The role of a companion attending consultations with the patient. A systematic review

Troy, Emma; Doltani, Deepak; Harmon, Dominic

doi:10.1007/s11845-018-1920-0

Cited by 15 publications

(18 citation statements)

References 28 publications

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“…For example, healthcare practitioners (HCPs) and patients tend to pursue different projects, which can align or disalign at different moments in an interaction. The presence of companionspeople who know the patient and attend healthcare encounters with them -introduces yet another set of projects, alignments, and misalignments (Laidsaar-Powell et al, 2013;Troy et al, 2019). This paper furthers our understanding of some of these complexities by analyzing episodes in which patients and companions take divergent positions on a healthcare measure in hospice-based palliative care interactions.…”

Section: Introductionmentioning

confidence: 94%

“…Companions play several roles in healthcare interactions, including providing medical history and prompting patients to raise topics (Clayman et al, 2005). Prior research on companion participation has overwhelmingly used two approaches (Laidsaar-Powell et al, 2013;Troy et al, 2019). In one, retrospective accounts gathered via questionnaires, interviews, and focus groups (e.g., Griffin et al, 2019) are used to characterize companions' experiences of communication in healthcare interactions.…”

Section: Companion Participation In Healthcare Interactionsmentioning

confidence: 99%

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Practitioners’ Dilemmas and Strategies in Decision-Making Conversations Where Patients and Companions Take Divergent Positions on a Healthcare Measure: An Observational Study Using Conversation Analysis

Pino

Doehring

Parry

2020

Health Communication

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The presence of companions adds complexity to healthcare interactions. Few studies have characterized challenges arising when interactions involve healthcare professionals (HCPs), patients, and companions, or how those challenges are managed. Using conversation analysis, we examined recorded episodes where patients and companions adopt divergent positions on healthcare measures (e.g., walking aids, homecare, medications). We found nine such episodes within a dataset of 37 palliative care consultations with 37 patients, their companions, and ten healthcare practitioners (HCPs)-doctors, physiotherapists and occupational therapists. Palliative care is one of several healthcare domains where companions substantially contribute to care, consultations, and decision making. We propose that, when patients and companions adopt divergent positions, HCPs face a 'dilemma of affiliation' wherein taking a position on the healthcare measure (e.g., recommending it) entails siding with one party, against the other. By examining what happens in the face of patient-companion divergence, we characterize HCPs' strategies and substantiate our proposal that these reflect an underlying dilemma. We show that: HCPs do not immediately take a position on the healthcare measure after patient-companion divergence emerges; and when HCPs take a position later in the consultation, they do so without ostensibly siding with the party who previously supported the healthcare measure. Further, once an HCP takes a position, the party who supports the measure can treat the HCP as an ally. We offer insights and propose implications for: palliative care; the interactional complexities of healthcare decision-making; and consultations in which companions participate.

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Section: Introductionmentioning

confidence: 94%

Section: Companion Participation In Healthcare Interactionsmentioning

confidence: 99%

Practitioners’ Dilemmas and Strategies in Decision-Making Conversations Where Patients and Companions Take Divergent Positions on a Healthcare Measure: An Observational Study Using Conversation Analysis

Pino

Doehring

Parry

2020

Health Communication

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“…These studies primarily leverage interviews with patients following consults ( Bracher et al, 2020 ; Rodin et al, 2009 ; Roter & Hall, 2006 ). As a result, most (75%–90%) studies on patient education do not account for real-time talk ( Georgopoulou et al, 2018 ; Peterson et al, 2016 ) and few (1%) involve family members or caregivers ( Troy et al, 2019 ). Interviews also may be inadequate as they rely on participants’ recollections of events which may be misremembered and are also described in relation to particular interviewers and contexts ( Whitaker & Atkinson, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Using Applied Conversation Analysis in Patient Education

Halpin

Konomos

Roulson

2021

Global Qualitative Nursing Research

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The conversation strategies patients and clinicians use are important in determining patient satisfaction and adherence, and health outcomes following patient education—yet most studies are rife with surveys and interviews which often fail to account for real-time interaction. Conversation analysis (CA) is a powerful but underused sociological and linguistic technique aimed at understanding how interaction is accomplished in real-time. In the current manuscript, we provide a primer to CA in an effort to make the technique accessible to patient education researchers including; The history of CA, identifying and collecting data, transcription conventions, data analysis, and presenting the findings. Ultimately, this article provides an easily digestible demonstration of this analytic technique.

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“…As described previously, surgical outpatient consultations pose unique challenges to achieve excellent practitioner and patient outcomes. Previous systematic reviews and meta‐analysis investigating the role and effect of a companion in outpatient consultations were largely based on available literature in the non‐surgical setting 15,18,19 . The rates of patient accompaniment ranges between 15% and 86% dependent on the context of consultation, while mean rates of accompaniment in adult patients is 37.6% 15,18,19 .…”

Section: Introductionmentioning

confidence: 99%

“…Previous systematic reviews and meta‐analysis investigating the role and effect of a companion in outpatient consultations were largely based on available literature in the non‐surgical setting 15,18,19 . The rates of patient accompaniment ranges between 15% and 86% dependent on the context of consultation, while mean rates of accompaniment in adult patients is 37.6% 15,18,19 . There is limited evidence on the effect of a companion on a surgical consultation.…”

Section: Introductionmentioning

confidence: 99%

The doctor will see you now: eye gaze, conversation and patient engagement in the surgical outpatient clinic. An Australian observational cross‐sectional study

Ting

Reid

Treloar

et al. 2021

ANZ Journal of Surgery

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Background Surgical outpatient consultations are demanding for the surgeon and patients without a definite formula for success. Various factors have been identified regarding factors that influence patient satisfaction and engagement. We aimed to examine the modern‐day surgical outpatient consultation and report on these factors. Methods An observational cross‐sectional study was performed by reviewing video recordings of 182 surgical consultations by 12 surgeons at The Queen Elizabeth Hospital, South Australia, Australia. Results The mean consultation time was 12.3 min, with pre‐surgical consultations being the longest. There were 107 consultations for benign conditions (58%). Proportionally, the consultant spoke most (51.9% of total consultation time), followed by the patient (19.5%) and then companion (8.2%). Forty‐eight (26.4%) patients brought a companion to the clinic but monopolisation of the consultation by the companion was rare. When a companion was present, there was more mutual eye gaze between the consultant and the patient. Interruptions were present in 23.6% of consultations and were associated with a significant increase of the length of the consultation. Table positioning did not seem to affect the dynamics of the outpatient consultation. Conclusion Companions are highly valuable for promoting patient engagement and their presence should be encouraged in surgical outpatients. Interruptions should be kept to a minimum to avoid unnecessary delays. Further studies should be conducted to investigate the effect of companions, interruptions and table positioning during a consultation on patient outcomes.

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The role of a companion attending consultations with the patient. A systematic review

Cited by 15 publications

References 28 publications

Practitioners’ Dilemmas and Strategies in Decision-Making Conversations Where Patients and Companions Take Divergent Positions on a Healthcare Measure: An Observational Study Using Conversation Analysis

Practitioners’ Dilemmas and Strategies in Decision-Making Conversations Where Patients and Companions Take Divergent Positions on a Healthcare Measure: An Observational Study Using Conversation Analysis

Using Applied Conversation Analysis in Patient Education

The doctor will see you now: eye gaze, conversation and patient engagement in the surgical outpatient clinic. An Australian observational cross‐sectional study

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