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Turn analysis and patient‐centredness in paediatric otolaryngology surgical consultations
Objectives Physician and patient/parent communication is of utmost importance in consultations to improve the shared decision‐making (SDM) processes. This study investigated SDM‐related outcomes through turn analysis and an assessment of patient‐centred dialogue. Design Multi‐centre prospective coho...
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| Published in: | Clinical otolaryngology 2020-09, Vol.45 (5), p.725-731 |
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| container_title | Clinical otolaryngology |
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| creator | Forner, David Ungar, Gilanders Chorney, Jill Meier, Jeremy Hong, Paul |
| description | Objectives
Physician and patient/parent communication is of utmost importance in consultations to improve the shared decision‐making (SDM) processes. This study investigated SDM‐related outcomes through turn analysis and an assessment of patient‐centred dialogue.
Design
Multi‐centre prospective cohort study analysing audio‐ and video‐recorded patient/parent‐physician interactions.
Setting
Two tertiary paediatric hospitals in Halifax, Nova Scotia and Salt Lake City, Utah.
Participants
Paediatric otolaryngologists, patients and parents during consultation for adenotonsillectomy.
Main outcome measures
Medical dialogue measures (turn analysis, patient‐centredness scores via the Roter Interaction Analysis System) and SDM questionnaires (SDM‐Q‐9).
Results
Turn density was significantly higher for physicians than patients/parents (P |
| doi_str_mv | 10.1111/coa.13564 |
| format | article |
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Physician and patient/parent communication is of utmost importance in consultations to improve the shared decision‐making (SDM) processes. This study investigated SDM‐related outcomes through turn analysis and an assessment of patient‐centred dialogue.
Design
Multi‐centre prospective cohort study analysing audio‐ and video‐recorded patient/parent‐physician interactions.
Setting
Two tertiary paediatric hospitals in Halifax, Nova Scotia and Salt Lake City, Utah.
Participants
Paediatric otolaryngologists, patients and parents during consultation for adenotonsillectomy.
Main outcome measures
Medical dialogue measures (turn analysis, patient‐centredness scores via the Roter Interaction Analysis System) and SDM questionnaires (SDM‐Q‐9).
Results
Turn density was significantly higher for physicians than patients/parents (P < .001), as were total statements (P < .001), and total time talking (P < .001). The opening statement was completed by the physician in 91.5% of interactions and was significantly longer than family opening statements (P = .003). The mean number of informed consent elements addressed per interaction was 4.5 out of 6. The mean patient‐centredness score was 0.2 (range 0‐0.56). Significant negative correlations between patient‐centredness score and physician turn density (r = −.390, P = .002), physician mean turn time (r = −.406, P = .001), total physician statements (r = −.426, P = .001) and total physician speaking time (r = −.313, P = .016) were noted. There were no correlations in SDM questionnaire scores with turn analysis variables, informed consent elements or patient‐centredness scores.
Conclusions
Surgeons dominated the consultation in terms of talking, mostly in a unidirectional manner. Neither patient‐centredness nor turn analysis correlated with perceptions of SDM from the parents' perspective.</description><identifier>ISSN: 1749-4478</identifier><identifier>EISSN: 1749-4486</identifier><identifier>DOI: 10.1111/coa.13564</identifier><identifier>PMID: 32368851</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>communication ; Correlation analysis ; Decision making ; Density ; Informed consent ; Medical personnel ; Otolaryngology ; paediatrics ; Parents ; Patients ; patient‐centred care ; Pediatrics ; Physicians ; physician‐patient relations ; Questionnaires ; shared ; tonsillectomy</subject><ispartof>Clinical otolaryngology, 2020-09, Vol.45 (5), p.725-731</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3534-1cfedb50cea0b6c0672b1e06d05708fd4f409170636e640e817f0afc026657913</citedby><cites>FETCH-LOGICAL-c3534-1cfedb50cea0b6c0672b1e06d05708fd4f409170636e640e817f0afc026657913</cites><orcidid>0000-0002-1014-3545 ; 0000-0002-8766-3266</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32368851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Forner, David</creatorcontrib><creatorcontrib>Ungar, Gilanders</creatorcontrib><creatorcontrib>Chorney, Jill</creatorcontrib><creatorcontrib>Meier, Jeremy</creatorcontrib><creatorcontrib>Hong, Paul</creatorcontrib><title>Turn analysis and patient‐centredness in paediatric otolaryngology surgical consultations</title><title>Clinical otolaryngology</title><addtitle>Clin Otolaryngol</addtitle><description>Objectives
Physician and patient/parent communication is of utmost importance in consultations to improve the shared decision‐making (SDM) processes. This study investigated SDM‐related outcomes through turn analysis and an assessment of patient‐centred dialogue.
