title: Respecting patients is associated with more patient-centered communication behaviors in clinical encounters.
abstract: OBJECTIVE
  Attitudes towards patients may influence how clinicians interact. We investigated whether respect for patients was associated with communication behaviors during HIV care encounters.
  
  
  METHODS
  We analyzed audio-recordings of visits between 413 adult HIV-infected patients and 45 primary HIV care providers. The independent variable was clinician-reported respect for the patient and outcomes were clinician and patient communication behaviors assessed by the Roter Interaction Analysis System (RIAS). We performed negative binomial regressions for counts outcomes and linear regressions for global outcomes.
  
  
  RESULTS
  When clinicians had higher respect for a patient, they engaged in more rapport-building, social chitchat, and positive talk. Patients of clinicians with higher respect for them engaged in more rapport-building, social chitchat, positive talk, and gave more psychosocial information. Encounters between patients and clinicians with higher respect for them had more positive clinician emotional tone [regression coefficient 2.97 (1.92-4.59)], more positive patient emotional tone [2.71 (1.75-4.21)], less clinician verbal dominance [0.81 (0.68-0.96)] and more patient-centeredness [1.28 (1.09-1.51)].
  
  
  CONCLUSIONS
  Respect is associated with positive and patient-centered communication behaviors during encounters.
  
  
  CONCLUSIONS
  Clinicians should be mindful of their respectful attitudes and work to foster positive regard for patients. Educators should consider methods to enhance trainees' respect in communication skills training.
authors: Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA. Electronic address: TES3J@hscmail.mcc.virginia.edu.
authors: Tabor E
authors: TE
authors: Flickinger
authors: Department of Medicine, Portland VA Medical Center, Portland, OR, USA; Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
authors: Somnath
authors: S
authors: Saha
authors: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors: Debra
authors: D
authors: Roter
authors: Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
authors: P Todd
authors: PT
authors: Korthuis
authors: Department of Medicine, St. Luke's Roosevelt, New York, NY, USA.
authors: Victoria
authors: V
authors: Sharp
authors: Department of Medicine, Wayne State University, Detroit, MI, USA.
authors: Jonathan
authors: J
authors: Cohn
authors: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors: Richard D
authors: RD
authors: Moore
authors: Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
authors: Karen S
authors: KS
authors: Ingersoll
authors: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors: Mary Catherine
authors: MC
authors: Beach
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D013637:Tape Recording
keywords: HIV/AIDS; Patient–clinician communication; Respect