title: Provider self-disclosure during contraceptive counseling.
abstract: OBJECTIVE
  Provider self-disclosure (PSD) - defined as providers making statements regarding personal information to patients - has not been well characterized in the context of contraceptive counseling. In this study, we describe the incidence, content and context of contraceptive PSD.
  
  
  METHODS
  This mixed methods analysis used data from the Provider-Patient Contraceptive Counseling study, for which 349 family planning patients were recruited from 2009 to 2012 from six clinics in the San Francisco Bay Area. Audio-recordings from their visits were analyzed for the presence or absence of PSD, and those visits with evidence of PSD were analyzed using qualitative methods. The associations of patient and provider demographics and patient satisfaction measures, obtained from survey data, with PSD were analyzed using bivariable and multivariable analyses.
  
  
  RESULTS
  Thirty-seven percent of providers showed evidence of PSD during at least one visit, and PSD occurred in 9% of clinic visits. Fifty-four percent of PSD statements were about intrauterine devices. About half of PSD statements occurred prior to the final selection of the contraceptive method and appeared to influence the choice of method. In post-visit surveys, all patients who reported receiving PSD considered it to be appropriate, and patient-reported PSD was not statistically associated with measures of patient satisfaction.
  
  
  CONCLUSIONS
  This study provides some support for the appropriateness of PSD during family planning encounters, at least as practiced during the sampled visits. Further research could explore whether this counseling strategy has an impact on patients' ability to identify the best contraceptive methods for them.
  
  
  CONCLUSIONS
  In this study, PSD did not have a demonstrated negative effect on the provider-patient relationship. In almost half of visits, PSD appeared to influence patients' choice of a method; whether this influence is beneficial needs further research.
authors.affiliation: Kaiser Permanente, 2425 Geary Boulevard, San Francisco, CA 94115, USA. Electronic address: merritt.mclean@kp.org.
authors.forename: Merritt
authors.initials: M
authors.lastname: McLean
authors.affiliation: University California San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
authors.forename: Jody
authors.initials: J
authors.lastname: Steinauer
authors.affiliation: Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Schmittdiel
authors.affiliation: Kaiser Permanente, 2425 Geary Boulevard, San Francisco, CA 94115, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Chan
authors.affiliation: University California San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Dehlendorf
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003267:Contraception; D003268:Contraception Behavior / Q000523:psychology; D003376:Counseling / Q000379:methods*; D030881:Disclosure; D005006:Ethnicity; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006801:Humans; D017060:Patient Satisfaction; D010819:Physician's Role; D010817:Physician-Patient Relations; D012495:San Francisco; D011795:Surveys and Questionnaires
keywords: Contraceptive counseling; Intrauterine device; Patient–provider communication; Self-disclosure