A linguistic study of patient-centered interviewing: Emergent interactional effects

• Published in: Patient education and counseling 2012-09, Vol.88 (3), p.373-380
• Main Authors: Hesson, Ashley M, Sarinopoulos, Issidoros, Frankel, Richard M, Smith, Robert C
• Format: Article
• Language: English
• Subjects: Accommodation; Adult; Aged; Communication; Discourse analysis; Doctors; Female; Humans; Internal Medicine; Interviewing; Interviews as Topic; Linguistics; Male; Middle Aged; Nursing; Patient centredness; Patient Satisfaction; Patient Simulation; Patient-Centered Care; Patient-centered interviewing linguistics; Physician-Patient Relations; Pilot Projects; Pilot studies; Provider–patient relationship; Sociolinguistics; Speech; Surveys and Questionnaires; Young Adult
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2012.06.005

Abstract Objectives To evaluate interactional effects of patient-centered interviewing (PCI) compared to isolated clinician-centered interviewing (CCI). Methods We conducted a pilot study comparing PCI ( N = 4) to CCI ( N = 4) for simulated new-patient visits. We rated interviews independently and measured patient satisfaction with the interaction via a validated questionnaire. We conducted interactional sociolinguistic analysis on the interviews and compared across three levels of analysis: turn, topic, and interaction. Results We found significant differences between PCI and CCI in physician responses to patients’ psychosocial cues and concerns. The number and type of physician questions also differed significantly across PCI and CCI sets. Qualitatively, we noted several indicators of physician–patient attunement in the PCI interviews that were not present in the CCI interviews. They spanned diverse aspects of physician and patient speech, suggesting interactional accommodation on the part of both participants. Conclusions This small pilot study highlights a variety of interactional variables that may underlie the effects associated with patient-centered interviewing (e.g., positive relationships, health outcomes). Question form, phonological accommodation processes, and use of stylistic markers are relatively unexplored in controlled studies of physician–patient interaction. Practice implications This study characterizes several interactional variables for larger scale studies and contributes to models of patient-centeredness in practice.