the first, context is determined by the goals or targets aimed at by both parties in the medical encounter. The second concerns the context of time, referring to the influence of previous and future medical encounters. The third is set up around the organizational context in which an interaction takes place and the last defines context by looking at a medical encounter as a meeting between two multifaceted parties. Studying a medical encounter in its broader context is expected to provide answers to intriguing questions such as why health care professionals do not always act in conformity with the general approved standards of high quality communication and how the factor time span can be used more effectively in the medical encounter. Eventually, a broader context view will bridge the existing gap between theory and practice.

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Section: Beyond the Dialoguementioning

confidence: 99%

Communication in context: new directions in communication research

Bensing

Dulmen

Tates

2003

Patient Education and Counseling

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“…Estimates vary as to the frequency of family members in medical visits but studies have found that companions attend between 20% and 37% of older adults' medical visits. [3][4][5][6] Researchers have documented both negative 5,7 and positive 6,8 effects associated with accompanied visits. For example, Green and associates 7 stated that individual patients get less attention from physicians when family members are present in the session.…”

mentioning

confidence: 99%

Influence of Accompanied Encounters on Patient-Centeredness with Older Patients

Shields

Epstein

Fiscella

et al. 2005

The Journal of the American Board of Family Medicine

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Objectives: To conduct a pilot study to examine physician patient interaction when elderly patients are accompanied during a medical visit.Methods: This was a study in which 30 patients were randomly assigned to be accompanied (13) or unaccompanied (17) during a regular medical visit to their physician. Visits were tape recorded, transcribed, and coded with the Measure of Patient-Centered Communication (MPCC) and with the Rochester Participatory Decision-Making Scale (RPAD).Results: We found no differences between the number of words spoken in accompanied versus unaccompanied visits, comparing patients alone with patients and companions combined. Physicians spoke longer without interruption in accompanied encounters (39.9 vs 78.6 words per speech turn). There were no differences in the level of MPCC or in the level of participatory decision making between the 2 types of visits. In accompanied visits, patients introduced most of the concerns and physicians discussed concerns with patients more than with companions.Conclusions: Previously reported differences in accompanied versus unaccompanied visits may reflect patients' preferences for being accompanied, the role they wish their companion to play, and the patients' health status. Being accompanied by a family member or friend does not result in less attention being paid to patients' concerns. (J Am Board Fam Pract 2005;18:344 -54.)

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“…However, Greene et al (35) found that when a relative or friend accompanied the older patient to a consultation, the patient was less likely to ask questions, less assertive and expressive and less likely to be involved in the decision-making process.…”

Section: Role Of a Family Member/friend In Communication Processmentioning

confidence: 99%