Influence of accompanied encounters on patient-centeredness with older patients.
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.
Shields
Cleveland G
CG
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
Epstein
Ronald M
RM
Fiscella
Kevin
K
Franks
Peter
P
McCann
Robert
R
McCormick
Kevin
K
Mallinger
Julie B
JB
D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D003142:Communication; D005194:Family Practice; D033062:Friends; D006801:Humans; D010817:Physician-Patient Relations