 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Marla L. Clayman, PhD, MPH1, Lawrence S. Wissow, MD, MPH2, and Debra Roter, DrPH2. (1) Division of Cancer Control and Population Sciences, Outcomes Research Branch, National Cancer Institute, 6130 Executive Boulevard , Room 4005, MSC 7344, Bethesda, MD 20892-7344, 301 435 4986, claymanm@mail.nih.gov, (2) Health Policy and Management, Johns Hopkins University, 624 North Broadway, Room 750, Baltimore, MD 21205
Objective: To describe the verbal behaviors in which companions engage that may promote or detract from the patient’s autonomy and characteristics of patients and companions that influence this behavior. Design/Methods: Verbal behaviors of companions in a cross-sectional sample of geriatric primary care visits were coded from videotapes (n=94). Autonomy-enhancing behaviors included prompting the patient to discuss topics and expanding the patient’s history. Autonomy detracting behaviors included interrupting and answering for the patient. Results: Expanding the patient’s history (n=74, 79%) and asking the doctor questions (n=47, 50%) were the most common companion behaviors. Autonomy detracting behaviors were less common, with answering for the patient in 20% of the visits and interrupting the patient and other controlling behaviors each occurring in about 10% of visits. Female companions were more likely to expand the history (p=.01), prompt patients to introduce topics (p=.08), and to interrupt the patient (p=.09) than male companions. Companions of older patients were more likely to repeat the doctor’s explanations (p=.05) and prompt patients (p=.01). Adult children of patients were more likely than spouses to engage in several behaviors: expand history (p=.09), repeat doctors’ explanations (p<.01), ask the patient questions (p<.01), and ask for the patient’s opinion (p=.08). Conclusions: Companions are primarily engaged in behaviors that enhance the patient’s autonomy by providing information to both doctor and patient. A small minority of companions engages in behaviors that are autonomy-detracting by not allowing patients to respond fully. Characteristics of patients, companions, and their relationship have some influence on the companion’s behaviors.
Learning Objectives:
Keywords: Communication, Elderly
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.