Journal of General Internal Medicine

, Volume 20, Issue 10, pp 906–910

Patient contribution to the medical dialogue and perceived patient-centeredness

An observational study in Japanese geriatric consultations
  • Hirono Ishikawa
  • Hideki Hashimoto
  • Debra L. Roter
  • Yoshihiko Yamazaki
  • Tomoko Takayama
  • Eiji Yano
Original Articles

DOI: 10.1111/j.1525-1497.2005.0200.x

Cite this article as:
Ishikawa, H., Hashimoto, H., Roter, D.L. et al. J GEN INTERN MED (2005) 20: 906. doi:10.1111/j.1525-1497.2005.0200.x

Abstract

BACKGROUND: Relatively few studies have directly addressed the interaction dynamics and consequences of a companion’s presence in the medical visit, and their findings have been contradictory.

OBJECTIVES: To examine how patient’s contribution to the medical dialogue, with or without the presence of a visit companion, is related to the perception of the medical visit as patient-centered.

DESIGN: Observational study using pre- and postvisit questionnaires and audiotape recording of medical visits.

PARTICIPANTS: One hundred and fifty-five patients aged 65 or over; 63 in medical visits that included the presence of a companion and 82 in visits that did not include a companion.

MAIN OUTCOME MEASURE: Patient ratings of visit patient-centeredness.

RESULTS: Long visits (greater than 10 minutes long) and visits in which patients were verbally active were rated as more patient-centered by patients than other visits. Since patients were generally less verbally active in visits that included a companion, accompanied visits, especially if they were less than 10 minutes long, received lower patient-centered ratings than others. The presence of a companion was not related to length of the visit, suggesting that the verbal activity of the companion was off-set by decreased verbal activity of the patient.

CONCLUSIONS: Our results have suggested that patients are more likely to perceive their physician and visit as patient-centered when they have an opportunity to engage directly in the medical dialogue. A minimal amount of “talk-time” for patients themselves should be safe-guarded even in a short visit, when a companion is present.

Keywords

patient-centerednesspatient participationpatient-physician communicationcompanionelderly

Copyright information

© Society of General Internal Medicine 2005

Authors and Affiliations

  • Hirono Ishikawa
    • 1
  • Hideki Hashimoto
    • 1
  • Debra L. Roter
    • 2
  • Yoshihiko Yamazaki
    • 3
  • Tomoko Takayama
    • 4
  • Eiji Yano
    • 1
  1. 1.Department of Hygiene & Public HealthTeikyo University School of MedicineTokyoJapan
  2. 2.Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Department of Health Sociology, School of Health Sciences & NursingThe University of TokyoTokyoJapan
  4. 4.Community Health & Nursing, Faculty of Health SciencesOkayama University Medical SchoolOkayamaJapan