title: Duration and structure of unaccompanied (dyadic) and accompanied (triadic) initial outpatient consultations in a specialist seizure clinic.
abstract: This study explores differences in the duration and structure of unaccompanied (dyadic) and accompanied (triadic) initial (diagnostic) outpatient consultations in a specialist seizure clinic. This is the first known study to explore this topic quantitatively by analyzing the discourse space taken up by the different participants in real clinical encounters. We did not observe significant differences between the duration of accompanied and unaccompanied interactions (p=0.589). Results suggest that patients occupy proportionally less discourse space (measured by the number of words produced) in accompanied interactions than in unaccompanied interactions (56.9% versus 28.3%, p ≤ 0.0001). In accompanied interactions, there is a weak negative correlation between the discourse space of patients and that of doctors (rs=-0.43, p=0.017) and a moderate to strong negative correlation with the discourse spaces of companions (rs=-0.64, p=0.001). These findings indicate that the presence of a companion may reduce opportunities for doctors to observe the interactional, linguistic, and topical features of seizure patient talk, whose differential diagnostic value has been described in a number of previous publications, or for patients to raise issues they want to talk about.
authors.affiliation: Centre for Advanced Studies in Language and Communication, The University of York, The Berrick Saul Building, Heslington, York YO10 5DD, UK. cmc518@york.ac.uk
authors.forename: Catherine
authors.initials: C
authors.lastname: Robson
authors.forename: Paul
authors.initials: P
authors.lastname: Drew
authors.forename: Markus
authors.initials: M
authors.lastname: Reuber
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003142:Communication; D005260:Female; D033062:Friends / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D010550:Personal Space; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D012189:Retrospective Studies; D012640:Seizures / Q000503:physiopathology / Q000523:psychology*; D013038:Specialization; D013997:Time Factors; D055815:Young Adult