The Cancode interaction analysis system in the oncological setting: reliability and validity of video and audio tape coding.
Cancode is a computerized interaction analysis system developed for cancer consultations. This paper assesses its reliability and validity, and compares the use of audio versus video tape; by assessing 30 consultations between an actor and 10 oncologists. Weighted Kappa inter- and intra-rater scores ranged from 0.5 to 1.0 and 0.58-1.0, respectively, and use of video tape did not alter verbal coding. Factor analysis of verbal codes revealed two factors, 'verbal control' and 'verbal support'. Verbal and non-verbal doctor behavior differed by patient type ('verbal support' P = 0.007, 'verbal control' P = 0.004, 'Responsiveness' P = 0.000, and 'Immediacy' P = 0.000). Inter-doctor variation was noted for 'verbal support' (P = 0.000) and 'Relaxation' (P = 0.000). 'Responsiveness' was negatively correlated with 'verbal support' (-0.58) and 'verbal control' (-0.65). Cancode is reliable, valid and sensitive to doctors behavioral changes. For a more passive patient, the doctor may switch from a 'cure' to 'care' oriented consult, responding to psycho-social instead of informational needs.
Dent
Elizabeth
E
Medical Psychology Research Unit, University of Sydney, Blackburn Building (D06), Sydney 2006, Australia.
Brown
Rhonda
R
Dowsett
Sharon
S
Tattersall
Martin
M
Butow
Phyllis
P
D000328:Adult; D000339:Affect; D003142:Communication; D003376:Counseling; D003625:Data Collection / Q000592:standards; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology; D009633:Nonverbal Communication / Q000523:psychology; D010353:Patient Education as Topic; D010358:Patient Participation; D016544:Patient Simulation; D010819:Physician's Role; D010817:Physician-Patient Relations; D012680:Sensitivity and Specificity; D012944:Social Support; D012984:Software / Q000592:standards*; D013637:Tape Recording / Q000592:standards*; D014705:Verbal Behavior; D014743:Videotape Recording / Q000592:standards*