title: Influence of accompanied encounters on patient-centeredness with older patients.
abstract: OBJECTIVE
  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.
authors.affiliation: University of Rochester Medical Center, Department of Family Medicine, Rochester Center to Improve Communication in Health Care, Rochester, NY 14620-2830, USA. Cleveland_Shields@urmc.Rochester.edu
authors.forename: Cleveland G
authors.initials: CG
authors.lastname: Shields
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Epstein
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
authors.forename: Robert
authors.initials: R
authors.lastname: McCann
authors.forename: Kevin
authors.initials: K
authors.lastname: McCormick
authors.forename: Julie B
authors.initials: JB
authors.lastname: Mallinger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D003142:Communication; D005194:Family Practice; D033062:Friends; D006801:Humans; D010817:Physician-Patient Relations