Evelyn Y Ho1, Genevieve Leung2, Jennifer Fung3, Jane Jih4. 1. Department of Communication Studies, University of San Francisco, San Francisco, CA, United States; Asian American Research Center on Health, San Francisco, CA, United States. Electronic address: eyho@usfca.edu. 2. Department of Rhetoric and Language, University of San Francisco, San Francisco, CA, United States. Electronic address: gleung2@usfca.edu. 3. Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, United States. Electronic address: Jennifer.Fung2@ucsf.edu. 4. Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, United States; Multiethnic Health Equity Research Center, University of California, San Francisco, San Francisco, CA, United States; Asian American Research Center on Health, San Francisco, CA, United States. Electronic address: Jane.Jih@ucsf.edu.
Abstract
OBJECTIVES: To examine audio-recorded primary care interactions with patient-initiated photo sharing around food and diet choices. METHODS: Data were 13 audio recordings of primary care visits with English-, Chinese-, or Spanish-speaking patients 60+ with two or more chronic conditions. Patients and clinicians completed pre-intervention surveys and some training on photo-taking / photo-sharing discussion. Data were analyzed using discourse analysis. RESULTS: Photo-based communication interactions lasted 3:34-28:37 min and averaged one-third of the visit. Clinicians and patients both initiated the photo-based talk and transition to other topics occurred smoothly. In eight of 13 interactions, the photo-based communication task was raised, but conversation did not occur at that moment. When discussed, the photos raised opportunities to talk about patient's decision-making which led to dietary suggestions including clinical nutrition suggestions and referrals to other specialty clinics. CONCLUSION: Photo-based communication in primary care can be used to promote patient activation and facilitate collaborative decision making that accounts for the patients' lived experiences and lifeworld. PRACTICE IMPLICATIONS: By setting the agenda early, clinicians or patients can designate the photo-sharing as a relevant part of the visit. Photos may be most relevant as part of the problem presentation, diagnosis, or treatment recommendation sections of the visit.
OBJECTIVES: To examine audio-recorded primary care interactions with patient-initiated photo sharing around food and diet choices. METHODS: Data were 13 audio recordings of primary care visits with English-, Chinese-, or Spanish-speaking patients 60+ with two or more chronic conditions. Patients and clinicians completed pre-intervention surveys and some training on photo-taking / photo-sharing discussion. Data were analyzed using discourse analysis. RESULTS: Photo-based communication interactions lasted 3:34-28:37 min and averaged one-third of the visit. Clinicians and patients both initiated the photo-based talk and transition to other topics occurred smoothly. In eight of 13 interactions, the photo-based communication task was raised, but conversation did not occur at that moment. When discussed, the photos raised opportunities to talk about patient's decision-making which led to dietary suggestions including clinical nutrition suggestions and referrals to other specialty clinics. CONCLUSION: Photo-based communication in primary care can be used to promote patient activation and facilitate collaborative decision making that accounts for the patients' lived experiences and lifeworld. PRACTICE IMPLICATIONS: By setting the agenda early, clinicians or patients can designate the photo-sharing as a relevant part of the visit. Photos may be most relevant as part of the problem presentation, diagnosis, or treatment recommendation sections of the visit.
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