Antoinette Schoenthaler1, Melissa Basile2, Tessa V West3, Adina Kalet4. 1. Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 East 30th Street, NY, 10016, USA. Electronic address: antoinette.schoenthaler@nyumc.org. 2. The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA. Electronic address: mbasile2@northwell.edu. 3. Department of Psychology, New York University Graduate School of Arts and Sciences, NY, USA. Electronic address: tessa.west@nyu.edu. 4. Division of General Internal Medicine and Clinical Investigation, Department of Medicine, New York University School of Medicine, NY, USA. Electronic address: Adina.kalet@nyumc.org.
Abstract
OBJECTIVE: To describe typologies of dyadic communication exchanges between primary care providers and their hypertensive patients about prescribed antihypertensive medications. METHODS: Qualitative analysis of 94 audiotaped patient-provider encounters, using grounded theory methodology. RESULTS: Four types of dyadic exchanges were identified: Interactive (53% of interactions), divergent-traditional (24% of interactions), convergent-traditional (17% of interactions) and disconnected (6% of interactions). In the interactive and convergent-traditional types, providers adopted a patient-centered approach and used communication behaviors to engage patients in the relationship. Patients in these interactions adopted either an active role in the visit (interactive), or a passive role (convergent-traditional). The divergent-traditional type was characterized by provider verbal dominance, which inhibited patients' ability to ask questions, seek information, or check understanding of information. In the disconnected types, providers used mainly closed-ended questions and terse directives to gather and convey information, which was often disregarded by patients who instead diverted the conversation to psychosocial issues. CONCLUSIONS: This study identified interdependent patient-provider communication styles that can either facilitate or hinder discussions about prescribed medications. PRACTICE IMPLICATIONS: Examining the processes that underlie dyadic communication in patient-provider interactions is an essential first step to developing interventions that can improve the patient-provider relationship and patient health behaviors.
OBJECTIVE: To describe typologies of dyadic communication exchanges between primary care providers and their hypertensivepatients about prescribed antihypertensive medications. METHODS: Qualitative analysis of 94 audiotaped patient-provider encounters, using grounded theory methodology. RESULTS: Four types of dyadic exchanges were identified: Interactive (53% of interactions), divergent-traditional (24% of interactions), convergent-traditional (17% of interactions) and disconnected (6% of interactions). In the interactive and convergent-traditional types, providers adopted a patient-centered approach and used communication behaviors to engage patients in the relationship. Patients in these interactions adopted either an active role in the visit (interactive), or a passive role (convergent-traditional). The divergent-traditional type was characterized by provider verbal dominance, which inhibited patients' ability to ask questions, seek information, or check understanding of information. In the disconnected types, providers used mainly closed-ended questions and terse directives to gather and convey information, which was often disregarded by patients who instead diverted the conversation to psychosocial issues. CONCLUSIONS: This study identified interdependent patient-provider communication styles that can either facilitate or hinder discussions about prescribed medications. PRACTICE IMPLICATIONS: Examining the processes that underlie dyadic communication in patient-provider interactions is an essential first step to developing interventions that can improve the patient-provider relationship and patient health behaviors.
Authors: Louis A Penner; John F Dovidio; Tessa V West; Samuel L Gaertner; Terrance L Albrecht; Rhonda K Dailey; Tsveti Markova Journal: J Exp Soc Psychol Date: 2010-03-01
Authors: Dean Schillinger; John Piette; Kevin Grumbach; Frances Wang; Clifford Wilson; Carolyn Daher; Krishelle Leong-Grotz; Cesar Castro; Andrew B Bindman Journal: Arch Intern Med Date: 2003-01-13
Authors: Michele Heisler; Sandeep Vijan; Robert M Anderson; Peter A Ubel; Steven J Bernstein; Timothy P Hofer Journal: J Gen Intern Med Date: 2003-11 Impact factor: 5.128