Design
Multi‐centre prospective cohort study analysing audio‐ and video‐recorded patient/parent‐physician interactions.
Setting
Two tertiary paediatric hospitals in Halifax, Nova Scotia and Salt Lake City, Utah.
Participants
Paediatric otolaryngologists, patients and parents during consultation for adenotonsillectomy.
Main outcome measures
Medical dialogue measures (turn analysis, patient‐centredness scores via the Roter Interaction Analysis System) and SDM questionnaires (SDM‐Q‐9).
Results
Turn density was significantly higher for physicians than patients/parents (P < .001), as were total statements (P < .001), and total time talking (P < .001). The opening statement was completed by the physician in 91.5% of interactions and was significantly longer than family opening statements (P = .003). The mean number of informed consent elements addressed per interaction was 4.5 out of 6. The mean patient‐centredness score was 0.2 (range 0‐0.56). Significant negative correlations between patient‐centredness score and physician turn density (r = −.390, P = .002), physician mean turn time (r = −.406, P = .001), total physician statements (r = −.426, P = .001) and total physician speaking time (r = −.313, P = .016) were noted. There were no correlations in SDM questionnaire scores with turn analysis variables, informed consent elements or patient‐centredness scores.
Conclusions
Surgeons dominated the consultation in terms of talking, mostly in a unidirectional manner. Neither patient‐centredness nor turn analysis correlated with perceptions of SDM from the parents' perspective.</description><subject>communication</subject><subject>Correlation analysis</subject><subject>Decision making</subject><subject>Density</subject><subject>Informed consent</subject><subject>Medical personnel</subject><subject>Otolaryngology</subject><subject>paediatrics</subject><subject>Parents</subject><subject>Patients</subject><subject>patient‐centred care</subject><subject>Pediatrics</subject><subject>Physicians</subject><subject>physician‐patient relations</subject><subject>Questionnaires</subject><subject>shared</subject><subject>tonsillectomy</subject><issn>1749-4478</issn><issn>1749-4486</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kMtKAzEUhoMotlYXvoAMuNHFtMnkMumyFG9Q6KauXIRMJlNS0klNZpDZ-Qg-o09idGoXgtmcH87HT84HwCWCYxTfRDk5RpgycgSGKCfTlBDOjg855wNwFsIGQoJhjk7BAGeYcU7RELysWl8nspa2CybEUCY72RhdN5_vHyoOr8tah5CYOi50aWTjjUpc46z0Xb121q27JLR-bZS0iXJ1aG0TG2I4ByeVtEFf7OcIPN_freaP6WL58DSfLVKFKSYpUpUuCwqVlrBgCrI8K5CGrIQ0h7wqSUXgFOWQYaYZgZqjvIKyUjBjjOZThEfgpu_deffa6tCIrQlKWytr7dogMjzlLMNZRiJ6_QfduCgg_k7ELcWcZoxG6ranlHcheF2JnTfbeK9AUHwbF9G4-DEe2at9Y1tsdXkgfxVHYNIDb8bq7v8mMV_O-sovy2yLwA</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Forner, David</creator><creator>Ungar, Gilanders</creator><creator>Chorney, Jill</creator><creator>Meier, Jeremy</creator><creator>Hong, Paul</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1014-3545</orcidid><orcidid>https://orcid.org/0000-0002-8766-3266</orcidid></search><sort><creationdate>202009</creationdate><title>Turn analysis and patient‐centredness in paediatric otolaryngology surgical consultations</title><author>Forner, David ; Ungar, Gilanders ; Chorney, Jill ; Meier, Jeremy ; Hong, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3534-1cfedb50cea0b6c0672b1e06d05708fd4f409170636e640e817f0afc026657913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>communication</topic><topic>Correlation analysis</topic><topic>Decision making</topic><topic>Density</topic><topic>Informed consent</topic><topic>Medical personnel</topic><topic>Otolaryngology</topic><topic>paediatrics</topic><topic>Parents</topic><topic>Patients</topic><topic>patient‐centred