Turn analysis and patient-centredness in paediatric otolaryngology surgical consultations.
Clin Otolaryngol
; 45(5): 725-731, 2020 09.
Article
em En
| MEDLINE
| ID: mdl-32368851
ABSTRACT
OBJECTIVES:
Physician and patient/parent communication is of utmost importance in consultations to improve the shared decision-making (SDM) processes. This study investigated SDM-related outcomes through turn analysis and an assessment of patient-centred dialogue.DESIGN:
Multi-centre prospective cohort study analysing audio- and video-recorded patient/parent-physician interactions.SETTING:
Two tertiary paediatric hospitals in Halifax, Nova Scotia and Salt Lake City, Utah.PARTICIPANTS:
Paediatric otolaryngologists, patients and parents during consultation for adenotonsillectomy. MAIN OUTCOMEMEASURES:
Medical dialogue measures (turn analysis, patient-centredness scores via the Roter Interaction Analysis System) and SDM questionnaires (SDM-Q-9).RESULTS:
Turn density was significantly higher for physicians than patients/parents (P < .001), as were total statements (P < .001), and total time talking (P < .001). The opening statement was completed by the physician in 91.5% of interactions and was significantly longer than family opening statements (P = .003). The mean number of informed consent elements addressed per interaction was 4.5 out of 6. The mean patient-centredness score was 0.2 (range 0-0.56). Significant negative correlations between patient-centredness score and physician turn density (r = -.390, P = .002), physician mean turn time (r = -.406, P = .001), total physician statements (r = -.426, P = .001) and total physician speaking time (r = -.313, P = .016) were noted. There were no correlations in SDM questionnaire scores with turn analysis variables, informed consent elements or patient-centredness scores.CONCLUSIONS:
Surgeons dominated the consultation in terms of talking, mostly in a unidirectional manner. Neither patient-centredness nor turn analysis correlated with perceptions of SDM from the parents' perspective.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Otolaringologia
/
Relações Médico-Paciente
/
Encaminhamento e Consulta
/
Procedimentos Cirúrgicos Otorrinolaringológicos
/
Tomada de Decisão Compartilhada
/
Hospitais Pediátricos
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Limite:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Clin Otolaryngol
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Canadá