Sarina R Isenberg1, Rebecca A Aslakson2, James N Dionne-Odom3, Katherine Clegg Smith4, Sarabdeep Singh5, Susan Larson6, John F P Bridges7, Thomas J Smith8, Jennifer L Wolff9, Debra L Roter10. 1. Temmy Latner Centre for Palliative Care and Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 60 Murray Street, 4th floor, Box 13, Toronto, Ontario, M5T 3L9, Canada. Electronic address: sarina.isenberg@sinaihealthsystem.ca. 2. Department of Anesthesiology, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21205, United States. Electronic address: raslaks1@jhmi.edu. 3. School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL MT412 K, United States. Electronic address: dionneod@uab.edu. 4. Department of Health, Behavior and Society, Johns Hopkins School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States. Electronic address: ksmit103@jhu.edu. 5. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, 401 N. Broadway, Baltimore, MD, 21287, United States. Electronic address: ssingh77@jhmi.edu. 6. Department of Health, Behavior and Society, Johns Hopkins School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States. Electronic address: slarson1@jhu.edu. 7. Department of Health, Policy and Management, Johns Hopkins School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States. Electronic address: jbridge7@jhu.edu. 8. Departments of Medicine and Oncology, Johns Hopkins Hospital, 601 N. Caroline Street, Baltimore, MD 21287, United States. Electronic address: tsmit136@jhmi.edu. 9. Department of Health, Policy and Management, Johns Hopkins School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States. Electronic address: jwolff2@jhu.edu. 10. Department of Health, Behavior and Society, Johns Hopkins School of Public Health, 624 N Broadway, Baltimore, MD 21205, United States. Electronic address: droter1@jhu.edu.
Abstract
OBJECTIVE: To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction. METHODS: Secondary analysis of 61 pre-surgical visit recordings with eight surgical oncologists at an academic tertiary care hospital using the Roter Interaction Analysis System (RIAS). Surgeons, patients, and companions completed post-visit satisfaction questionnaires. Poisson and logistic regression models assessed differences in communication and satisfaction when companions were present vs. absent. RESULTS: There were 46 visits (75%) in which companions were present, and 15 (25%) in which companions were absent. Companion communication was largely emotional and facilitative, as measured by RIAS. Companion presence was associated with more surgeon talk (IRR 1.29, p = 0.006), and medical information-giving (IRR 1.41, p = 0.001). Companion presence was associated with less disclosure of lifestyle/psychosocial topics by patients (IRR 0.55, p = 0.037). In adjusted analyses, companions' presence was associated with lower levels of patient-centeredness (IRR 0.77, p 0.004). There were no differences in patient or surgeon satisfaction based on companion presence. CONCLUSION: Companions' presence during pre-surgical visits was associated with patient-surgeon communication but was not associated with patient or surgeon satisfaction. PRACTICE IMPLICATIONS: Future work is needed to develop interventions to enhance patient-companion-provider interactions in this setting.
OBJECTIVE: To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction. METHODS: Secondary analysis of 61 pre-surgical visit recordings with eight surgical oncologists at an academic tertiary care hospital using the Roter Interaction Analysis System (RIAS). Surgeons, patients, and companions completed post-visit satisfaction questionnaires. Poisson and logistic regression models assessed differences in communication and satisfaction when companions were present vs. absent. RESULTS: There were 46 visits (75%) in which companions were present, and 15 (25%) in which companions were absent. Companion communication was largely emotional and facilitative, as measured by RIAS. Companion presence was associated with more surgeon talk (IRR 1.29, p = 0.006), and medical information-giving (IRR 1.41, p = 0.001). Companion presence was associated with less disclosure of lifestyle/psychosocial topics by patients (IRR 0.55, p = 0.037). In adjusted analyses, companions' presence was associated with lower levels of patient-centeredness (IRR 0.77, p 0.004). There were no differences in patient or surgeon satisfaction based on companion presence. CONCLUSION: Companions' presence during pre-surgical visits was associated with patient-surgeon communication but was not associated with patient or surgeon satisfaction. PRACTICE IMPLICATIONS: Future work is needed to develop interventions to enhance patient-companion-provider interactions in this setting.
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