care</topic><topic>Pediatrics</topic><topic>Physicians</topic><topic>physician‐patient relations</topic><topic>Questionnaires</topic><topic>shared</topic><topic>tonsillectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Forner, David</creatorcontrib><creatorcontrib>Ungar, Gilanders</creatorcontrib><creatorcontrib>Chorney, Jill</creatorcontrib><creatorcontrib>Meier, Jeremy</creatorcontrib><creatorcontrib>Hong, Paul</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical otolaryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Forner, David</au><au>Ungar, Gilanders</au><au>Chorney, Jill</au><au>Meier, Jeremy</au><au>Hong, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Turn analysis and patient‐centredness in paediatric otolaryngology surgical consultations</atitle><jtitle>Clinical otolaryngology</jtitle><addtitle>Clin Otolaryngol</addtitle><date>2020-09</date><risdate>2020</risdate><volume>45</volume><issue>5</issue><spage>725</spage><epage>731</epage><pages>725-731</pages><issn>1749-4478</issn><eissn>1749-4486</eissn><abstract>Objectives
Physician and patient/parent communication is of utmost importance in consultations to improve the shared decision‐making (SDM) processes. This study investigated SDM‐related outcomes through turn analysis and an assessment of patient‐centred dialogue.
Design
Multi‐centre prospective cohort study analysing audio‐ and video‐recorded patient/parent‐physician interactions.
Setting
Two tertiary paediatric hospitals in Halifax, Nova Scotia and Salt Lake City, Utah.
Participants
Paediatric otolaryngologists, patients and parents during consultation for adenotonsillectomy.
Main outcome measures
Medical dialogue measures (turn analysis, patient‐centredness scores via the Roter Interaction Analysis System) and SDM questionnaires (SDM‐Q‐9).
Results
Turn density was significantly higher for physicians than patients/parents (P < .001), as were total statements (P < .001), and total time talking (P < .001). The opening statement was completed by the physician in 91.5% of interactions and was significantly longer than family opening statements (P = .003). The mean number of informed consent elements addressed per interaction was 4.5 out of 6. The mean patient‐centredness score was 0.2 (range 0‐0.56). Significant negative correlations between patient‐centredness score and physician turn density (r = −.390, P = .002), physician mean turn time (r = −.406, P = .001), total physician statements (r = −.426, P = .001) and total physician speaking time (r = −.313, P = .016) were noted. There were no correlations in SDM questionnaire scores with turn analysis variables, informed consent elements or patient‐centredness scores.
Conclusions
Surgeons dominated the consultation in terms of talking, mostly in a unidirectional manner. Neither patient‐centredness nor turn analysis correlated with perceptions of SDM from the parents' perspective.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32368851</pmid><doi>10.1111/coa.13564</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1014-3545</orcidid><orcidid>https://orcid.org/0000-0002-8766-3266</orcidid></addata></record> |
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| source | Wiley |
| subjects | communication Correlation analysis Decision making Density Informed consent Medical personnel Otolaryngology paediatrics Parents Patients patient‐centred care Pediatrics Physicians physician‐patient relations Questionnaires shared tonsillectomy |
| title | Turn analysis and patient‐centredness in paediatric otolaryngology surgical consultations |
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