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The Journal of the American Board of Family Practice 18:344-354 (2005)
© 2005 American Board of Family Practice

Original Research

Influence of Accompanied Encounters on Patient-Centeredness with Older Patients

Cleveland G. Shields, PhD, Ronald M. Epstein, MD, Kevin Fiscella, MD, MPH, Peter Franks, MD, Robert McCann, MD, Kevin McCormick, MD, PhD and Julie B. Mallinger, BA

University of Rochester Medical Center, Department of Family Medicine, Rochester Center to Improve Communication in Health Care (CGS, RME, KF), University of Rochester School of Medicine, Rochester, NY
University of Rochester School of Medicine, Department of Medicine, Highland Hospital (RM, KM), Rochester, NY
University of Rochester School of Medicine, Department of Hematology/Oncology (JBM), Rochester, NY
University of California, Department of Family and Community Medicine, Center for Health Services Research in Primary Care, Sacramento, CA (PF)

Correspondence: Corresponding author: Cleveland G. Shields, PhD, University of Rochester Medical Center, Department of Family Medicine, Rochester Center to Improve Communication in Health Care, 1381 South Avenue, Rochester, NY 14620-2830 (e-mail: Cleveland_Shields{at}urmc.Rochester.edu)

Objectives: To conduct a pilot study to examine physician patient interaction when elderly patients are accompanied during a medical visit.

Methods: This was a study in which 30 patients were randomly assigned to be accompanied (13) or unaccompanied (17) during a regular medical visit to their physician. Visits were tape recorded, transcribed, and coded with the Measure of Patient-Centered Communication (MPCC) and with the Rochester Participatory Decision-Making Scale (RPAD).

Results: We found no differences between the number of words spoken in accompanied versus unaccompanied visits, comparing patients alone with patients and companions combined. Physicians spoke longer without interruption in accompanied encounters (39.9 vs 78.6 words per speech turn). There were no differences in the level of MPCC or in the level of participatory decision making between the 2 types of visits. In accompanied visits, patients introduced most of the concerns and physicians discussed concerns with patients more than with companions.

Conclusions: Previously reported differences in accompanied versus unaccompanied visits may reflect patients’ preferences for being accompanied, the role they wish their companion to play, and the patients’ health status. Being accompanied by a family member or friend does not result in less attention being paid to patients’ concerns.






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Copyright © 2005 by the American Board of Family Medicine.