Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data.
To describe the frequency, roles, and utility of family companion involvement in the care of patients with Heart Failure (HF) care and to examine the association between audiotaped patient, companion, and provider communication behaviors.



We collected survey data and audiotaped a single medical visit for 93 HF patients (36 brought a companion into the examination room) and their cardiology provider. Communication data was analyzed using the Roter Interaction Analysis System.



There were 32% more positive rapport-building statements (p<0.01) and almost three times as many social rapport-building statements (p<0.01) from patients and companions in accompanied visits versus unaccompanied patient visits. There were less psychosocial information giving statements in accompanied visits compared to unaccompanied patient visits (p<0.01.) Providers made 25% more biomedical information giving statements (p=0.04) and almost three times more social rapport-building statements (p<0.01) in accompanied visits. Providers asked fewer biomedical and psychosocial questions in accompanied versus unaccompanied visits. Providers made 16% fewer partnership-building statements in accompanied versus unaccompanied visits (p=0.01).



Our findings are mixed regarding the benefits of accompaniment for facilitating patient-provider communication based on survey and audiotaped data.



Strategies to enhance engagement during visits, such as pre-visit question prompt lists, may be beneficial.
Department of Medicine, Division of General Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill School of Medicine, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. Electronic address: crystal_cene@med.unc.edu.
Crystal W
CW
Cené
Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Beth
B
Haymore
North Carolina Translational & Clinical Sciences Institute, University of North Carolina at Chapel Hill School, Chapel Hill, NC, USA; Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
Jeffrey P
JP
Laux
North Carolina Translational & Clinical Sciences Institute, University of North Carolina at Chapel Hill School, Chapel Hill, NC, USA; Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
Feng-Chang
FC
Lin
College of Nursing, Michigan State University, East Lansing, Michigan, USA.
Dana
D
Carthron
Department of Health Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Debra
D
Roter
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lisa A
LA
Cooper
Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Patricia P
PP
Chang
Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Brian C
BC
Jensen
Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Paula F
PF
Miller
Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; Center for Health Equity Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Giselle
G
Corbie-Smith
D000328:Adult; D000368:Aged; D003142:Communication; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D009819:Office Visits / Q000706:statistics & numerical data; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012944:Social Support; D013637:Tape Recording
Family; Heart failure; Patient-provider communication; Social support; Visit companions